The Physics Department of Trento University (Italy), in collaboration with Bruker Biospin decided to set up a 4T MR system for research in the neurological field as well as on the biological effects of high field MRI. Nowadays the number of similar apparatus set up in the world is very low, several of these operate in the USA, some in Australia and one in Israel. Due to the very low diffusion of these equipments and to the few knowledges today available about the biological effects by clinical application of high field MRI, the problems related to the installation of the apparatus from the safety point of view are not well standardized. Therefore, in Trento, it has been necessary to deal with many problems regarding the set up of the MRI apparatus, taking also into account the current law in Italy with respect the safety and protection in MRI applications. In the present paper the Authors show the carried out studies and analyses, in relation to the organization of the safety aspects. These studies have resulted in arranging specific guidelines for: working in controlled way; emergency procedures for the patient advanced life support; procedures for the protocol of patient protection; rules for the safety of the operators, patients and general public. The carried out analyses have mainly taken into account the danger identification and the risk evaluation. For this reason it was set up a test protocol regarding:the performing tests, the very detailed test modalities for their periodic performance and the test sequence. For the patient safety and protection it has been necessary to put care, in the first step of the survey, to the subjects in critical situations, due to: working activity, clinical history, health conditions of the patient at the moment of the examination. So it has been necessary to set up an anamnesis questionnaire for the patient, finalized to spot: (1) the patients with particular contraindications for the MR examination; (2) the patients which could need medical treatments of urgency; (3) the patients which could need medical treatments, owing to the high magnetic field. Setting up the guidelines, the considered agents from the safety point of view have been: noise, anaesthetic effects, in the case of examination of anaesthetized patients, zones with controlled access, presence of cryogenic substances, static magnetic field, gradients, Larmour frequency, temperature and relative moisture. In fact these factor can provoke: cardiac stimulation, peripheral nervous stimulation, indirect bioeffects due to the ferromagnetic objects. The carried out evaluation has taken into account also the last IRPA/ICNIRP Recommendations on the "Protection of the patient undergoing a magnetic resonance examination" and it has represented the preliminary study to obtain the authorization by Ministry of Health in Italy, for the installation and use of the 4T MR system, before starting the clinical research in specialist radiological examination
HIGH FIELD MRI: SAFETY AND PROTECTION PROBLEMS RELATED TO THE INSTALLATION AND THE MANAGEMENT OF A 4T EQUIPMENT
Russo A;Speranza A
2006
Abstract
The Physics Department of Trento University (Italy), in collaboration with Bruker Biospin decided to set up a 4T MR system for research in the neurological field as well as on the biological effects of high field MRI. Nowadays the number of similar apparatus set up in the world is very low, several of these operate in the USA, some in Australia and one in Israel. Due to the very low diffusion of these equipments and to the few knowledges today available about the biological effects by clinical application of high field MRI, the problems related to the installation of the apparatus from the safety point of view are not well standardized. Therefore, in Trento, it has been necessary to deal with many problems regarding the set up of the MRI apparatus, taking also into account the current law in Italy with respect the safety and protection in MRI applications. In the present paper the Authors show the carried out studies and analyses, in relation to the organization of the safety aspects. These studies have resulted in arranging specific guidelines for: working in controlled way; emergency procedures for the patient advanced life support; procedures for the protocol of patient protection; rules for the safety of the operators, patients and general public. The carried out analyses have mainly taken into account the danger identification and the risk evaluation. For this reason it was set up a test protocol regarding:the performing tests, the very detailed test modalities for their periodic performance and the test sequence. For the patient safety and protection it has been necessary to put care, in the first step of the survey, to the subjects in critical situations, due to: working activity, clinical history, health conditions of the patient at the moment of the examination. So it has been necessary to set up an anamnesis questionnaire for the patient, finalized to spot: (1) the patients with particular contraindications for the MR examination; (2) the patients which could need medical treatments of urgency; (3) the patients which could need medical treatments, owing to the high magnetic field. Setting up the guidelines, the considered agents from the safety point of view have been: noise, anaesthetic effects, in the case of examination of anaesthetized patients, zones with controlled access, presence of cryogenic substances, static magnetic field, gradients, Larmour frequency, temperature and relative moisture. In fact these factor can provoke: cardiac stimulation, peripheral nervous stimulation, indirect bioeffects due to the ferromagnetic objects. The carried out evaluation has taken into account also the last IRPA/ICNIRP Recommendations on the "Protection of the patient undergoing a magnetic resonance examination" and it has represented the preliminary study to obtain the authorization by Ministry of Health in Italy, for the installation and use of the 4T MR system, before starting the clinical research in specialist radiological examinationI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
