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ACR Guidance Document Questions and Answers 100% Accurate
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ACR Guidance Document
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ACR Guidance DocumentWhat is the purpose of ACR guidelines for MR safety? - answer So that these
guidelines provide a basis for MR practitioners to develop and implement their own MR
policies and practices.
Are the principles behind MR Safe Practice guidelines intended to apply only to
diagnostic settings? - answer They are intended to apply to not only diagnostic settings
- but also patient, research subject, and health care personnel safety for all MRI
settings, including those designed for clinical diagnostic imaging, research,
interventional, and intra-operative MR Applications.
Is it safe to assume MR compatibility if it's not clearly documented in writing? - answer
Especially with increased implementation of field strengths of 3T and higher, is never
safe to assume MR compatibility if it's not clearly documented in writing.
Does a significant change in safety parameters of the MR environment site require a
review of safety policies and procedures? - answer Policies and procedures need to be
reviewed concurrently with the introduction of any significant changes in safety
parameters of the MR environment of the site and updated as needed.
What is the purpose of an MR medical director (MRMD)? - answer Each site will name
an MR medical director whose responsibilities will include ensuring that MR safe
practice guidelines are established and maintained as current and appropriate for the
site.
Whose responsibility is it to ensure that the policies and procedures are adhered to? -
answer It is the responsibility of the site administration to ensure that the policies and
procedures that are derived from MR safety guidelines (MRMD responsible for
guidelines) are adhered to by all of the site's personnel.
When should safety incidents and "near misses" be reported, and to whom? -
answerProcedures should be in place to ensure that any and all adverse events, MR
safety incidents, or "near misses" that occur in the MR site are to be reported to the
medical director in a timely manner and used in continuous quality improvement efforts.
MRI Zone 1 - answerFree access to general public
MRI Zone 2 - answerInterface between zone 1 and 3, where screening happens and
patients are not free to move throughout this zone at will, but are rather under the
supervision of MR personnel.
, MRI Zone 3 - answerFree access by unscreened non-MR Personnel or ferromagnetic
objects or equipment can result in serious injury or death. Access is restricted and
controlled via an access key, passkey, or other reliable, physically restricting method
(like badge access.) Screened patients and non level-2 MR personnel need to be under
super direct supervision of level-2 MR personnel.
Zone 4 - answerArea with MR scanner itself. Strict access, no unscreened, in-
supervised individuals should be in it. Area should be clearly marked as potentially
hazardous and state that the magnet is always on.
Can combination key locks be used to restrict access to zone 3? - answerCombination
keys cannot be used to restrict access to Zone 3 as they are more widely distributed
than initially intended and site restriction violations are more likely with this setup.
Is Zone 3 strictly horizontal? - answerSince the magnetic field is three dimensional,
zone 3 can extend above and below the magnet in the vertical plane. Areas above and
below that exceed 5-gauss should be clearly marked as potentially hazardous.
Can conventional metal detectors be used as adjunct for screening? -
answerConventional metal detectors can not differentiate between ferrous and non-
ferrous metals and therefore should not be used. Specialized ferromagnetic detection
systems are available and are recommended as an adjunct to thorough and
conscientious screening of persons and decides approaching zone 4.
Who should always accompany non-MR personnel through zones 3 and 4? -
answerLevel-1 personnel are permitted unaccompanied access through zones 3 and 4,
and are allowed to accompany non-MR personnel into and throughout zone 3 but not
zone 4. Only level-2 personnel are responsible for admitting non-MR personnel into
zone 4.
How many times does a non-emergent patient have to be screened? - answerA non-
emergent patient has to be MR safety screened on site by a minimum of 2 separate
individuals, at least one of whom should be a level 2 MR personnel. At least one of
these forms of screening should be performed verbally or interactively.
How many times does an emergent patient have to be screened? - answerAn emergent
patient can be screened only once, provided that the individual screening is a level 2
personnel.
What methods of screening are used for individuals that have a history of potential
ferromagnetic foreign object penetration? - answerExamples of acceptable methods of
screening include patient history, x-rays, prior CT or MR studies of questioned anatomic
area (after the incident), or access to written documentation as to the type of implant or
foreign object that is within the patient.
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