Standardizing Magnetic Resonance Imaging Protocols Across a Large Radiology Enterprise: Barriers and Solutions

Standardization of magnetic resonance imaging protocols is important to achieve reproducible and effective outcomes across a large volume of patient examinations. It also ensures a consensus-driven approach to imaging, while reducing inefficient workflow practices. This article details our approach and experience with implementing systematic methods to address obstacles, and instituting a protocol strategy from development to installation to feedback.

A collaborative planning and implementation strategy was derived to address and centralize protocol standardization for 25 MRI systems across 14 imaging centers. In addition to establishing radiologist-lead working groups to define clinical need for each division, we enlisted MR physicists to work with sites to outline system capability and recommend best practices for each protocol method. The strategy also involved protocol alternatives due to patient type, and steps to ensure image quality feedback mechanisms.

We found that a collaborative team of radiologists, physicists, and technologists is vital for creating structured and categorized protocols that balances clinical need and accepted standards, with system technical capability and exam time limitations. A formalized protocol document and numbering system was created to allow efficient order-to-protocol assignment and selection. Consideration for other variables, such as patient type, user education, and automated tasks, further extend protocol usability and standardization in clinical practice.

MRI protocol standardization is a significant challenge within a large institution, which requires ongoing oversight and improvement. An organized committee of stakeholders, incorporating clinical, technical, and site-specific expertise, is an important first step to understand the current state and direct standardization goals.