MR safety considerations for patients undergoing prostate MRI

Area of Science:

• Radiology and Medical Imaging
• Biomedical Engineering

Background:

• Increasing prevalence of prostate MRI scans in an aging patient population.
• Patients frequently have passive or active implants and devices, categorized as MR safe, conditional, or unsafe.
• MR-conditional active implants require specific environments and parameters for safe scanning.

Purpose of the Study:

• To discuss strategies for optimizing prostate MRI and PET-MRI in patients with implants and devices.
• To address concerns related to image optimization and artifact reduction.
• To ensure patient safety and diagnostic image quality in the presence of implants.

Main Methods:

• Review of imaging strategies for passive implants (e.g., hip prostheses, fiducial markers, seeds, clips) to overcome susceptibility artifacts in diffusion-weighted imaging (DWI).
• Discussion of parameter modifications for MR-conditional active implants, such as cardiac implantable electronic devices (CIED).
• Strategies to minimize susceptibility artifact and decrease specific absorption rate (SAR) at lower magnet strengths (e.g., 1.5 T).

Main Results:

• Identified unique concerns for image optimization with passive implants causing geometric distortion in DWI.
• Demonstrated that diagnostic-quality prostate MRI can be achieved with MR-conditional active implants by modifying imaging parameters and using lower magnet strengths.
• Described specific imaging techniques to mitigate artifacts and reduce SAR.

Conclusions:

• Knowledge of MR safety is crucial for patients undergoing prostate MRI and PET-MRI with implants.
• Tailored imaging strategies are essential for managing susceptibility artifacts and ensuring patient safety.
• Achieving diagnostic-quality prostate MRI is feasible even with the presence of various passive and active implants.