Examining Disparities in Patient Motion During MRI

Intra-procedural patient motion is common in clinical MRI and degrades image quality. We evaluated whether certain clinical characteristics and patient sociodemographic factors are associated with patient motion during MRI.

We retrospectively reviewed consecutive MRI reports from 2022 at two U.S. urban health systems (university and safety net). Exams were acquired using standardized protocols and reported by a single academic radiology group. Motion was defined by any mention of "motion" in the report body or impression. Clinical and sociodemographic characteristics were extracted from the electronic health record. Multivariable logistic regression assessed associations between patient characteristics and motion, adjusting for care setting.

Among 68,517 MRIs, emergency and inpatient studies had higher odds (OR) [95%CI] of motion compared with outpatient exams (emergency OR 2.55; [2.38,2.74]; inpatient OR 3.26; [3.06,3.48]). After adjustment, older age remained associated with motion, (≥85 years OR 1.91; [1.64,2.23], vs. 19-34 years). Male gender had higher odds than female (OR 1.14; [1.08,1.20]). Black race had higher odds than White (OR 1.18; [1.10,1.27]). Increasing obesity was associated with greater odds (class II OR 1.11; [1.01,1.22]; class III OR 1.48; [1.34,1.64]). Ethnicity, preferred language, and health system were not significantly associated with motion.

Motion on MRI disproportionately affects elderly patients, men, individuals with obesity, and Black patients, independent of care setting. Accounting for motion-risk factors into scheduling, pre-scan counseling, and positioning protocols may reduce motion-limited studies. Addressing these patterns through workflow design is important for promoting equitable, high-quality MRI across diverse patient populations.