Breast MRI in Patients With Active Implanted Metallic Devices: How We Do It

Area of Science:

• Radiology
• Medical Imaging
• Biomedical Engineering

Background:

• Increasing use of breast MRI and prevalence of active implanted metallic devices (AIMDs) leads to more patients with AIMDs referred for breast MRI.
• AIMDs pose risks during MRI, including physical forces, heating, electrical interference, and image artifacts.
• Limited existing guidance complicates safe MRI performance in this population.

Purpose of the Study:

• To present strategies for safely conducting breast MRI in patients with AIMDs.
• To maintain diagnostic integrity while managing risks and artifacts.
• To provide a framework for radiology practices encountering these complex cases.

Main Methods:

• Multistep screening process for identifying AIMDs.
• Adherence to manufacturer-specific MRI-conditional guidelines.
• Protocol modifications to balance image quality, scan time, and artifact reduction.
• Review of clinical cases involving various AIMDs (pacemakers, neurostimulators, etc.).

Main Results:

• Demonstrated safe breast MRI performance in patients with diverse AIMDs.
• Identified specific artifact patterns and mitigation techniques.
• Highlighted situations where MRI may be contraindicated and alternatives suggested.
• Noted new MRI safety CPT codes.

Conclusions:

• Implementing structured workflows enhances safe access to breast MRI for patients with AIMDs.
• Careful screening and protocol adaptation are crucial for successful examinations.
• This approach supports informed decision-making for both clinicians and patients.