Adapting Radiology Magnetic Resonance Safety Workflows to Magnetic Resonance Imaging Simulation in Radiation Oncology

Area of Science:

• Medical Physics
• Radiation Oncology
• Radiology

Background:

• Magnetic resonance imaging (MRI) integration into radiation oncology (RO) necessitates enhanced safety protocols.
• Existing American College of Radiology guidelines offer broad MRI safety advice but lack RO-specific adaptation details.
• Limited published experience exists for implementing MRI safety workflows in RO settings, particularly with MRI simulators.

Purpose of the Study:

• To evaluate the impact of MRI safety interventions in radiation oncology at a single institution.
• To assess the effectiveness of a modified radiology workflow, department-wide education, and visual aids in improving MRI safety.
• To analyze safety endpoints including same-day cancellations, high-risk patient identification, and safety events.

Main Methods:

• Three plan-do-study-act (PDSA) cycles were conducted using a 3-T MRI simulator in RO.
• Cycle 1: Adapted a two-screen functional workflow from radiology.
• Cycle 2: Implemented comprehensive department-wide MRI safety education.
• Cycle 3: Introduced a visual aid for patient screening.
• Retrospective review of MRI schedules for safety endpoints.

Main Results:

• Same-day MRI simulation cancellations were 6.6%, 10.4%, and 7.4% across PDSA cycles (p = 0.51).
• Identification of patients with implants requiring MRI safety team review increased from zero in cycles 1-2 to three in cycle 3.
• No safety events (SEs) occurred during the study period.

Conclusions:

• A radiology-derived MRI safety workflow was successfully implemented in radiation oncology.
• Repeated, targeted education and visual tools improved the early identification of high-risk patients.
• While cancellation rates did not significantly change, these interventions suggest potential for improved early detection of unsafe implants, enhancing MRI simulation efficiency.