Design, Operation, and Safety of Single‐Room Interventional MRI Suites: Practical Experience From Two Centers

Abstract

The design and operation of a facility in which a magnetic resonance imaging (MRI) scanner is incorporated into a room used for surgical or endovascular cardiac interventions presents several challenges. MR safety must be maintained in the presence of a much wider variety of equipment than is found in a diagnostic unit, and of staff unfamiliar with the MRI environment, without compromising the safety and practicality of the interventional procedure. Both the MR-guided cardiac interventional unit at Kings College London and the intraoperative imaging suite at the National Hospital for Neurology and Neurosurgery are single-room interventional facilities incorporating 1.5 T cylindrical-bore MRI scanners. The two units employ similar strategies to maintain MR safety, both in original design and day-to-day operational workflows, and between them over a decade of incident-free practice has been accumulated. This article outlines these strategies, highlighting both similarities and differences between the units, as well as some lessons learned and resulting procedural changes made in both units since installation.

Safety Management for MR-Guided Interventions

“…White et al (8) suggest not only to use checklists in daily practice, but to appoint a special person (usually radiologist) -Procedure Safety Officer -to control the safety protocol realization and to make records with SSCL. Soroka et al (13) also offer to appoint a physician as a manager, who will be responsible for the processes monitoring on the regular basis (or for the concrete operation).…”

“…This fact demands a precise hybrid theater design and planning and management processes standardization (8). Intraoperative MRI in high-energy field (1.5-3.0T) followed with strong conditions for ferromagnetic and non-magnetic surgical tools control and accurate patient logistics and routing (9).…”

“…For vital functions monitoring and support a hospital needs to have the MRcompatible anesthesiology equipment (special ventilator, infusion pumps, pulse oximeters, catheters, needles etc.) (8). White et al (8) suggest that modified surgical safety checklist is the applicable tool for the safety risks ensuring and allows the strong MR-related challenges control.…”

“…(8). White et al (8) suggest that modified surgical safety checklist is the applicable tool for the safety risks ensuring and allows the strong MR-related challenges control. Hybrid surgery means a combination of conventional and endovascular interventions, thus a facility planning team needs to consider not only magnetic field but both MRrelated, sterility, anesthesiology care and radiation-related aspects.…”

Interventional CMR: Clinical Applications and Future Directions

“…Options for construction include single room [79], moveable [80], or separate room localized systems. Placing MRI and X-ray in separate rooms allows both to be used independently and maximize usage.…”