Book Review

Abstract

Reference Manual for Magnetic Resonance Safety, Implants, and Devices: 2010 Edition Frank G. Shellock, PhD Los Angeles, CA: Biomedical Research Publishing Group; 2010. $79; 599 pages; Softcover Diego R. Martin MD, PhD*, * Professor and Director of MRI, Director of the Clinically Applied Research Body, MRI Program, Department of Radiology, Emory University School of Medicine, Atlanta, Georgia, USA. As indicated in the title, this book is the latest edition of a reference manual directed predominantly toward magnetic resonance imaging (MRI) technologists and facility managers. This manual is centered on providing an organized, searchable compilation of medical devices or foreign bodies that may be on or in patients being considered for MRI studies and then categorizing each of these with regard to relative magnetic properties and relative safety or risk to the patient. The information is derived from standardized test results, including placing the object in question within the magnet and determining behavior, as well as referencing publications from established reference bodies of expertise, including the International Society of Magnetic Resonance in Medicine (ISMRM), the American College of Radiology (ACR), the Food and Drug Administration (FDA), the National Electrical Manufacturers Association (NEMA), the International Electro-technical Commission (IEC), the Medical Devices Agency (MDA), and the Institute of Magnetic Resonance, Safety, Education and Research (IMRSER). The manual is divided into sections and, compared to the 2009 edition, has received a number of important updates. Section I has an updated description and discussion of safety guidelines and recommendations. Templates for patient screening forms and guidelines for scanning patients with electronically activated devices are provided to assist facilities in establishing safety standards of practice. These forms are in English and Spanish. This element of the manual represents a vital aid to the many centers that may not have intrinsic expertise in MRI safety support. Another critical update pertains to a section on “MRI contrast agents and nephrogenic systemic fibrosis (NSF).” The recommendations in this section are current and well-reasoned and the author has provided a list of Websites from which emerging information on NSF may be monitored. Highly useful sections are also dedicated to methods and safety considerations for patients who are claustrophobic, patients who should be monitored during scanning, issues related to pregnancy, and a discussion on contrast reactions. Section II lists and categorizes relative magnetic properties and safety of implants, devices, and materials tested within the MRI systems. This represents the core of the reference manual and has been expanded to also update the list for devices tested at the higher 3 Tesla field strength. Considerations are directed toward both safety categorization related to the patient and also with regard to the potential for adverse effects on the subsequent operation or performance of medical devices. The Appendix is a useful supplement to Section II. In the current edition we are provided with an updated list of over 200 manufacturers of medical devices and implants with the corresponding Website shown for contact information. In summary, the 2010 edition is an incremental update of a reference manual that is coordinated with the MRISafety.com reference Website and that has a proven indispensable role for guiding safe practice at MRI facilities both in the United States and abroad. The prior editions have become the standard of reference for safety at most MRI centers and the current edition provides the latest updates for 1.5 and 3 Tesla systems, contrast safety updates, and guidelines for screening and safe practices.