We agree with de Vocht and Kromhout that vital sign and cognitive ability measurements from 25 subjects are not sufficient to validate human safety at 9.4 T. However, we strongly disagree with their comment that a “firm conclusion” regarding human safety was reached. Both the abstract and the conclusion of the article state that the data suggest (rather than demonstrate) that human exposure to a 9.4-T static magnetic field does not represent an immediate and readily demonstrated safety concern. Obviously, additional data are required to make a firm conclusion of human safety at 9.4 T. However, such data will become available at a slow rate due to the limited number of ultra-high-field human MR scanners currently in existence. It is important that initial experimental data are presented to remove any theoretical fears that would halt future safety testing. Our initial experimental data do suggest that any effects that may be present will require a large number of subjects but do indicate that such safety testing can proceed. Contrary to the unfounded accusation of de Vocht and Kromhout, no participant comments or reported sensations were ignored at any time during this study. As stated in the manuscript, “Volunteers reporting any unusual sensations or discomforts were encouraged [emphasis added] to give a detailed account of the experience.” Specifically, we comment that “[v]olunteers indicated that these sensations [vertigo or light-headedness] were primarily experienced when being moved through the static magnetic field of the 9.4T scanner and that the sensations did not persist once they were stationary for several minutes” and that “[n]o volunteers reported any experienced discomforts persisting outside of the magnet room.” We found that all experienced discomforts and sensations, including vertigo, were consistent with those previously reported. Additional data on the distributions of the measured vital sign and cognitive data were included in table and figure form in an earlier version of the manuscript. At the request of the editor and the reviewers, these data were removed from the final version. These data were, however, peer reviewed. Staff working near the 9.4-T MR scanner are rarely exposed to a static magnetic field larger than 400 mT. During a typical human experiment, staff will be in a field greater than 0.5 mT only when moving the subject into, and out of, the magnet. This process takes approximately five minutes total. As members of the small group of personnel working with a human scanner above the U.S. Food and Drug Administration (FDA) 8 T limit, we are naturally interested in any safety implications for ultra-high-field MR personnel. The improved sensitivity at ultra-high-field enables imaging of nonproton nuclei within times acceptable to human subjects. Even though many of the required frequencies are close to that of protons at lower fields (e.g., 17-O at 9.4 T is 54 MHz, 1-H at 1.5 T is 64 MHz), imaging frequency must still be considered a parameter to be explored with respect to human safety. Therefore, although we are in the process of collecting additional safety data, we suspect that it will be some time before any firm conclusion about the safety of human exposure to 9.4 T can be made. Ian C. Atkinson PhD*, Keith R. Thulborn MD, PhD*, * Center for MR Research, University of Illinois at Chicago, Chicago, Illinois, USA.
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