Current Considerations in MRI Safety for Pediatric Patients
In recent interviews, Emanuel Kanal, MD, and Tobias Gilk, MRSO, MRSE, discuss new multicenter research examining pediatric MRI safety as well as key challenges and preventive measures in this patient population.
In a recently published study reviewing MRI safety incidents over a six-year period at five U.S. children’s hospitals, researchers found that Zone IV MRI safety incidents were rare (146 out of a total of 540,987 MRI exams).1
However, the study authors noted common themes with projectiles involved in 30 percent of the cases of safety incidents and burn/thermal injuries occurring in 13 percent of the reported cases. The researchers also found that safety protocols were not followed in 60 percent of the Zone IV MRI safety incidents.1
In recent interviews with Diagnostic Imaging, Emanuel Kanal, MD, and Tobias Gilk, MRSO, MRSE, shared their observations on the study and discussed pertinent challenges with MRI safety in the pediatric population.
“It's overtly rare for us to hurt people in MRI anywhere ever. That having been said, the real issue (is that) virtually 100 percent of the time that we do injure someone, it's pilot error. It's our fault, and that means they're avoidable. That means they didn't have to happen. That means we can do better. So, in that sense, this paper, if anything, helps to highlight exactly that,” emphasized Dr. Kanal, the director of magnetic resonance services and chief of the Division of Emergency Radiology at the University of Pittsburgh Medical Center (UPMC).
Ensuring physical separation from the bore wall, the use of padding to prevent skin to skin contact and removal of any materials that could be electrically conductive are key principles that are over 90 percent effective in preventing thermal/burn injuries from MRI exams, according to Gilk. He also cautions clinicians to be on the lookout for antimicrobial elements in clothing.
“(There) can also be antimicrobial treatments in off-the-shelf clothing, and those antimicrobial treatments are typically nanoparticles, silver or copper, which means it may look like a cotton shirt. But if it's antimicrobial, it essentially could be metal, very fine quantities of metal, and (one) could wind up heating up a patient's t-shirt as has been done before,” pointed out Gilk, founder of Gilk Radiology Consultants, senior vice president of RADIOLOGY-Planning and board member of the American Board of Magnetic Resonance Safety (ABMRS).
Reference
- Guan A, Iyer RS, Barth RA, et al. Pediatric MRI safety: frequency, types, and severity of zone IV MRI safety events at five U.S. children’s hospitals. J Am Coll Radiol. 2026 May 8:S1546-1440(26)00244-9. doi: 10.1016/j.jacr.2026.05.013. Online ahead of print.
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