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Winter 2012

No Longer Off-Limits

Date: February 1, 2012

MRI newly possible for millions of people.

More than 2 million people in the United States currently have pacemakers or implanted defibrillators. And until recently, MRI has been mostly off-limits to these patients due to safety concerns. That’s problematic because MRI is considered superior to CT scans in many clinical scenarios, especially brain and spinal cord imaging, notes Saman Nazarian, assistant professor of medicine.

Now he and his Hopkins colleagues have developed a new safety protocol that is already turning out to be a real game changer.

“The guidelines we have published can be used to make MRI more available to people who could benefit from early detection of cancer and other diseases and for guiding surgeons during procedures,” says Nazarian. He and his team reported their results recently in Annals of Internal Medicine.

The new protocol is proving useful for cardiac patients who seek ablation for ventricular tachycardia, says study co-author Henry Halperin. “We have safely performed cardiac MRI exams for more than 700 patients,” says Halperin. The clinical safety protocol that the Hopkins team developed—which includes device selection, reprogramming the device to a safe mode, and carefully monitoring the patient during the scan—is now being adopted by institutions around the world.

“With the advancing age of the population and the expanding indications for pacemakers and defibrillators, the capability to perform MRI in device recipients has become an increasingly important issue, and a lifesaving one for some patients,” says Nazarian.

He adds that many of the patients with cardiac devices who have come to Hopkins for an MRI scan had tumors and other serious problems diagnosed and treated—problems that had been missed by a previous imaging test, such as a CT or ultrasound exam.    

Ellen Beth Levitt

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