Recommended responsibilities for management of MR safety

FOREWORD The following article was approved by consensus of the scientific and medical societies with major representation in Europe. The mode of operation was that an initial draft was provided by the safety committee of ISMRM (Fernando Calamante (chair), Bernd Ittermann, Emanuel Kanal). An intersociety working group on MR safety was established with representation from each society as follows: Alberto Torresin (EFOMP); Renato Padovani (EFOMP); Sija Geers-van-Gemeren (EFRS); Csaba Vandulek (EFRS); Linda Knutsson (ESMRMB); David Norris (ESMRMB, ISMRM, chair); Stephen Keevil (ESR); Gabriel Krestin (ESR); Siegfried Trattnig (ISMRM); Titti Owman (ISMRM, SMRT). Comments on the draft were circulated by email, and the Committee met several times by teleconference until the final version was agreed. Several non-European societies later approved the document, which is an important step towards international acceptance. The motivation for generating this document was the enactment of the EU-directive on physical agents (electromagnetic fields, Directive 2013/35/EU), which defines exposure limits to electric and magnetic fields in the work place. This must be transposed into national law within the EU by 1 July 2016. After a lengthy consultation process this directive also contains a derogation for MRI. The EU expects that the MR community display a high degree of self-regulation, and develop effective training programs for workers in the field. As a first step it is then necessary to define the roles and responsibilities of workers, so that appropriate training programs can be developed, which may ultimately be offered by multiple providers. A consistent challenge was to find a general form that could be translated into the working practice of different safety cultures and legislative environments. The proposed solution envisages that one person is operationally responsible for the facility and this is the MR medical or research director (MRMD/MRRD) and further that there is one person who is closely involved with scanning who takes on the role of MR safety officer (MRSO). This represents the minimum configuration for any site. Additionally, the role for a higher level of technical expertise was defined in the form of the MR safety expert (MRSE), but at the same time it was accepted that for small sites this level of expertise would not necessarily be available “in house,” and hence such expertise could be accessed externally as necessary. In the typical configuration the qualifications for the three roles will be: MRMD/MRRD, MD/PhD; MRSO, radiographer (Europe), technologist (USA and elsewhere); MRSE, physicist. However, these are certainly not prescribed and may be readily fulfilled by workers with different backgrounds, also subject to national requirements. At present there are a number of certifications that could be appropriate, particularly at the level of the safety officer (for example, training courses offered by ESMRMB and ISMRM), and it is hoped that the generation of this document and its widespread acceptance will elicit more internationally recognized training courses that are matched to the three areas of responsibility defined here, as is already done in the USA by the newly formed American Board of Magnetic Resonance Safety.