Patient movement during MRI: Additional points to ponder

A study on the high cost of patient movement during MRI scans released last spring has drawn a thought-provoking letter to the editor of the journal that published the study report.

In “Toward Quantifying the Prevalence, Severity, and Cost Associated With Patient Motion During Clinical MR Examinations,” Jalal Andre, MD, of the University of Washington in Seattle and colleagues estimated the price tag of motion artifacts at $115,000 per scanner per year.

“These costs may affect much of the global MR community, reducing resource efficiency and the quality of patient care,” Andre et al. wrote in the Journal of the American College of Radiology.

JACR posted the article online in May and ran it in the July print edition.

In the response letter, which JACR published online Dec. 30, S. Ali Nabavizadeh, MD, of the University of Pennsylvania, adds three points for additional consideration.

First, writes Nabavizadeh, the original study authors recommended more investment in research and software packages for motion correction, “but it would be interesting to know how often the currently available motion correction sequences and softwares were used in the study.”

He points out that some motion correction techniques, such as PROPELLER, have been shown to be useful in clinical settings, are available on the majority of imaging platforms and are commonly used in moving patients.

Second, Nabavizadeh stresses the importance of educating patients prior to scanning them. He cites previous studies demonstrating that basic patient education on the need to remain still can significantly curtail the need for do-overs tracing to patient movement. 

“In my personal experience,” he adds, “even health care workers such as members of the sedation team and emergency department physicians need to be more aware of the importance of this issue.”

Finally, Nabavizadeh, a radiologist, reminds colleagues within the specialty that—regardless of the financial consequences of patient motion—radiologists are the physicians who are ultimately responsible for the entire imaging process.

“Our disclaimers with regard to motion degradation limiting the quality of a study are not dissimilar to an operative note indicating that a tumor could not be completely resected because the patient woke up from anesthesia prematurely,” writes Nabavizadeh.

“We need to get involved with patients who move, much earlier than the moment at which the technologist calls the reading room to let us know that the patient moved and that the study is thus nondiagnostic.”