[Intl_DxMedPhys] insulin pumps and CT

Tue Mar 4 10:13:52 EST 2025

CT exams are much shorter than MR, so adverse events are unlikely to occur during the exam. Thus the main concern is the damage to the device.

One study (https://urldefense.com/v3/__https://pubmed.ncbi.nlm.nih.gov/17463138/__;!!KGKeukY!0UVZElsSB1-hKn5unX1BqwUvoPHTgb7kFAKacK1iMa9_P74J5pKACsUKOywQEh8hwMxV0xHLVdVqx7kvxNbRpcpL4JhrXQfsyQoEe3Q$ ) has looked at the effects of irradiation on pacemakers and found the effects were, for most part, transient, meaning effects went away as soon as the device was out of x-ray beam.

Thanks,
Baojun

From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+baojunli=bu.edu at lists.osu.edu> On Behalf Of McCann, Aaron via Intl_dxmedphys_wd_osu_list
Sent: Tuesday, March 4, 2025 6:43 AM
To: intl_dxmedphys_wd_osu_list at lists.osu.edu
Subject: Re: [Intl_DxMedPhys] insulin pumps and CT

Hi all, Sites *not* employing an all-or-nothing policy should be aware that this is still a dynamic field and that further testing of these devices may result in changes to their formal safety status. For example, some (not all) FreeStyle Libre
Hi all,

Sites *not* employing an all-or-nothing policy should be aware that this is still a dynamic field and that further testing of these devices may result in changes to their formal safety status. For example, some (not all) FreeStyle Libre device models have recently received FDA clearance as MR Conditional (and as safe to be worn during CT, x-ray and diathermy procedures), rendering the published table at the start of this thread out of date:

https://urldefense.com/v3/__https://www.medscape.com/viewarticle/newer-abbott-libre-cgm-sensor-use-now-okay-during-imaging-2024a1000k2f__;!!KGKeukY!0UVZElsSB1-hKn5unX1BqwUvoPHTgb7kFAKacK1iMa9_P74J5pKACsUKOywQEh8hwMxV0xHLVdVqx7kvxNbRpcpL4JhrXQfsNyVD7ww$ 

One other consideration: I am aware of at least one report where a patient was informed that their glucose monitor should be removed prior to MRI – they did so themselves a few hours before their examination, and subsequently suffered a hypoglycaemic episode during the scan. These devices are critical for some patients in managing their own conditions, and the duration without monitoring should be kept as short as possible. Having an advance plan in place for removal and replacement that involves the patient is important.

Kind regards,
Aaron
_____________________________
Dr Aaron McCann
Clinical Scientist

Radiological Imaging & Protection Service
Regional Medical Physics Service
Belfast Health & Social Care Trust

Forster Green Site
110 Saintfield Road
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Tel: 028 9504 4863

(Note: my normal office hours are Mon-Fri 8am – 4pm)

From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+aaron.mccann=belfasttrust.hscni.net at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces+aaron.mccann=belfasttrust.hscni.net at lists.osu.edu>> On Behalf Of Szczykutowicz, Timothy P via Intl_dxmedphys_wd_osu_list
Sent: 03 March 2025 23:19
To: intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: Re: [Intl_DxMedPhys] insulin pumps and CT

The borders of the state are the borders of the university (badgers will get this reference) Attached is our current all or nothing policy. Thanks to all who have sent me their policies and links!!! I also just pinged my rad onc friends that
The borders of the state are the borders of the university (badgers will get this reference)

Attached is our current all or nothing policy.

Thanks to all who have sent me their policies and links!!!

I also just pinged my rad onc friends that live in the basement here. They brought up a good point…. What are you going to do for 25 fractions!?

-stick

Timothy P. Szczykutowicz, Ph.D., DABR
Associate Professor
Departments of Radiology, Medical Physics and BME
University of Wisconsin Madison
Cell# 1-716-560-7751
Office# 1-608-263-5729
he/him/his

From: Josh M Wilson <joshua.wilson at duke.edu<mailto:joshua.wilson at duke.edu>>
Sent: Monday, March 3, 2025 4:20 PM
To: Szczykutowicz, Timothy P <TSzczykutowicz at uwhealth.org<mailto:TSzczykutowicz at uwhealth.org>>; intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>; Wunderle, Kevin <Kevin.Wunderle at osumc.edu<mailto:Kevin.Wunderle at osumc.edu>>
Subject: Re: insulin pumps and CT

You don't often get email from joshua.wilson at duke.edu<mailto:joshua.wilson at duke.edu>. Learn why this is important<https://urldefense.com/v3/__https:/aka.ms/LearnAboutSenderIdentification__;!!KGKeukY!0OUW5OkrU1mkaxwZm91wzoWYV97nYSEjtoVhCustFte0tslNQT5dN-D8oynIYskROSPNpsfefAMhQHEVE15bhBw_EQ5QRYv9gUPhSqcy6kZu1fGVYA$>

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Deja vu; attached from the old listserv. As far as I can tell, no one publicly shared a policy to the last request. YMMV.

Best,
Josh M. Wilson, PhD

Radiation Physicist, Clinical Imaging Physics Group
Duke University Health System

Director, Duke Imaging Physics Residency Program
Assistant Professor, Department of Radiology
Duke University School of Medicine
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From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu>> on behalf of Wunderle, Kevin via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Sent: Monday, March 3, 2025 4:35 PM
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Subject: Re: [Intl_DxMedPhys] insulin pumps and CT

Hey Tim,

This is an important topic, and one that has substantial cost liability for patients who, for some units, must replace those devices, and, as you allude to, substantial liability for institutions that do anything other than what the device manufacturers state.

Perhaps this is a topic to bring to the AAPM MPI (Medical Physics Institute) for investigation as a potential project? Jatinder Palta is the director of this new endeavor and might be interested in hearing about this need.

Kind regards,

Kevin

[The Ohio State University]
Kevin Wunderle, PhD, FAAPM, FACR
Professor, Department of Radiology

Diagnostic Medical Physicist
395 W. 12th Avenue,

Floor 4, Room 424

Columbus, OH, 43210
216-245-5513 Mobile
kevin.wunderle at osumc.edu<mailto:kevin.wunderle at osumc.edu>

From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+kevin.wunderle=osumc.edu at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces+kevin.wunderle=osumc.edu at lists.osu.edu>> On Behalf Of Szczykutowicz, Timothy P via Intl_dxmedphys_wd_osu_list
Sent: Monday, March 3, 2025 4:24 PM
To: intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: [Intl_DxMedPhys] insulin pumps and CT

Anyone have a policy for insulin pumps and sensors other than “taken them off” for CT they are willing to share? huge risk if they malfunction…possible death, so I get why folks defer to the vendor policies which don’t

Anyone have a policy for insulin pumps and sensors other than “taken them off” for CT they are willing to share?

huge risk if they malfunction…possible death, so I get why folks defer to the vendor policies which don’t appear to be actually tested inside a scanner.

I found this paper, link below. But it basically says listen to the vendors. It seems in practice, this would be complicated if we have to have  a workflow where each device is looked up.

https://urldefense.com/v3/__https://link.springer.com/article/10.1007/s11892-021-01375-7__;!!KGKeukY!0UVZElsSB1-hKn5unX1BqwUvoPHTgb7kFAKacK1iMa9_P74J5pKACsUKOywQEh8hwMxV0xHLVdVqx7kvxNbRpcpL4JhrXQfskbcxqg8$ <https://urldefense.com/v3/__https:/link.springer.com/article/10.1007/s11892-021-01375-7__;!!KGKeukY!2X8iwvcZaThROZKzTShLM48XXAAcboXdv6Nd6eTUed_wyUTOhUxUGhsoBXCoSXWbfJXR7CxWoS34HSLrfILeEy0e1iO_WRko7ct0-yQ3BcMzZ9HaWQ$>

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Timothy P. Szczykutowicz, Ph.D., DABR
Associate Professor
Departments of Radiology, Medical Physics and BME
University of Wisconsin Madison
Cell# 1-716-560-7751
Office# 1-608-263-5729
he/him/his

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