[Intl_DxMedPhys] Pregnant Patient Consenting in MRI

[Steven Shea]

Dear Gretchen,

Our site does not require informed consent for noncontrast MRI in pregnant
patients. That was based on the fact that the vast majority of data has
failed to show that exposure to MR has deleterious effects on the
developing fetus. (More specifics are in the 2024 ACR Manual on MR safety.)
The manual also has this statement:

Thus, the ACR Manual on MR Safety supports the clinical use of MR imaging
for patients known or suspected to be pregnant under the following
conditions:
1) MR system up to 3T in Normal Operating Mode (Whole body-averaged-SAR,
2-W/kg);
2) there is expected benefit to the patient and/or fetus from performing
the exam;
3) There is no other practical way to obtain the same information for
patient care [7].

The American College of Obstetricians and Gynecologists clinical guidelines
acknowledge MR and ultrasound (US) as the ‘imaging techniques of choice for
the pregnant patient, but they should be used prudently and only when use
is expected to answer a relevant clinical question or otherwise
provide medical benefit to the patient’ [17].


The latter might help justify the case for not consenting given this is
rarely done for ultrasound, in my experience.

We did mandate that all pregnant patients should be scanned in "Normal
mode" and should preferentially be scanned on 1.5T, mainly to limit thermal
energy given "the indications that the embryo is potentially more sensitive
to thermal events in the first trimester." (2024 ACR Manual MR Safety).
Radiologists can override "normal mode" based on a specific patient
risk-benefit assessment.

I hope that information helps.

Best regards,

Steven Shea, PhD
Associate Professor, MR Scientist
Department of Radiology & Medical Imaging. Loyola Medicine


On Tue, Apr 1, 2025 at 11:01 AM <
intl_dxmedphys_wd_osu_list-request at lists.osu.edu> wrote:

>
> From: Gretchen Raterman Bell <gretchen.raterman at gmail.com>
> To: intl_dxmedphys_wd_osu_list at lists.osu.edu
> Cc:
> Bcc:
> Date: Mon, 31 Mar 2025 16:26:03 -0500
> Subject: [Intl_DxMedPhys] Pregnant Patient Consenting in MRI
> Hi, everyone: I am trying to gather as much data as I can on what
> institutions are doing in regards to pregnant patients undergoing an MRI,
> no contrast involved.   What level of informed consent, if any, do the
> facilities you cover require?
> Hi, everyone:
>
> I am trying to gather as much data as I can on what institutions are doing
> in regards to pregnant patients undergoing an MRI, no contrast involved.
> What level of informed consent, if any, do the facilities you cover
> require?  It was my opinion that all pregnant patients shall be consented
> prior to MR scanning, and I got a lot of pushback based on logistics.
> There's also a debate on what consent actually looks like, in practice, and
> on paper.  Is the radiologist directly talking to the patient every time?
> Does the technologist briefly go over a sheet they sign?
>
> Any insights are VERY much appreciated.  This is a sensitive topic without
> an abundance of guidance.
>
> Gretchen R. Bell, M.S., DABR
> Diagnostic Imaging Physicist
> Ochsner Medical Center
> (504)842-8506
>
>
>
>
>
>
>
>
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://lists.osu.edu/mailman/private/intl_dxmedphys_wd_osu_list/attachments/20250404/76ee82fe/attachment.html>