Defining RF Burns with Kelly Mantooth

In this episode, Robert and Reggie speak with Kelly Mantooth, an MR Safety expert, about RF burns in MRI. They discuss the definition of RF burns, how they differ from overall heating (SAR), the four types of burns (proximity, looping, resonant, and reflective), statistics on RF burns, causes, preventative measures, treatment, and personal experiences. Key points include: RF burns are caused by local/focal heating rather than overall heating, positioning and proper padding are crucial for prevention, certain sequences don't necessarily increase burn risk, and identifying high-risk patients is important. Kelly shares stories from her career that influenced her passion for MR safety.
Chapters
00:00:28 Introduction and Background
Robert and Reggie introduce Kelly Mantooth, an MR Safety expert with extensive experience. Kelly shares her background, including being an MR Tech for 13 years, obtaining her MRSO and MRSE certifications, serving on the ABMRS board, and being the National MR Safety Trainer for Metrasense. They discuss the difference between MRSO and MRSE roles.
00:03:14 Defining RF Burns
Kelly explains that RF burns are caused by local or focal heating, distinct from overall or diffuse heating (SAR). She clarifies that high SAR doesn't necessarily lead to burns, and that burns can occur even with low SAR if there is local heating due to factors like skin-to-skin contact or conductive clothing.
00:17:23 Types of RF Burns
Kelly outlines the four types of RF burns: proximity burns (caused by being close to the RF transmitter), looping/induced current loop burns (caused by skin-to-skin contact), resonant burns (caused by objects matching the wavelength of the scanner), and reflective burns (caused by metallic fibers in clothing).
00:35:07 Statistics and Reporting
They discuss the lack of comprehensive data and reporting on RF burn incidents, with Kelly noting that adverse events are often not discussed or shared, hindering learning opportunities. She emphasizes the importance of open communication and learning from incidents.
00:35:48 Causes and Risk Factors
Potential causes and risk factors for RF burns are explored, including body habitus, field strength, positioning, contact with objects, and specific sequences. Kelly stresses that while higher field strengths and certain sequences increase overall heating, burns are more related to local heating factors like positioning and contact.
00:37:49 Preventative Measures
Preventative measures are discussed, such as proper positioning, padding, ensuring no skin-to-skin contact, removing conductive clothing and jewelry, and identifying high-risk patients (e.g., anesthetized, pediatric, or obese patients). Kelly emphasizes the importance of following protocols and checklists, likening it to aviation safety.
00:47:06 Treatment and Personal Experiences
Kelly describes the treatment process for RF burns, including taking photos, measuring the burn, monitoring progression, and potential surgical intervention for severe cases. She shares personal experiences, including a formative incident early in her career that sparked her passion for MR safety, and a recent case involving a patient with an embedded metal fragment.
00:52:32 Closing Thoughts and Career Fulfillment
In closing, Kelly highlights the most fulfilling moment of her career: passing the MRSE exam and being able to share her knowledge to improve patient safety. The group emphasizes the importance of continuous learning, open communication, and prioritizing safety in the MRI field.
Metrasense Website - www.metrasens....

[@demetriceburgess6338]

Excellent podcast , I’m actually in Dr.Kanal’s MRSO Training Conference now

[@rainyparis5922]

Excellent podcast.
Going for my MRSO certification this summer so this podcast is definitely motivating for me.
Love the safety content and education!

[@1shot-1kill84]

Good point. Yes you're correct. The Libre models website says to remove them before MRI, CT and Diathermy treatments. We see them often at our site. We schedule their appointments when it's time for them to change it to a new one, then its already off anyways. They're pretty expensive also, it saves the patient a wasted sensor.

[@carlam6669]

I am a retired engineer who used to work at Abbott Diabetes Care doing failure analysis of returned glucose monitors and Libre sensors. I would be very concerned about damage to the electronics caused by the RF field and less so about the magnetic field. Damage could range from just causing it to become inoperable to getting hot enough to burn the patient. I can’t recall if there was an inductor (has a ferrous core) in the sensor, probably not.
Every so often we would get a conventional glucose monitor that a customer had put in a microwave oven (to dry it out???). Such glucose monitors would be badly charred and melted. I reproduced the phenomenon myself to confirm that was what happened and observed sparks and smoke within seconds of turning the microwave oven on.

[@scottferguson3491]

Excellent podcast. With regard to the glucose monitor question I believe there’s a chance you could burn the patient because of the electronic components in the sensor. Also, the sensor can malfunction after being exposed to strong magnetic field. Correct me if I’m wrong, but I believe that’s true.

[@samhat71]

Excellent learning so much. Working with several technologists and never heard of putting an ice pack on it? Were can I learn more about this process/option.

[@mri_safetyexpert_kellye]

Hi!! The ACR Manual on MR Safety from 2023 talks about cold compresses on tattoos- I think page 58/59. Hope that’s helpful! 🙂

[@MekhiOdmark]

this is soo goo!

[@EmmaBoyda]

Very nice

[@b.a.6362]

Would extra thin people be more sensitive to diffuse heating? Would high amounts of heavy metals in the blood increase heating up blood? Or colloidal silver on skin?

[@MariamDurphey]

Absolutely Dop ☝️

[@OdieHibbert]

OH YEAH

[@LillieKuechle]

🤩🤩🤩

[@CaleighGulick]

😍

[@MarielleKesinger]

👍

[@CasimirCabatu]

😍😍😍😍

[@JoanneTappen]

🚀🚀🚀💯🚀🚀🚀🚀 Nice

[@AsiaDegaust]

😎

[@JenaBeaman]

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