MR SYSTEM OPERATION AND SAFETY TRAINING

EVERYONE INVOLVED IN RUNNING AN EXPERIMENT ON OR AROUND THE LARGE AND SMALL BORE RESEARCH MAGNETS IS REQUIRED TO TAKE THE SAFETY/TRAINING CLASS.

Mary O’Hara will hold training sessions as needed, which averages out to at least twice monthly. Notifications of these training sessions will be announced via email on the mri-scan and small bore lists. If you have not done so already- please sign up for the appropriate list to get scanning updates. Go to: http://www.nmr.mgh.harvard.edu/martinos/userInfo/operations/mailingLists.php to sign up.
Our training system consists of five levels,

  • A) White =Safety
  • B) Yellow = In Training (for all areas)
  • C) Green = Certified Scanner for human scanning on Bays 2, 3, 4, 5 & 6
  • D) Dark Blue = Certified Scanner for Animal scanning on the Small Bore scanners.
  • E) Light Blue = Certified user of the surgical prep-room.

The descriptions of each role are below. We have developed this system so we can better keep track of what level each person is at in his or her training, as well as to ensure that each person has received the proper training to work around a MRI scanner.

***If you do not have a badge, you should not be in the scanning bays or prep rooms, you can and will be asked to leave***

Badges usually take up to 3-4 business days to make. Larry White will send out an email to the mri-scan/small-bore list notifying you that your badge is ready. Badges may be picked up in room 1.010D ((Mary & Larry’s office behind bay1) in building 149.

The Technical staff reserves the right to refuse anyone permission to operate the magnets.

I. Description of Training Levels
II. Training Program Contents
III. Evaluation and Certification Procedure
IV. Center Record Keeping


I.Description of Training Levels

A) White = Safety: This is a person who is present during the scan and is available to assist in setting up the subject in the magnet, assist if there is an emergency but, will not be running the magnets (nursing).

Training requirements to obtain a white SAFETY badge include: Step 1: Watch the safety video (~20 minutes) Step 2: Take and pass the Safety Training Video Test (passing score is an 8 our of 10 (~5-10 minutes) Step 3: Attend the 1st half of Mary's Lecture (the safety portion) (~30 minutes). Altogether this training session takes approximately 1 hour.

B) Yellow = In Training: This is a person who is present during the scan session and is in training to learn the finer details of running the scanner. This yellow, "In Training" badge allows the person to assist with the setup of the subject in the magnet room, setup and run the stimulus and scanner equipment, and to assist in an emergency under the supervision of a person at the Certified Level status (See Manual for further details).

Training requirements to obtain a yellow IN TRAINING badge include: Step 1: Watch the safety video (~30 minutes) Step 2: Take and pass the Safety Training Video Test (passing score is an 8 our of 10 (~5-10 minutes) Step 3: Attend the 1st half of Mary's Lecture (the safety portion) (~30 minutes). Step 4: Attend the 2nd half of Mary's Lecture (the scanner/console training portion (~50 minutes) Altogether this training session takes approximately 2+ hours.

C) Green = Certified Scanner for the regular bays
D) Dark Blue = Small Bore Scanners**
E) Light Blue = for the surgical prep room**

This person has completed steps 1-4 of the initial training and has been scanning with a member of their lab who is already certified to scan until the person in training becomes proficient in scanning and MRI safety. This process takes a minimum of 4 months. (See list on last page of packet for check off list of items each person should be able to do for either A, B or C above). For someone who is training for the regular scanning bays (Bays 2,3,4,5 or 6), human or nonhuman and feel like he/she is proficient with everything on the check off list and has been scanning at least 4 months, then they are to email mri-time@nmr.mgh.harvard.edu to set up an appointment with Mary or Larry. One of them will then observe you during a scan session with a real subject to determine your qualification to become a "Certified Scanner".

**If you are training to work the Small Bore Scanners or in the Surgical Prep Room- you need to speak with George Dai (dai@nmr.mgh.harvard.edu) or John Moore (john@nmr.mgh.harvard.edu), respectively, to set up appointments to be signed off.

II.Training Program Contents

SAFETY/TRAINING CLASS

(Download the MRI Safety and Operations Training Manual)

Introduction

  • Starting with a brief description of the Martinos Center, how we work and how we fall under the umbrella of the MGH Radiology department.
  • Siemens safety video & quiz (30-40 minutes)
  • A start to finish walk through of a research scan
    • Proper attire for scanning
    • Meeting & Consenting the subject (know your IRB consent contents)
    • Subject screening (any questions or doubts, no scan)
    • Consent & screening copies (what gets copied and who gets them)
    • Subject prep
    • Scanner & equipment prep (no identifiers on scanner)
    • Who’s at the scanner a minimum of 2 (who is not)
    • Medical emergencies
    • Incidental findings Discovery of a potential physical abnormality
    • Miscellaneous policies & procedures
    • Q&A

A phantom scan at the magnet

    • Logging in
    • Subject prep  & positioning
    • Projector & button box use
    • Using the scanner trigger for starting laptops
    • Saving & transferring data
    • Trouble shooting (reboot vs shutdown)
    • What are all the red buttons for?
    • Logging off
    • Q&A

III. Evaluation and Certification Procedure

  • View Safety Video
  • Complete Training
  • Scan a subject or phantom (development badge only) with technical staff member ("qualifying exam")

IV. Center Record Keeping

The Martinos Center will keep records of all investigators certified to operate scanners including:

  • Date of safety video viewed
  • Date of training course completed, trainer
  • Date of qualifying scan session

Discovery of a Potential Abnormality During a Research Scan

On occasion, a potential abnormality will be discovered during a research MR scan. The abnormality may be a benign "normal variant" or may be something more serious. Most researchers at the Martinos Center are not trained to make this distinction (nor is the research study the appropriate situation for clinical diagnosis). However, it is important that investigators be prepared to handle such an event should it occur.

I. Research Data and Clinical Diagnosis
II.
If an Abnormality is Suspected
III.
Deciding to Terminate the Study
IV.
Additional Information
V.
Contact

 


I. Research Data and Clinical Diagnosis

Subjects participating in research experiments should be advised beforehand that the imaging data to be acquired is not equivalent to a diagnostic work-up. This should be stressed verbally and stated explicitly in the informed consent document. Similarly, when a research subject asks, "So does my brain look OK?” the investigator's response should be to reiterate the above.

For certain studies (especially those involving clinical populations, MGH patients, or others for whom the likelihood of discovering abnormalities is high), it is recommended (and sometimes required by the IRB) that arrangements be made by the PI for clinical readings of all MR scans acquired. For these studies, a procedure for acquiring appropriate images and handling clinical situations should be included in the research protocol, and explained in the informed consent document.

II. If an Abnormality is Suspected

If you suspect an abnormality during a scanning session, contact Mary O’Hara or Larry White, they will look at the images and contact a radiologist if necessary. If clinical follow-up is recommended, the radiologist (and not the researcher) should convey this to the subject.

If you are scanning after hours and no one is available for immediate consultation, the researcher should e-mail mri-time@nmr.mgh.harvard.edu with the subjects ID and Mary or Larry will have a radiologist review the images ASAP.

The researcher should never discuss the potential abnormality with the subject before a radiologist has been consulted and a medical professional has explained the situation to the subject.

III. Deciding to Terminate the Study

The researcher may or may not decide to terminate the study. In either case, care should be taken not to alarm the subject. The potential brain abnormality should not be discussed with the subject at this time.

IV. Additional Information

If additional questions arise concerning a specific case, the investigator may seek the advice of the MGH Human Subjects Optimum Care Committee (617-726-2988).

If a subject does not have insurance or cannot pay for recommended medical services, they may contact the MGH Social Services Office (617-726-2640).

V. Contact

Mary Foley or Larry White

 

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