Rationale & Background:
Magnetic resonance imaging (MRI) is an integral part of diagnostic workup and monitoring for many clinical problems, and its use in the United States has increased dramatically over the last 25 years.1-3 Both 1.5T and 3T machines are widely used, with each field strength preferred for certain imaging scenarios.4-6 Multiple types of implantable hearing devices (IHD) have current or prior contraindications to the use of MRI.
Position Statement:
Given the high likelihood of requiring an MRI scan in the future, maintaining access to MRI is critical for all patients receiving IHD. Manufacturers should make every effort to develop or implement the technology necessary to bring currently MRI unsafe devices to this standard and ensure future devices are MRI safe. As both 1.5T and 3T magnetic field strengths are desirable for different imaging applications, industry standard in labeling for IHD should be MRI conditional or MRI approved up to and including 3.0T. Considering literature demonstrating the possibility of significant complications in systems where magnet displacement is possible,7-17 MRI should be available to patients with IHD without the need for a head wrap. For patients with currently implanted devices which were not approved for MRI at time of implantation, every effort should be made to develop assistive devices, processes, or mechanisms to eliminate or minimize risk to the patient during MRI to enable access to MRI for these patients.
Supplement:
Device Manufacturer MRI Safety and Contact Information
| Manufacturer | Telephone | Website |
| Advanced Bionics | 877.829.0026 | https://www.advancedbionics.com/us/en/portals/professional-portal/products/mri-safety.html |
| Cochlear Americas | 800.523.5798 | https://www.cochlear.com/us/en/professionals/resources-and-training/mri-guidelines |
| Envoy Medical | 877.900.3277 | https://www.envoymedical.com/patients |
| MED-EL | 888.633.3524 | https://www.medel.com/important-safety-information |
| Medtronic | 800.874.5797 | https://www.medtronic.com/content/dam/medtronic-com/us-en/patients/treatments-therapies/bone-conduction/documents/alpha-2-mpo-eplus-product-brochure.pdf |
| Oticon Medical | 888.277.8014 | https://www.oticonmedical.com/us/support/i-have-a-ci-implant/safe-mri-scan |
| Ototronix | 855.696.2986 | http://www.ototronix.com/important-safety-information/ |
References:
- Mitchell JM. Utilization trends for advanced imaging procedures: evidence from individuals with private insurance coverage in California. Med Care 2008; 46:460-466.
- Smith-Bindman R, Kwan ML, Marlow ECet al. Trends in Use of Medical Imaging in US Health Care Systems and in Ontario, Canada, 2000-2016. JAMA 2019; 322:843-856.
- Smith-Bindman R, Miglioretti DL, Larson EB. Rising use of diagnostic medical imaging in a large integrated health system. Health Aff (Millwood) 2008; 27:1491-1502.
- Huang BY, Castillo M. Neurovascular imaging at 1.5 tesla versus 3.0 tesla. Magn Reson Imaging Clin N Am 2009; 17:29-46.
- Khodarahmi I, Fritz J. The Value of 3 Tesla Field Strength for Musculoskeletal Magnetic Resonance Imaging. Invest Radiol 2021; 56:749-763.
- Radbruch A, Paech D, Gassenmaier Set al. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 2. Invest Radiol 2021; 56:692-704.
- Broomfield SJ, Da Cruz M, Gibson WP. Cochlear implants and magnetic resonance scans: A case report and review. Cochlear Implants Int 2013; 14:51-55.
- Carlson ML, Neff BA, Link MJet al. Magnetic Resonance Imaging With Cochlear Implant Magnet in Place: Safety and Imaging Quality. Otol Neurotol 2015; 36:965-971.
- Cuda D MA, Succo G. Focused tight dressing does not prevent cochlear implant magnet migration under 1.5 tesla MRI. Acta Otorhinolaringol Ital 2013; 33:133–136.
- Grupe G, Wagner J, Hofmann Set al. Prevalence and complications of MRI scans of cochlear implant patients : English version. HNO 2017; 65:35-40.
- Hassepass F, Stabenau V, Arndt Set al. Magnet dislocation: an increasing and serious complication following MRI in patients with cochlear implants. Rofo 2014; 186:680-685.
- Jeon JH, Bae MR, Chang JW, Choi JY. Reversing the polarity of a cochlear implant magnet after magnetic resonance imaging. Auris Nasus Larynx 2012; 39:415-417.
- Kim BG, Kim JW, Park JJ, Kim SH, Kim HN, Choi JY. Adverse events and discomfort during magnetic resonance imaging in cochlear implant recipients. JAMA Otolaryngol Head Neck Surg 2015; 141:45-52.
- Ozturk E, Doruk C, Orhan KS, Celik M, Polat B, Guldiken Y. A Rare Complication of Cochlear Implantation After Magnetic Resonance Imaging: Reversion of the Magnet. J Craniofac Surg 2017; 28:e372-e374.
- Shew M, Wichova H, Lin J, Ledbetter LN, Staecker H. Magnetic resonance imaging with cochlear implants and auditory brainstem implants: Are we truly practicing MRI safety? Laryngoscope 2018.
- Walker B, Norton S, Phillips G, Christianson E, Horn D, Ou H. Comparison of MRI in pediatric cochlear implant recipients with and without retained magnet. Int J Pediatr Otorhinolaryngol 2018; 109:44-49.
- Young NM, Rojas C, Deng J, Burrowes D, Ryan M. Magnetic Resonance Imaging of Cochlear Implant Recipients. Otol Neurotol 2016; 37:665-671.
