Ads create artifacts in MRI's public image

The uneasy relationship between the news media and radiology tookanother blow to the chin last week. MRI centers in the Los Angelesarea have been coping with a wave of canceled procedures aftera series of advertisements were broadcast claiming that MRI examscan kill patients.

The ads were promotions for a television news series that presenteda more balanced view of MRI, and the reporter who produced theseries disavowed the promo spots. But the damage has been done,and many radiologists are wondering if the ads will have a long-termeffect on the public's perception of MRI.

The radio and television spots aired in the first week of Februaryand promoted a three-part news series on MRI safety by consumerreporter David Horowitz. The series began Feb. 3 on the eveningnews on KCBS-TV in Los Angeles.

The spots began by extolling the utility of MRI in diagnosingtumors and back disorders. They concluded, however, with the assertionthat MRI can kill.

"The promos were out of this world," said Dr. CharlesSchatz, president of the Los Angeles Radiological Society. "Itwas terrible sensationalism. Unfortunately, it had a very, verynegative effect on the lay population."

The basis for the claims in the promos were isolated casesin which patients with ferrous material in their bodies have beenkilled or injured after undergoing MRI scans. The news seriesitself also focused on the complications patients have experiencedwhen prescan screening techniques failed to identify ferromagneticimplants or other foreign objects.

In the first segment of the series, Horowitz interviewed aman who said he was lifted off a scanner table after being allowedinto the magnet while wearing a belt with a metal buckle. Thesegment also described an incident in which a woman with a ferromagneticaneurysm clip was killed while undergoing a scan.

The complications described by the Horowitz series are notnew to radiologists and those familiar with MRI. Indeed, Horowitztold SCAN that the idea for the series was proposed by a radiologistas a way to educate the public about the potential dangers ofMRI for patients with ferromagnetic implants.

"What we're trying to do is to create awareness amongthe public about some of the safety things they need to know beforethey go in (for a scan)," Horowitz said. "What we havefound is that the public is really unaware of this."

The series did emphasize that the incidents being describedwere isolated, and that MRI scans are safe for most people.

"Medical experts are in agreement about the current safetyof magnetic resonance," Horowitz said during the program."It's safe to undergo an MRI, especially if it can help yourdoctor detect a problem during the early stages, something thatcan be treated quickly."

But the promos for the series are another matter.

"I had nothing to do with promos," Horowitz said."The result of this is that everything that is being promotedfrom now on will come by me before the promo actually gets onthe air so at least I can read it."

In the aftermath of the series, radiologists in the Los Angelesarea are trying to determine the extent of the damage to MRI'simage. Radiologists contacted by SCAN said that the promos causedmany patients to cancel scans, although the exact number of cancellationshas not been determined.

The scare is the second such incident in three months in whichnews coverage has resulted in frightened patients and canceledimaging procedures. In December, a series of newspaper articlesin the Cleveland Plain Dealer on deaths from radiation therapycaused some patients to cancel nuclear medicine exams after theseries confused radiation therapy and nuclear medicine (SCAN 1/27/93).

In the end, the Horowitz series probably served the purposeof educating lay people about the potential dangers of MRI scansfor patients with ferromagnetic implants. But many industry observersfeel that the segments could have made their point in a less sensationalmanner.

"With any diagnostic procedure or a procedure that's performedin a hospital there's always a very remote risk of hazard to anindividual," said Frank Shellock, director of research anddevelopment at Tower Imaging in Los Angeles. Shellock was interviewedfor the program.

"The fact is that we do very elaborate screening procedures,and I don't think that message got across as much. They were emphasizingthe fact that people could die or get injured."