The Reading Room Podcast: A Closer Look at MRI Safety for Pediatric Patients

While MRI safety incidents involving pediatric patients are rare, there are common causes in the Zone IV MRI safety incidents that do occur in this patient population, according to recently published research in the Journal of the American College of Radiology.

In the study, conducted at five U.S. children’s hospitals over a six-year period, researchers noted 146 Zone IV safety incidents in a total of 540,987 MRI exams. The study authors noted that projectiles were involved in 30 percent of the safety incidents and burn/thermal injuries occurred in 13 percent of the Zone IV cases.¹

In a recent Reading Room podcast, Tobias Gilk, MRSO, MRSE, and Emanuel Kanal, MD, shared their perspectives on the research and key takeaways from the study.

Gilk noted three key principles that are over 90 percent effective in preventing thermal/burn injuries, including physical separation from the bore wall, the use of padding to prevent skin to skin contact and removal of any materials that could be electrically conductive. Gilk added that clinicians should also be on the lookout for antimicrobial elements in clothing.

“(There) can also be antimicrobial treatments in off-the-shelf clothing, and those antimicrobial treatments are typically nanoparticles, silver or copper, which means it may look like a cotton shirt. But if it's antimicrobial, it essentially could be metal, very fine quantities of metal, and (one) could wind up heating up a patient's t-shirt as has been done before,” pointed out Gilk, founder of Glik Radiology Consultants, senior vice president of RADIOLOGY-Planning and board member of the American Board of Magnetic Resonance Safety (ABMRS).

The researchers also found that safety protocols were not followed in 60 percent of the Zone IV MRI safety incidents.¹

“It's overtly rare for us to hurt people in MRI anywhere ever. That having been said, the real issue (is that) virtually 100 percent of the time that we do injure someone, it's pilot error. It's our fault, and that means they're avoidable. That means they didn't have to happen. That means we can do better. So, in that sense, this paper, if anything, helps to highlight exactly that,” emphasized Dr. Kanal, the director of magnetic resonance services and chief of the Division of Emergency Radiology at the University of Pittsburgh Medical Center (UPMC).

For more insights from Emanuel Kanal, MD and Tobias Gilk, listen below or subscribe on your favorite podcast platform.

Reference

1. Guan A, Iyer RS, Barth RA, et al. Pediatric MRI safety: frequency, types, and severity of zone IV MRI safety events at five U.S. children’s hospitals. J Am Coll Radiol. 2026 May 8:S1546-1440(26)00244-9. doi: 10.1016/j.jacr.2026.05.013. Online ahead of print.