About Tobias Gilk, Editor

This blog is written, edited and maintained by Tobias Gilk, a certified MR Safety Officer (MRSO).

Tobias offers a vendor-neutral consulting service for radiology / imaging providers, providing guidance with respect to safety, operations, best practices, and accreditation standards (such as those from the Joint Commission and the American College of Radiology).

Additionally, Tobias is a Board member and officer of the American Board of Magnetic Resonance Safety (ABMRS), serves as Senior Vice President of RADIOLOGY-Planning (a company that designs radiology, nuclear medicine and radiation therapy facilities for healthcare providers), and was the former President and MRI Safety Director for Mednovus (a manufacturer of ferromagnetic detection products). Tobias is a prior member of the ACR’s MR Safety Committee (chaired by MRI safety expert, Emanuel Kanal, MD) and one of the co-authors of the ACR’s Guidance Document for Safe MR Practices: 2007, is a former member of the Corporate Advisory Board for the Institute for Magnetic Resonance Safety, Education and Research (founded by Frank Shellock, Ph.D.), and has written or contributed to a combined total of hundreds of articles, presentations and best-practice standards documents on MRI safety.

Tobias’ articles are published widely, and he is a highly regarded speaker and consultant on MRI safety issues, having been invited to present at national and international conferences and meetings.

This blog represents Tobias’ individual professional musings and are not necessarily those of any of the organizations or companies with which he is associated.

Want to contact Tobias? You can reach him via the contact information at the bottom of each of his posts on this blog, or contact him through Facebook by clicking the link below…

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Or contact him through Twitter via his profile there…

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23 thoughts on “About Tobias Gilk, Editor

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  8. Matt Woods

    Tobias I work at a Hospital that just recently moved our MRI from a trailer parked on the lot to inside the Hospital. My boss and I are trying to revamp our Safety manual as there are a few more people with access now. We do all the normal screening and questions but would like to have a video to share with new hires and all personel not associated with the radiology department. I was wondering if you could give me a website and or place to purchase a video and any tips on making a easy to understand mri safety protocol. We have never had a problem with MRI safety yet and are trying to be proactive. Thanks for any help you can give me. Matt Woods Rt(R)(MR)

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  11. kim Greco

    Ryan,
    Do you have any tips on how to handle these situations? I am currently working in an MRI clinic. We have 2 MRI Technologists: hours 730-430. We have no PSA/Clerical support. Technologists are required to protocol/schedule/mail apt letters/answer phone/ screen pts/gather implant information/medical surgical reports and eventually scan the patient. As you can imagine there are many daily distractions. The technologists are concerned for patient safety/privacy.
    All scheduling is done in zone 3 which is a huge concern.(privacy) We also have a backlog of 5 weeks in scheduling due to these insufficiencies. Management was alerted.
    The technologists made suggestions to management:
    1 Technologist will work 3- 12 hour shifts to open up 3 nights per week( 430-8 pm )
    1 CT Technologist to cross train in MRI to work on the 2 days the 12 hour technologist is not here.
    *A requirement of 2 technologists in the MRI area is mandatory by policy , except for emergencies. (This happens frequently-sick, vacation etc. )
    Also a tech aid was hired to work with the 12 hour Technologist for the 3 evening shifts.
    Our concern still is the scheduling and lack of PSA/Clerical support.
    Can you imagine arriving at your doctor’s office with no one at the front desk?
    The only support is a CT PSA that calls MRI to tell them a patient is here-however that PSA is out on leave frequently or not at the desk. This is a huge problem for us.
    Can you make any suggestions to help these deficiencies? Could you provide me with a model/data to prove PSA/Clerical help is needed in this area?
    Kimberly Greco
    Kimberly.greco@va.gov

    How would I research information that states how to staff for an MRI Clinic?

  12. Tobias Gilk Post author

    Hello Kim,
    First, as a general resource, I might suggest that you look at RBMA (Radiology Business Management Association). They might have resources specific to MR staffing that would be helpful to you.
    It sounds to me as though your MR techs are being asked to do too much that isn’t scanning the patients. If you’re running with weeks of backlog, I think that there are a few things that warrant attention.

    1. before adding hours of operation, I think it would be more beneficial to have someone look at operational efficiency, from patient scheduling / screening, down to the protocols / sequences used for standard MR exams. Shaving 5 minutes off each exam can make a huge difference when evaluated over weeks / months.

    2. make better use of resources I bet you already have. I suspect that your facility has a centralized scheduling function, and I would suggest seeing if you can get them to schedule and pre-screen your patients. I would not count on this pre-screen to be thorough, so I would have the MR staff do the follow-up, appointment confirmation call in which your staff reviews the screening information with the patient, but regular schedulers should at least be able to weed-out (or red-flag) pacemaker or shrapnel patients for you.

    I hope these suggestions help, at least a bit.

    Tobias

  13. Tobias Gilk Post author

    Kim,

    Often times it is hugely beneficial to have someone from the outside come in to help streamline operations. If you ever need it, I’d be happy to recommend some people who might be able to make a huge difference for you.

    Tobias

  14. Betty M.

    My husband is scheduled for an MRI in the next week or so for some back pain. He has worked as a metal fabricator/welder for 30+ years and has been exposed to metals (steel, aluminum, etc.) for the entire time, including the inhalation of (metal) fumes. Should he have any safety concerns with how an MRI device might react during the MRI procedure? Is it possible that his body could have some lingering metal in it due to this continuous daily exposure? Any advice is appreciated. Thank you.

  15. Tobias Gilk Post author

    Betty, I’m sorry to be slow in replying to your questions. I trust that – by now – your husband’s MRI is over, and that it went smoothly. But even so, let me tackle your questions.
    Metals can be a safety risk, and an image-quality risk. I’m not aware of any reported issues with the inhalation of fumes containing metal. Interesting, but not something that I’m aware of having any safety implications.
    Any electrically-conductive material (which is pretty much all metals) can potentially be at risk of heating, but they generally have to be fairly long, and not a ‘splinter’ or a ‘bb’. Ferromagnetic materials can be risks because of the way that the MRI scanner likes to pull and twist on those types of metals.
    If your husband has any known retained metal within his body, it is extremely important to let the MRI provider know about it, in advance. Most of the time it turns out to not be a major safety concern, but we want to make sure that the radiologist who is going to be responsible for the safety of the exam helps to make that call.
    I hope this helps, even if it is a bit late.

  16. Alice Price

    I was diagnosed with a meningioma in November 2012 and have been having MRIs regularly since then. In the last 3 months, my left ankle sets off the airport metal detector. It has happened 4 times. Is it possible the metal in the contrast is accumulating in my body?
    Thank you.

  17. Tobias Gilk Post author

    A very interesting question…

    There is very recent research in the radiology journals that demonstrate that some patients (and we don’t yet know how many or why) appear to retain measurable amounts of some of the gadolinium contrast agents (linear structured agents, not any of the macrocyclics, as of yet). The amounts / concentrations of the retained contrast is very small, and I would be surprised if an airport-style metal detector would be capable of either the quantity (very small) or a diffuse distribution of contrast (if it were throughout the body). And since gadolinium contrast is typically injected into an MRI patient’s bloodstream when used, that it would accumulate in one ankle, of all the places in the body, seems to me to be very unlikely.

    I’m not sure what may be causing the metal detectors to alarm on your ankle, but in my opinion it is extraordinarily unlikely that it relates to MRI contrast. If you have any questions about this, however, I recommend that you speak with the radiologist who has read one of your recent MRI scans.

    I hope this helps.

  18. Lynds

    I need to contact Tobias Gilk ASAP. Time is of the essence. Please answer.
    Thank you,
    Lynda

  19. Rebeeca J. Reyes

    Had MRI of c spine on 5/14/14 in which tech inadvertently placed a lead apron with cable on my abdominal area. Thereafter, I felt pain in my back and shock sensations all over my body even up this day. Pain in back showed white patches and diagnosed as hypopigmentation of skin in back. Other dermatologists said it was due to severe dry skin. Also, bursting pain in head and later on MRI of head revealed 2 small lesions in brain of unknown tumors. Last Sept 6, 2016 a neurosurgeon in Chicago (I am from Las Vegas, Nv) told me that he couldn,t clear identify the lesions. They are neither epidermoid nor arachnoid cysts. Another neurosurgeon gave a conflicting opinion and advised that I see him in 6 months. I have had 3 MRIs of the brain and the lesions remain stable in size and nature. I felt pain everyday but it feels like more “shock” rather than a prolonged and lingering pain.

    None of the lawyers in Nevada would accept my case because they told me that it was hard to prove and that MRI is a very safe procedure. Other attys told me that they represent the provider in the past.
    I was also diagnosed with a small cyst in liver. The cable was close to my right abd. and the pain originated from that area. A surgeon took a small piece of tissue from lower abd. area knowing that the pain was from upper side of abdomen …… pathology report revealed lipoma.
    Right now, a lawyer friend is willing to represent me if I could have a provider/expert willing to provide an absolute causation or medical certainty that my condition was from the medical error during the MRI procedure. My PCP diagnosed me with shock and hypopigmentation of skin months after the MRI with metal. She, too, did not believe that I could have mishaps during MRI. Pls. help. I am concern of the lesions in my brain. Neurosurgeon suggested that I need MRI of brain every 6 months to evaluate if the lesions are growing.

  20. Tobias Gilk Post author

    Rebecca,

    It would be highly irregular for there to be a lead apron in MRI (lead is a frequent shielding material for ionizing radiation, such as X-rays, but has no practical use in MRI, which uses magnetism and radio frequency energies).

    It sounds as if you’re looking for a medical diagnosis, which I’m afraid I can’t give. I would encourage you to share any health concerns with your physician(s) (which it sounds as if you’re doing). I do wish you well.

    Respectfully,

    Tobias

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