title: Surgical briefings, checklists, and the creation of an environment of safety in the neurosurgical intraoperative magnetic resonance imaging suite.
abstract: Technological advances have made it possible to seamlessly integrate modern neuroimaging into the neurosurgical operative environment. This integration has introduced many new applications improving surgical treatments. One major addition to the neurosurgical armamentarium is intraoperative navigation and MRI, enabling real-time use during surgery. In the 1970s, the American College of Radiology issued safety guidelines for diagnostic MRI facilities. Until now, however, no such guidelines existed for the MRI-integrated operating room, which is a high-risk zone requiring standardized protocols to ensure the safety of both the patient and the operating room staff. The forces associated with the strong 1.5- and 3.0-T magnets used for MRI are potent and hazardous, creating distinct concerns regarding safety, infection control, and image interpretation. Authors of this paper provide an overview of the intraoperative MRI operating room, safety considerations, and a series of checklists and protocols for maintaining safety in this zero tolerance environment.
authors.affiliation: Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Gazanfar
authors.initials: G
authors.lastname: Rahmathulla
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Recinos
authors.forename: David E
authors.initials: DE
authors.lastname: Traul
authors.forename: Rafi
authors.initials: R
authors.lastname: Avitsian
authors.forename: Marisa
authors.initials: M
authors.lastname: Yunak
authors.forename: Nicole T
authors.initials: NT
authors.lastname: Harper
authors.forename: Gene H
authors.initials: GH
authors.lastname: Barnett
authors.forename: Violette Renard
authors.initials: VR
authors.lastname: Recinos
mesh_terms: D000758:Anesthesia; D057189:Checklist; D003199:Computer Systems; D004574:Electromagnetic Fields; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019300:Medical Errors / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods*; D009873:Operating Rooms / Q000458:organization & administration; D061214:Patient Safety