Underwear in MRI!

Recently there has been a lot of attention focussed on what patients wear in MRI. It comes after a case report detailing how a patient experienced skin burns in an MRI scanner in an unfortunate incident thought to be linked to her clothing.

The study explained that the patient's undershirt had silver-embedded microfibers which were likely to have caused the burns. As she was sedated she was unable to respond to the heating sensations and alert the radiographer.

Unfortunately no-one has tried to reconstruct this scenario in a scientific way and find the exact mechanism that caused the burn. The case study guessed that it may have been eddy currents generated in the material, or it could possibly have been due to the antenna effect, but these have not been proved. It is also an isolated case-study.

There have since been follow-up articles related to the use of so-called tech clothing in MRI. Tech clothing has seen a sharp increase in popularity in recent years, giving fabrics anti-microbial, heat-dissipating, and sun-shielding properties using a range of metal-based technologies. Silver, copper and zinc oxide can be encorporated into these garments, and so potentially could cause problems in MRI.

A study by Yang et al last year found that almost half of MRI radiographers don't always ask their patients to change their clothing before having their scan. For me the issue goes further than this. It is possible that a radiographer may overlook the patient's underwear, or be reluctant to make excessive enquiries into what is being worn. It could pose more of an issue if the patient is not the same gender as the radiographer.

If the patients wears cotton socks for his or her scan, it is unlikely that a conductive loop can be formed between the feet. But this can be a potential problem if they are wearing copper or silver-impregnated socks.

Another pitfall is the fact that tech clothes don't always have labels which properly detail their make-up. For example UnderArmour's Boxerjock comes in a box advertising it's 'Cupron antifungal fibers' which make up 2.6% of the garment. The large tear-away label inside the pants simply states 90% polyester 10% elastane. The same is printed inside the garment. I for one am not keen on fishing inside underwear to check for labels, and it seems that it wouldn't help to do this anyway.

Helen Yang's paper recommended always getting patients changed into hospital attire. This is good except for the fact that underwear was overlooked. Patients could change into a gown or scrubs but still have copper pants.

In the meantime someone needs to properly investigate if and exactly how tech materials pose a hazard in MRI. I can see it now....   Hotpants? MR safety of the Boxerjock by Shellock.

Martin Baker

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