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Biological Effects and Safety in Magnetic Resonance Imaging: A Review

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      Abstract

      Since the introduction of Magnetic Resonance Imaging (MRI) as a diagnostic technique, the number of people exposed to electromagnetic fields (EMF) has increased dramatically. In this review, based on the results of a pioneer study showing in vitro and in vivo genotoxic effects of MRI scans, we report an updated survey about the effects of non-ionizing EMF employed in MRI, relevant for patients’ and workers’ safety. While the whole data does not confirm a risk hypothesis, it suggests a need for further studies and prudent use in order to avoid unnecessary examinations, according to the precautionary principle.

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      Most cited references 73

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      Guidelines for limiting exposure to time-varying electric, magnetic, and electromagnetic fields (up to 300 GHz). International Commission on Non-Ionizing Radiation Protection.

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        An increased micronucleus frequency in peripheral blood lymphocytes predicts the risk of cancer in humans.

        The frequency of micronuclei (MN) in peripheral blood lymphocytes (PBL) is extensively used as a biomarker of chromosomal damage and genome stability in human populations. Much theoretical evidence has been accumulated supporting the causal role of MN induction in cancer development, although prospective cohort studies are needed to validate MN as a cancer risk biomarker. A total of 6718 subjects from of 10 countries, screened in 20 laboratories for MN frequency between 1980 and 2002 in ad hoc studies or routine cytogenetic surveillance, were selected from the database of the HUman MicroNucleus (HUMN) international collaborative project and followed up for cancer incidence or mortality. To standardize for the inter-laboratory variability subjects were classified according to the percentiles of MN distribution within each laboratory as low, medium or high frequency. A significant increase of all cancers incidence was found for subjects in the groups with medium (RR=1.84; 95% CI: 1.28-2.66) and high MN frequency (RR=1.53; 1.04-2.25). The same groups also showed a decreased cancer-free survival, i.e. P=0.001 and P=0.025, respectively. This association was present in all national cohorts and for all major cancer sites, especially urogenital (RR=2.80; 1.17-6.73) and gastro-intestinal cancers (RR=1.74; 1.01-4.71). The results from the present study provide preliminary evidence that MN frequency in PBL is a predictive biomarker of cancer risk within a population of healthy subjects. The current wide-spread use of the MN assay provides a valuable opportunity to apply this assay in the planning and validation of cancer surveillance and prevention programs.
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          MR procedures: biologic effects, safety, and patient care.

          The technology used for magnetic resonance (MR) procedures has evolved continuously during the past 20 years, yielding MR systems with stronger static magnetic fields, faster and stronger gradient magnetic fields, and more powerful radiofrequency transmission coils. Most reported cases of MR-related injuries and the few fatalities that have occurred have apparently been the result of failure to follow safety guidelines or of use of inappropriate or outdated information related to the safety aspects of biomedical implants and devices. To prevent accidents in the MR environment, therefore, it is necessary to revise information on biologic effects and safety according to changes that have occurred in MR technology and with regard to current guidelines for biomedical implants and devices. This review provides an overview of and update on MR biologic effects, discusses new or controversial MR safety topics and issues, presents evidence-based guidelines to ensure safety for patients and staff, and describes safety information for various implants and devices that have recently undergone evaluation. Copyright RSNA, 2004
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            Author and article information

            Affiliations
            [1] ITENI Laboratory, CNR Institute of Clinical Physiology, Pisa, Italy; E-Mails: valeh@123456ifc.cnr.it (V.H.); giovannetti@123456ifc.cnr.it (G.G.)
            [2] Department of Information Engineering, University of Pisa, Italy; E-Mail: nicvanel@123456ifc.cnr.it
            [3] MRI Laboratory, G. Monasterio Foundation and CNR Institute of Clinical Physiology, Pisa, Italy; E-Mail: lomass@123456ifc.cnr.it
            [4] Cell Biology and Cytogenetics Unit, CNR Institute of Clinical Physiology, Pisa, Italy
            Author notes
            [*]Authors to whom correspondence should be addressed; E-Mails: llandini@123456ifc.cnr.it (L.L.); s.simi@123456ifc.cnr.it (S.S.); Tel.: +39 050 3152779, +39 050 3152615; Fax: +39 050 315 2166
            Journal
            Int J Environ Res Public Health
            101238455
            International Journal of Environmental Research and Public Health
            Molecular Diversity Preservation International (MDPI)
            1661-7827
            1660-4601
            June 2009
            10 June 2009
            : 6
            : 6
            : 1778-1798
            2705217
            19578460
            10.3390/ijerph6061778
            ijerph-06-01778
            © 2009 by the authors; licensee Molecular Diversity Preservation International, Basel, Switzerland.

            This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).

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