Adapting to survive – This is aimed at MR types but the topic of change and future proofing could be applicable to many areas.

I am no oracle, influencer or business mogul (although I did try to ski moguls once – disaster), but I think that radiographers, and MR techs in particular should start looking to their future. AI and machine learning are on our doorstep and MR techs need a tangible asset to assist in ongoing employment. That asset is an in-depth knowledge of MR Safety. More on that later, but first some boring indulgence I like to call ‘background’.

I had my first MR in a Fonar in 1990 and they thought I had a brain tumour (which may have explained a few things) but it turned out to just be a big cystic hole in my head (which definitely explained a few things and proved my father’s theory). The scan took an age and I was comforted by the human voice between the scans.

Forward two years and I was working on a Siemens Magnetom where we had plenty of time to learn the physics during scans when the dual echo PD/T2 took 8:43 minutes. We came to understand sequence parameter manipulation in detail – especially if the patient moved and we repeated.

As scans got faster, our attention expanded to recognising anatomy and pathology so we could rub our radiologists nose in it if they missed anything – kind of a sport really, just not sanctioned by the IOC. This focus has held fast up until recently. If you work in one of our scanners and can’t tell the difference between an arachnoid cyst and an epidermoid, think the duct of Santorini is a river in Greece, or haven’t got a filthy acrostic that helps you identify the cranial nerves, you are in trouble.

But, like all else in life, things change (can’t remember if that is paraphrasing Gandhi or my mother talking about undies). Not being a particularly bright person I decided that I would leach the brainpower of others. To that end I became a conference organiser (specifically a Certified Event Manager – yep, its a thing) and have been doing that part time since 94. Over that time I have begged and pleaded with some of the greatest minds in the radiology world to come and talk in Australia – even those that are already here. If all else fails, pulling out the sob story about the pseudo brain tumour comes to my aid.

Anyway, I digress, the point of this was supposed to be that the gurus repeatedly demonstrated that we are becoming increasingly automated, and if you extrapolate that to its logical conclusion, the machines we work on will be able to do most of what we pride ourselves on doing now.

You have probably seen the machine that never misses when cannulating, the gradual but ever increasing implementation of compressed sensing, the coils that recognise where anatomy is, the beginnings of AI reading scans, and those weird, dog-like robots. Actually the last thing hasn’t got anything to do with it but they kind of freak me out.

I would suspect that with the speed things are changing, we have 5-10 years at most in our current mode. Speaking to Dr Elliot Fishman (name drop – kaboom) the other day and saying that a few of the radiologists I knew didn’t think AI would affect them too much when it arrived. He replied ‘too late, it is already here’ and reminded me that it is advancing rapidly in every field and endeavour, which made me check my radiology-centric thoughts.

Vendors will develop algorithms that will automatically sense anatomy, select the appropriate scan parameters according to the referral, highlight irregularities in anatomy/pathology and from there possibly generate a report. Where does that leave us?

I am an arch cynic, so the more often I hear people from outside radiology (physicists, cyber dudes, entrepreneurs) working on things that will make them a squillion bucks assuring me that there is little to worry about, the more I worry.

Well, this circuitous and torturous journey has led me back to what I could have said in a few sentences. I think that humans will always prefer humans to take care of them and that humans have an intuitive side which allows us to ascertain if people are not telling the whole truth when answering questions. Also, we are getting implanted with increasing amounts of stuff to help us live better/longer.

The combination of these factors makes MR Safety a prime candidate for helping us keep our positions. We will become even more-so the gatekeepers of our realm (insert dramatic fantasy music) and I would guess that a few super-users will set up the machines and their protocols and then we will be the patient protectors/escorts who also enter data.

So to conclude my first and probably last ever dissertation (sounds more impressive than ‘disjointed crazy talk’), now is the time to study your MR Safety and future-proof yourself.

When I asked him, Manny Kanal (name drop 2 – kablam), had this to say about the future in his usual concise style –ask him for a sentence, get a chapter 😉

“I am a pilot, and much of what I learned about implementing safety comes from the aviation industry. Safety dramatically improves when we learn to not just use, but actually fully master, two things in the cockpit: Checklists and Automation. Add to that in-depth knowledge about the underlying mechanisms governing flight, and you become the true master of the modality. These are what separate a good pilot from a great pilot. It is the same with MR professionals. The best of the best know and master and always implement safety checklists, take full advantage of all automation technology available, and truly understand the technology running MR imaging systems. That is the difference between the technician and the technologist… the employee versus the professional. And it is that which will be even more desperately required in our industry as it continues to progress and advance.”

Of course, I have never been right about much before, so not too confident at improving my record, but there is always a first time. All this being said, I think it is a very exciting time to be alive and can’t wait to see what’s around the corner.

At present Australian MR techs/docs have an opportunity to take the ABMRS exam for MR Safety Certification. MR Safety does not change when it crosses borders and it is ludicrous to think that every country around the world would set their own exam – 194 differing exams does not spell standardisation and standardisation is what we need. This exam has been set by some of the most knowledgeable people in the field and modified for an international audience. The RANZCR has adopted the MRMD/SO/SE model so it is a perfect fit.

Radiologists should note that with this model, you are the one in the box seat when making MR Safety decisions. It is an empowering thing to actually understand the subject that you are in charge of controlling.

Details at if you are interested. If we get 100 takers by 13/3/2018 for the exam it goes ahead, if not, the exam money is refunded in full.

Its time to grasp the nettle –don’t let this fantastic opportunity pass us by.

Rhys Wallace 
MR Tech & PCO

n.b. I have no financial affiliation whatsoever with the ABMRS. I have paid for the venue as I see the exam as worthwhile and way past time we had it.