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Pregnancy testing before MRI for neuroimaging research: Balancing risks to fetuses with risks to youth and adult participants

  • Tamara J. Sussman
    Correspondence
    Corresponding author: 1051 Riverside Drive, Room 6307, New York, New York, 10032,
    Affiliations
    Department of Psychiatry, Columbia University, New York, NY, USA, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY 10032, USA
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  • David Pagliaccio
    Affiliations
    Department of Psychiatry, Columbia University, New York, NY, USA, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY 10032, USA
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Published:August 21, 2022DOI:https://doi.org/10.1016/j.bpsc.2022.08.006
      While conducting research, it is crucial to protect our participants from undue risk. For human neuroimaging, many institutions require excluding pregnant people from completing magnetic resonance imaging (MRI) for research to minimize potential risk. This often entails mandatory urine pregnancy testing for all people assigned female at birth who have started to menstruate. This restriction stemmed from early concerns about fetal health from animal studies that have not been substantiated through human research. Yet, some institutions do not require this and many researchers are actively pursuing human fetal MRI.

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      References

        • Heinrichs W.L.
        • Fong P.
        • Flannery M.
        • Heinrichs S.C.
        • Crooks L.E.
        • Spindle A.
        • Pedersen R.A.
        Midgestational Exposure of Pregnant Balb/C Mice to Magnetic-Resonance Imaging Conditions.
        Magn Reson Imaging. 1988; 6 (PubMed PMID: WOS:A1988N803000013): 305-313https://doi.org/10.1016/0730-725x(88)90407-9
        • Yip Y.P.
        • Capriotti C.
        • Talagala S.L.
        • Yip J.W.
        Effects of Mr Exposure at 1.5-T on Early Embryonic-Development of the Chick.
        Jmri-J Magn Reson Im. 1994; 4 (PubMed PMID: WOS:A1994PH08900014): 742-748https://doi.org/10.1002/jmri.1880040518
        • Mevissen M.
        • Buntenkotter S.
        • Loscher W.
        Effects of Static and Time-Varying (50-Hz) Magnetic-Fields on Reproduction and Fetal Development in Rats.
        Teratology. 1994; 50 (PubMed PMID: WOS:A1994QF41100007): 229-237https://doi.org/10.1002/tera.1420500308
      1. Magin RL, Lee JK, Klintsova A, Carnes KI, Dunn F. Biological effects of long-duration, high-field (4 T) MRI on growth and development in the mouse. J Magn Reson Imaging. 2000;12(1):140-149. doi: Doi 10.1002/1522-2586(200007)12:1<140::Aid-Jmri15>3.3.Co;2-149. PubMed PMID: WOS:000171294600015.

        • Tyndall D.A.
        • Sulik K.K.
        Effects of Magnetic-Resonance-Imaging on Eye Development in the C57bl/6j Mouse.
        Teratology. 1991; 43 (PubMed PMID: WOS:A1991EZ23300009): 263-275https://doi.org/10.1002/tera.1420430310
        • Glover P.
        • Hykin J.
        • Gowland P.
        • Wright J.
        • Johnson I.
        • Mansfield P.
        An assessment of the intrauterine sound intensity level during obstetric echo-planar magnetic resonance imaging.
        Br J Radiol. 1995; 68 (Epub 1995/10/01. PubMed PMID: 7496710): 1090-1094https://doi.org/10.1259/0007-1285-68-814-1090
        • Mervak B.M.
        • Altun E.
        • McGinty K.A.
        • Hyslop W.B.
        • Semelka R.C.
        • Burke L.M.
        MRI in pregnancy: Indications and practical considerations.
        J Magn Reson Imaging. 2019; 49 (PubMed PMID: WOS:000459608500001): 621-631https://doi.org/10.1002/jmri.26317
        • Zvi E.
        • Shemer A.
        • Toussia-Cohen S.
        • Zvi D.
        • Bashan Y.
        • Hirschfeld-Dicker L.
        • Oselka N.
        • Amitai M.M.
        • Ezra O.
        • Bar-Yosef O.
        • Katorza E.
        Fetal Exposure to MR Imaging: Long-Term Neurodevelopmental Outcome.
        AJNR Am J Neuroradiol. 2020; 41 (Epub 2020/09/12. PubMed PMID: 32912871; PMCID: PMC7658847): 1989-1992https://doi.org/10.3174/ajnr.A6771
        • Chartier A.L.
        • Bouvier M.J.
        • McPherson D.R.
        • Stepenosky J.E.
        • Taysom D.A.
        • Marks R.M.
        The Safety of Maternal and Fetal MRI at 3 T.
        Am J Roentgenol. 2019; 213 (PubMed PMID: WOS:000492296800038): 1170-1173https://doi.org/10.2214/Ajr.19.21400
        • Jaimes C.
        • Delgado J.
        • Cunnane M.B.
        • Hedrick H.L.
        • Adzick N.S.
        • Gee M.S.
        • Victoria T.
        Does 3-T fetal MRI induce adverse acoustic effects in the neonate? A preliminary study comparing postnatal auditory test performance of fetuses scanned at 1.5 and 3 T.
        Pediatr Radiol. 2019; 49 (Epub 2018/10/10. PubMed PMID: 30298210): 37-45https://doi.org/10.1007/s00247-018-4261-2
        • Ray J.G.
        • Vermeulen M.J.
        • Bharatha A.
        • Montanera W.J.
        • Park A.L.
        Association Between MRI Exposure During Pregnancy and Fetal and Childhood Outcomes.
        Jama-J Am Med Assoc. 2016; 316 (PubMed PMID: WOS:000382460200018): 952-961https://doi.org/10.1001/jama.2016.12126
        • Bouyssi-Kobar M.
        • du Plessis A.J.
        • Robertson R.L.
        • Limperopoulos C.
        Fetal magnetic resonance imaging: exposure times and functional outcomes at preschool age.
        Pediatr Radiol. 2015; 45 (PubMed PMID: WOS:000363522500012): 1823-1830https://doi.org/10.1007/s00247-015-3408-7
        • Choi J.S.
        • Ahn H.K.
        • Han J.Y.
        • Han Y.J.
        • Kwak D.O.
        • Velazquez-Armenta E.Y.
        • Nava-Ocampo A.A.
        A case series of 15 women inadvertently exposed to magnetic resonance imaging in the first trimester of pregnancy.
        J Obstet Gynaecol. 2015; 35 (PubMed PMID: WOS:000369868400035): 871-872https://doi.org/10.3109/01443615.2015.1017559
        • Strizek B.
        • Jani J.C.
        • Mucyo E.
        • de Keyzer F.
        • Pauwels I.
        • Ziane S.
        • Mansbach A.L.
        • Deltenre P.
        • Cos T.
        • Cannie M.M.
        Safety of MR Imaging at 1.5 T in Fetuses: A Retrospective Case-Control Study of Birth Weights and the Effects of Acoustic Noise.
        Radiology. 2015; 275 (PubMed PMID: WOS:000355987700025): 530-537https://doi.org/10.1148/radiol.14141382
        • Reeves M.J.
        • Brandreth M.
        • Whitby E.H.
        • Hart A.R.
        • Paley M.N.J.
        • Griffiths P.D.
        • Stevens J.C.
        Neonatal Cochlear Function: Measurement after Exposure to Acoustic Noise during in Utero MR Imaging.
        Radiology. 2010; 257 (PubMed PMID: WOS:000284469300025): 802-809https://doi.org/10.1148/radiol.10092366
        • Kok R.D.
        • de Vries M.M.
        • Heerschap A.
        • van den Berg P.P.
        Absence of harmful effects of magnetic resonance exposure at 1.5 T in utero during the third trimester of pregnancy: a follow-up study.
        Magn Reson Imaging. 2004; 22 (PubMed PMID: WOS:000222493200012): 851-854https://doi.org/10.1016/j.mri.2004.01.047
        • Lum M.
        • Tsiouris A.J.
        MRI safety considerations during pregnancy.
        Clin Imag. 2020; 62 (PubMed PMID: WOS:000524352300011): 69-75https://doi.org/10.1016/j.clinimag.2020.02.007
      2. Gynecologists. ACoOa. Guidelines for diagnostic imaging during pregnancy and lactation. Obstetrics & Gynecology. 2017;130(4)(Committee Opinion No. 723. )

        • Maralani P.J.
        • Kapadia A.
        • Liu G.
        • Moretti F.
        • Ghandehari H.
        • Clarke S.E.
        • Wiebe S.
        • Garel J.
        • Ertl-Wagner B.
        • Hurrell C.
        • Schieda N.
        Canadian Association of Radiologists Recommendations for the Safe Use of MRI During Pregnancy.
        Can Assoc Radiol J. 2022; 73 (PubMed PMID: WOS:000745494300014): 56-67https://doi.org/10.1177/08465371211015657
      3. Grainger D. Safety guidelines for magnetic resonance imaging equipment in clinical use. 2014.

        • K E.
        • Barkovich A.J.
        • Bell C.
        • Borgstede J.P.
        • Bradley Jr., W.G.
        • Hernandez D.
        • Expert Panel on MR Safety
        ACR guidance document on MR safe practices: 2013.
        J Magn Reson Imaging. 2013; 37: 501-530
        • Quinn G.P.
        • Sutton S.K.
        • Winfield B.
        • Breen S.
        • Canales J.
        • Shetty G.
        • Sehovic I.
        • Green B.L.
        • Schabath M.B.
        Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) Perceptions and Health Care Experiences.
        J Gay Lesbian Soc Serv. 2015; 27 (Epub 2015/01/01. PubMed PMID: 30996583; PMCID: PMC6464116): 246-261https://doi.org/10.1080/10538720.2015.1022273
      4. Abma JC, & Martinez, G. M. . Sexual activity and contraceptive use among teenagers in the United States, 2011-2015. National health statistics reports, : 2017.

        • Chumlea W.C.
        • Schubert C.M.
        • Roche A.F.
        • Kulin H.E.
        • Lee P.A.
        • Himes J.H.
        • Sun S.S.
        Age at menarche and racial comparisons in US girls.
        Pediatrics. 2003; 111 (PubMed PMID: WOS:000180135200033): 110-113https://doi.org/10.1542/peds.111.1.110
        • Cavazos-Rehg P.A.
        • Krauss M.J.
        • Spitznagel E.L.
        • Schootman M.
        • Bucholz K.K.
        • Peipert J.F.
        • Sanders-Thompson V.
        • Cottler L.B.
        • Bierut L.J.
        Age of sexual debut among US adolescents.
        Contraception. 2009; 80 (PubMed PMID: WOS:000268983000009): 158-162https://doi.org/10.1016/j.contraception.2009.02.014
      5. NYCLU. ACLU of New York; [updated July 8, 2022]. Available from: https://www.nyclu.org/en/know-your-rights/your-rights-pregnant-or-parenting-teen#:∼:text=You%20have%20the%20right%20to,HIV%20test%20without%20your%20permission.

      6. State OotGoNY. Abortion Access Always: Governor Hochul Announces Robust, Multi-Platform Public Education Campaign for All Seeking Reproductive Healthcare 2022 [cited 2022 7/7/2022]. Available from: https://www.governor.ny.gov/news/abortion-access-always-governor-hochul-announces-robust-multi-platform-public-education.

        • Trotta D.
        Prosecutor to drop charges against Texas woman over her abortion.
        Reuters. 2022 April 11; : 2022
      7. Dzhanova Y. Americans should be 'really careful' about using period-tracking apps now that Roe v. Wade is gone, White House warns. Business Insider. 2022 Jul 9, 2022, 10:52 AM.

      8. NIH. Available from: https://grants.nih.gov/policy/humansubjects/coc/information-institutional-responsibilities.htm.

      9. Rutgers. PREGNANCY TEST RELEASE FORM. Available from: https://rubic.rutgers.edu/RUBIC-MRI-revised-pregnancy-2022.pdf.

      10. CAMRIS. CAMRIS Policy and Procedures. Available from: https://www.med.upenn.edu/camris/policy-and-procedures.html.

      11. Committee for Protection of Human Subjects UoC, Berkeley. MAGNETIC RESONANCE IMAGING (MRI) IN RESEARCH 2021. Available from: https://cphs.berkeley.edu/mri.pdf.

      12. FDA. FDA Drug Safety Communication: FDA warns that gadolinium-based contrast agents (GBCAs) are retained in the body; requires new class warnings. 2017.