ACR Blue Ribbon Panel response to the AJR commentary by Shellock and Crues on the ACR White Paper on MR Safety.

31 ince its recent publication, the “American College of Radiology [ACR] White Paper on MR Safety” and its “ACR Magnetic Resonance [MR] Safe Practice Guidelines” [1] have met with a continually growing wave of support that has proven to be most gratifying to all involved in its creation. There has been widespread support for the concept of standardization of MR safety practices throughout the MR industry in clinical and research settings as a means of helping to decrease the incidence of those adverse MR-related events that are potentially avoidable. Generation of guidelines that would meet with universal approval would be difficult. Lenient guidelines result in criticism from those who believe that not enough is being done to protect patients and MR health care workers from potentially avoidable adverse events. Stringent recommendations might invoke protests against excessive external controls and the expense of implementation and restriction of the free practice of medicine and diagnostic radiology. Each of these potential concerns is valid in its own right. The “ACR Magnetic Resonance Safe Practice Guidelines” presented in the “American College of Radiology White Paper on MR Safety” attempt to balance these concerns yet accomplish the stated objective of improving the safety of MR examinations. It is for these reasons that the comments by our colleagues, Shellock and Crues [2], in their commentary are most appreciated. Unfortunately several misunderstandings in the commentary have introduced a note of confusion to some in our industry who wish to apply these guidelines to their own practices. It is the purpose of this response to clarify these issues.