Metallic implants in MRI. Hazards and imaging artifacts

Magnetic resonance imaging (MRI) is an examination method for noninvasive soft tissue imaging without the use of ionizing radiation. Metallic implants, however, may pose a risk for the patient and often result in imaging artifacts. Due to the increasing number of implants, reducing these artifacts has become an important goal. In this review, we describe the risks associated with implants and provide the background on how metal-induced artifacts are formed. We review the literature on methods on how to reduce artifacts and summarize our findings. The literature was searched using PubMed and the keywords "MRI metal artifact reduction", "metallic implants" and "MRI artefacts/artifacts". The MRI compatibility of implants has to be evaluated individually. To reduce artifacts, two general approaches were found: a) parameter optimization in standard sequences (echo time, slice thickness, bandwidth) and b) specialized sequences, such as VAT, OMAR, WARP, SEMAC and MAVRIC. These methods reduced artifacts and improved image quality, albeit at the cost of a (sometimes significantly) prolonged scan time. New developments in accelerated imaging will likely shorten the scan time of these methods significantly, such that routine use may become feasible.