Latest / Rad Chat / E210: Hannah Barnsley - Implant Safety in MRI
Transcript
- Jo McNamara Rad Chat Host (00:00) Hello everyone and welcome to Rad Chat, founded by me, Jo McNamara. Naman Julka-Anderson (00:04) And me, Naman Julka-Anderson. Rad Chat is a forward-thinking global knowledge hub where healthcare professionals can advance their expertise in therapeutic radiography and oncology. Unlike traditional academic resources, we blend real-world experience, expert insights, best practice, and patient perspectives. Jo McNamara Rad Chat Host (00:21) We make advanced knowledge engaging and accessible, supporting continuous learning and professional development without compromising patient care or your personal time by providing insights into both technical skills and career development, helping you to progress confidently in your field and shape your professional future. Naman Julka-Anderson (00:38) Just to let you know, our episodes may contain sensitive and difficult topics that you might find distressing or triggering. Please consider checking out another episode. Jo McNamara (00:48) So this is episode 210, which is part of our education and workforce development series, where we will be hearing from our guest, Hannah Barnsley, talking about her experiences as a diagnostic radiographer working in MRI, and also talking about her amazing research. So welcome to Rad Chat, Hannah. How are you? Hannah (01:06) Thanks very much. Really good, thank you. Jo McNamara (01:09) ⁓ brilliant. So Hannah, tell us a little bit about yourself. What do you do? Hannah (01:14) So as you said, I am a diagnostic radiographer ⁓ currently working at the Royal Marsden in MRI. I've been a radiographer for too many years, possibly about 20 years now, ⁓ covering most modalities, but yep, finding myself in MRI these days with a little extra research on the side. Jo McNamara (01:36) So tell us what made you go to diagnostic radiography and not therapeutic? Naman Julka-Anderson (01:42) We're all thinking it Hannah. Hannah (01:43) That's a tough question. That's a hard question and I'm not sure I have an answer to that actually, if I'm honest. I think it was, I don't actually know what it was 20 years ago, more than 25 years ago. I'm not sure I can remember. Jo McNamara (01:59) Did you always want to work in healthcare? Hannah (02:02) Well, once I started thinking about jobs as you do when you're at school, healthcare came up and healthcare resonated with me, but it took me a little while to figure out what I wanted to do in healthcare, I have to say. The obvious being kind of doctors or nurses, but didn't want to do either of those. So by the time we got through to R in those, perspectives we used to have back in the day that used to thumb through yeah, radiography was a was a good choice and I and I think at the time as well it was You know, but still now I imagine all the things you can do with it as well, know, not just diagnostic and therapeutic isn't it? I mean not quite sure what's down the therapeutic line, but in diagnostics, there are so many branches You know, you can really find something to get your teeth into so I think that's what Really got me was just, I personally found it more interesting than maybe some other professions. Naman Julka-Anderson (03:04) Diplomatically said there, thank you. Obviously you're in MRI now, before you got into MRI. Did you do any other specialties first? Hannah (03:05) Hahaha there's actually not a lot I haven't done, along the diagnostic pathway. I've been exceptionally lucky, I think, over my career and I've done, well, everything really. I've been very lucky that I've been able to travel around and, you know, work in different countries and I've been able to experience all the different modalities. So from maybe the more common, you know, obviously the plain film, CT, things like that, but I've got to work in interventionals, like general intervention, neuro intervention, cardiacs, some weird and wacky procedures that we have done that hadn't been done in the UK for quite a few years, but I managed to see some in different parts of the world. Yeah, so I've done quite a lot. I think it's, yeah, I really enjoyed being able to do all of that before setting down with a single modality because at least I know that this is this is where I'm supposed to be like in MR not that I didn't enjoy the rest of it really did but it's nice having experienced it all. Jo McNamara (04:23) It's nice that you shopped around and then found your calling when you finally entered the MRI. Hannah (04:26) Yeah, shopped around. Shopped around is probably quite a good way to say it. Absolutely. No, it was great. Loved being able to do it. Lots of different, know, the more odd kind of screening and kind of interventional cases that we used to do kind of in Australia that we hadn't really done here or haven't seen here at all. It's really interesting. Jo McNamara (04:31) you So what does a day as an MRI diagnostic radiographer look like? Hannah (04:58) I mean they can be very different, I think, depending on where you work, like a lot of different modalities, I imagine. So the work that I do at the moment is purely oncology-based, looking for like diagnosis and monitoring disease in that sphere, which comes with some tricky moments. Obviously, it's quite an emotional place to work, the people that you're coming through you know, it's not a great time when you come have to come to an oncology center. So, you know, we get to spend quite a bit of time with our patients, which is nice. And it's a bit, you know, the work these days is a bit more kind of surrounded, you know, quite patient focused. They're doing those kind of diagnostic or ⁓ kind of follow up scans and, and quite a bit of research scanning as well that we do at the Marsden as well In my last job that I had though, quite different. The pace was a lot faster. Our patients were, you know, the cohort was quite different. We had a lot more, what's the word I'm looking for? The patient groups we had were probably more complex just due to the illnesses that we were seeing them with being a neuro center. We had a lot more kind of GA cases and things. So a lot more kind ⁓ of interdisciplinary working, know, different teams in the hospitals and things like that, that's the good thing about MRI. Depending on where you work, the days are very, very different. They're my only experiences. Naman Julka-Anderson (06:42) When patients get to look at their MRI scans, what are the different things that they look at? so for example if I've had an MRI in India that gets reported and you just get given it so you can see the T1, T2, whatever, that kind of stuff, that was probably what I was trying to ask. Hannah (06:58) Well, imagine, depending on what you've had scanned, mean, the types of pictures you get in MRI are really interesting to look at. They are very detailed. So I know when I've looked at my own images coming obviously for being a radiographer is obviously a bit different knowing what I'm looking at anyway, it's when I've looked at my images, it's, what's my heart size? Oh, what does my liver look like? Does that look normal? Is it size? What else? So. I don't know, I'm not necessarily looking at the problem, but looking at, you know, everything else and how it all fits and... ⁓ you know, probably could lose a bit of weight there and, you know, because, ⁓ I've noticed, Jo McNamara (07:53) I was gonna say Hannah when I when I look at my MRI I'm like ⁓ yeah there's lots of fatty tissue there Hannah (08:00) It's just Definitely could lose it, you know do with losing a couple of pounds but also when you're lying down anyway It's never going to be it's never gonna be good but yeah, that's what I look at yeah, as you know for the average person if they were looking at their own pictures. Jo McNamara (08:21) Hannah, something that a lot of the general public maybe get confused between is the diagnostic radiographer who actually takes the MRI scan and then the radiologist and you know, Naman and I hear it all the time about, I've been to see the radiologist and you know that that's not necessarily what has actually happened. So can you just tell us in layman's terms what is the difference between your role as a diagnostic radiographer versus your colleagues who are then called radiologists. Hannah (08:57) My tongue in cheek answer would be we do the work and they get the credit for it. However, radiographers are the ones who are physically there taking the pictures, the x-rays, the scans, whatever it might be, they're the ones that you're stood in front of who are taking the pictures. Radiologists are our doctors who then take those images and create a report which your teams will then use in the diagnosis or monitoring of whatever you're there to be seen. So yeah, that's the difference. We're radiographers are classed as allied health professionals. And then our radiologists are the doctors. Naman Julka-Anderson (09:52) Hannah, why is it important to have pre-screening before MRI? Hannah (09:57) The easy answer, the quick answer would be to make sure that everyone is safe to go into MRI. It's a really important part of our job. Before we take you into it, there are different things within the MRI scanner that can cause issues if we don't know about certain things. So in MRI, we have the main magnetic field, which is always on, which if there's ferromagnetic, that can cause an issue in the scanner. And then we also, the way that we acquire the pictures, we use what's called radio frequency energy that helps us to make the pictures. And that can also cause issues depending on what might be there. So, for someone walking in with nothing inside them, there is no issue whatsoever. ⁓ But the idea of the pre-screening questionnaires is to find out whether there is something inside the body that might have an issue once we take it into MRI. And it's really important because there's a few things that can happen. The most obvious one and the videos that you see flying around the internet are anything ferromagnetic, which obviously gets attracted to the scanner. If it's something big like an oxygen cylinder or something, big noises, lots of damage, ⁓ not very good. But if it's something inside the body that's ferromagnetic, ⁓ it can move. And then anything moving inside the body can cause issues. And then we have the issues with the RF energy that going in with heating. If we have anything that can conduct heat, and that can heat up, we have issues then within the body as well, ⁓ burning. So we need to make sure that anything that does go in is safe. Now, I mean, there's very few absolute contraindications in MRI anymore ⁓ these days, but there's still a lot of implants and a lot of, you know, medically implanted devices that still have conditions attached to them. So the pre-screening, questionnaire is just it's to make sure that we know what is there so that we can meet the conditions For like to complete a scan safely basically, so it's really important. We're able to gather as you know as much information as possible as we can on what's inside. Jo McNamara (12:17) Hannah, I know one of the things we get asked a lot through Rad Chat is, I've been referred to go and have a CT scan, but I know that MRI is more detailed. Why am I having a CT rather than an MRI? Hannah (12:33) It's very broad question. And it would depend why you're having the scan in the first place. There are some things that can be found on a CT scan, a CT scan takes seconds, an MRI scan, I think our quickest MRI scan that we do where I am at the moment is probably about 15 minutes. So that's quite... a bit different, you know, kind of two minutes versus 15. And that's just depending on that, you know, that's not necessarily comparing the like for like scans. So it depends if the clinical question can be asked in a CT, then it's kind of, it's more cost effective. It's quicker, you know, there's higher throughput. You can get a lot more people through CT in a day than you can in MRI. But I think MRI is being used more and more which is causing so many issues with capacity and everything and the length of scans are going up as technology improves and we're doing more sequences, there are more sequences available to us. So it's really a matter of the clinical question, I think, and why are you having that done in the first place? And can the question be answered with a CT versus an MR? Naman Julka-Anderson (13:54) Because with CT there's more radiation isn't there? But MR is... Hannah (13:58) MR comes with zero radiation. But there is a lot more, you know, lower dose CT techniques these days, faster scanning. And again, you know, even AI is being, you know, to improve image quality with those lower dose scans as well. So it's risk benefit, I guess, isn't it? And depending, depending on why you're having that scan. Jo McNamara (14:23) It's helpful for patients though, isn't it? Because I think sometimes they get to hear about these things that, you know, potentially they think are better quality and they kind of think, well, why aren't I having that? So it's great. I'm sure anyone listening to this podcast is really pleased to be able to kind of identify why some people would have an MRI versus a CT. It just helps to explain it. Hannah (14:45) absolutely. Absolutely. And even, you know, I had to think about it, say, what would I want if I was in the same position? You know, and it's I mean, there are some cases where a CT or an x-ray maybe or something like that. I probably would go for that over an MRI, because I know I can get it quicker and it would still answer the question. Jo McNamara (14:52) Yeah. What do you think about the private pre-screening tests that currently are advertised absolutely everywhere? Hannah (15:22) I can understand why people want them. I can wholly understand why, you you would want, you know, you have access to that kind of service. I understand why people would want to. Although we are seeing increased numbers of people that are coming back to the NHS because things have been found, but not necessarily things that warrant any worry shall we say you know we're all there are benign things happening inside all of us that we would never know about um but obviously once something is found it does have to be followed up so you know on the other side whereas I absolutely 100 understand why people would want that and that service is a great service but it is then also increasing the pressure on the NHS because we are then having to follow up things that are found that may not be of any consequence. Naman Julka-Anderson (16:17) Early diagnosis is obviously better, but as you said, even with that there's challenges that the more people get diagnosed quicker than before, their capacity is also going to be an issue. That's where some of their kind of, you know, at home kits and stuff, if they're not all kind of looked into properly and if everyone's suddenly doing an at home PSA test, for example, it's going to result in more people going to their GP and potentially more biopsies for no reason, that kind of stuff. Hannah (16:40) Yeah. It's difficult, isn't it? Because in the long run, early diagnosis, say, I mean, if we're looking at it purely, say, a cost or a capacity issue, it saves it all. You know, the earlier you can catch something, the less invasive kind of treatments or the less invasive interventions that need to happen, the earlier it's caught. So it's such a tricky, it's such a tricky situation, isn't it? But the infrastructure has to be there for it. As you say, it's possibly not at the moment. So it's difficult, isn't it? Jo McNamara (17:21) I love a bit of a debate though. Hannah (17:22) It's absolutely, I mean, I guess in a perfect world, we would all be having our, you know, whole body MRIs, you know, maybe once we all hit 40 or something, you know, see what's going on in there and, you know, figure out anything and then we can have them every 10 years or something. But in reality, there is just not, there's not the money for that. There's not the capacity for that. There's not the radiographers for that. So. Jo McNamara (17:29) Yeah. Yeah. Yeah, So moving on to radiographers, can you tell us a little bit about your research? Hannah (18:07) So a lot of my research to date has been about finding implants inside people before an MRI scan. It started as a small project when I worked in our neuro department actually, we had, due to the nature of our patients again, know, neurosurgery, cognitive issues, neurodegenerative issues, things like that. Or we had, you know, so we had lot of GA patients, things like that. Not everyone was able to answer a standard questionnaire. So internationally, the standard for pre-MRI screening is a questionnaire followed by a verbal review. But many of our patients weren't able to do that. So we were using a lot of the imaging that we had, CT imaging, X-ray imaging to do a lot of our safety checks. But that's not actually recommended by the MHRA, like our UK guidance outside of patients who are unconscious or unresponsive, who don't have kind of accurate medical records or a next of kin. So, you know, the use of imaging is quite far down the list in that respect, but we were using it on a very broad spectrum of patients. And it started at looking to see if we could use CT scouts, like so the scans that we use to plan a CT scan, to see if we could use those, because they have the same anatomical positioning as a series of x-rays, which is recommended by the MHRA. And it kind of all blossomed from there, really. So we found that in our small study that we did at our center, we did find that we had really good results being able to find and then name implants on the CT scouts and having then presented that to a couple of conferences. And then again, just chatting with other radiographers about how we screen our patients and things, we kind of realised that there is no training for this. You know, we're not taught how to find medical implants on x-rays. You know, we might know about all these different kinds of implants, but we don't actually know what they look like. And a lot of the time, if you were to Google what these look like, you get the actual pictures kind of out of the box kind of images. So yeah, a lot of my research from then on in has been about, you know, how do we teach radiographers to... find and name implants on x-ray. And that's kind of resulted in the e-learning for healthcare, MRI safety, implant recognition program. And it's been quite successful. It turns out that it was a gap that we hadn't noticed needed filling, which is the point of research, I guess. Naman Julka-Anderson (21:03) Yeah, like a mic drop moment right there for you. ⁓ Hannah (21:05) Yeah, it's always nice when you get to, you know, it's one thing being interested and wanting to get involved in research and you know, especially it's becoming more and more kind of talked about, especially in the radiography world. I think you guys in radiotherapy are probably a lot further ahead than us in diagnostics in terms of research and getting involved, but it's so difficult to try and find something you want to, you know, if you're interested in that, it's so hard to find your in. So when you do, it is a bit of a mic drop moment when you find, oh, and it's such a, I don't want to say a basic kind of idea, but essentially that kind of is what it is. It's something we do every day, but actually we just need the evidence to prove it works. So it's so nice when you can find that something that you can really sink your teeth into. Naman Julka-Anderson (21:55) What are all the different types of implants? Hannah (21:56) So the way that I would kind of classify implants, would classify them as kind of active implants and passive implants, if I was to describe them. Active implants being things that electronic devices, these are things that might have batteries and electronics within them. And they actually, they serve a functional purpose in that respect. So things like pacemakers, nerve stimulators, implantable pain relief systems, things like that. you know, tiny little electronics in the body. they're kind of active implants. And then we have passive implants. So it's essentially anything that isn't electronic. So something like a stent or a heart valve, or an aneurysm clip or something like that, that would be kind of a passive implant. Naman Julka-Anderson (22:55) I did text Jo saying, is it the type of implant I'm thinking or is it something else? Jo McNamara (23:02) I'm just thinking, ⁓ will I be able to have an MRI with my brand new leg pins that I've got after breaking my leg? ⁓ Hannah (23:11) Yes, yes you will. I feel pretty confident, very confident. Jo McNamara (23:16) changed the metals that they've used then over time? Hannah (23:20) In some things, yes, we are seeing, with the more standard kind of implants, possibly not. So I think orthopaedic implants have probably been very similar materials for quite a long time. But there are things that are changing. Especially with things like active implants, think a lot of manufacturers, because the importance of MRI and the availability of MRI is so different now than it was 20 years ago. There really is a push to make things MR conditional and to have that MR conditional ability. I think manufacturers are starting to use less ferromagnetic materials. They're trying to make devices smaller. So even if they do have ferromagnetic materials, the impact is a lot less. So I think, so they have over time, mean, once upon a time, know, aneurysm clips that, know, used in the brain after a ruptured aneurysm, they used to be ferromagnetic. But now I think you would be hard pushed to find ferromagnetic aneurysm clips, for example, these days, I imagine most of them out there probably would be at MR conditional these days just because post subarachnoid haemorrhage you probably want an MRI scan so there has been that need to to change yeah. Naman Julka-Anderson (24:59) You've talked about quite a lot of different advances, I guess, in quite a short space of time. What else is coming next? Hannah (25:09) Another big question. What's next? I mean, in terms of implants, like there probably isn't, I mean, the list is probably endless. There's implants probably for things that, I mean, I have no clue about yet and we won't do until they come out onto the market. In terms of MRI. With the technology that's available these days, again, mean, it's probably endless. mean, the types of scans that we're able to do these days, the shorter acquisition times, things like that, is all down to ⁓ the advances in the hardware and the software that you can get these days. There's a lot of AI now involved in MRI to speed up image acquisition to... to improve image quality, better signal to noise ratios, things like that. So that's probably where things are going. Naman Julka-Anderson (26:09) When you talk about sequencing, just for someone who doesn't know much about it, how would you explain it? What are the different sequences that can be done for an MRI scan, etc? Hannah (26:19) So when we talk about coming for an MRI scan, we talk about the scan as a whole. But anyone who's had an MRI scan will know that the noise starts and it stops and it starts and it stops and it makes different noises depending on what you're doing. And basically as part of the MRI scan, it's not one picture that you're doing for 45 minutes. It's lots of smaller pictures and they're taken and they're pictures that are taken at different times using different kind of acquisition timings and methods to be able to get different pictures that show different things. So one picture might show is more anatomical. So it's kind of they're more a T one weighted image. It's more grey. It's ⁓ and we're kind of more looking at anatomy there. We then have what's called a T2 weighted image, where fluid, like water is bright and it's more, that can be described a bit better as looking for pathology. Pathology tends to have more water in it than normal tissue. So you can see more pathologies on a T2 and then you have sequences that can, because fat can also be bright the way that we take pictures on a T2 weighted scan so you can have images that saturate the fat out so that's dark. That's more gray. So it's only fluid that's bright and it just shows different things and it's and allows our radiologist to be able to Determine better what's going on inside the body determine, you know Have more, you know easier to make a diagnosis on what they see so it's lots of different pictures that look a bit different and yeah, which will give different information. Jo McNamara (28:28) For any patients listening, Hannah, who have never had an MRI scan before, what can they expect? Hannah (28:37) I would like to say it's not as bad as your friend has told you because people do come having never had an MRI scan, having heard horror stories. But I would say it's not the most pleasant thing to have done, but it's also not terrible. So the expectation being you have to lie still and I hate using the word tunnel, but it's the best word I have right now. Just lying down on a table, while we take the pictures, the worst part is probably the noise. It's a very noisy machine, but whichever center that you go to for your scan, you'll be given hearing protection. And yeah, it's, I think the expectation being that it's not gonna be over in a couple of minutes. It does take a little bit of time. ⁓ It's important that you're comfortable for the scan. So, cause it's very easy to lie down bit tense and a bit apprehensive and then once we've left the room go well I'm so uncomfortable now I'm I want to move and I want to which obviously why you're taking pictures is not ideal because they're just like photographs if you move we get blurry pictures so I think just making sure you know it's going to be noisy you know you have to lie down for a period of time depending on what you're having scanned and that it's just really important that you're comfortable you get yourself comfortable and you get yourself in position where you can pretend you're elsewhere. Jo McNamara (30:11) We often say in CT that if you're not having your head or neck scanned, you could wear a hat, because obviously we lose a lot of body heat through our head. And we also typically say, if you are allowed, wear gloves, because it's your fingers and your hands that typically get really cold. we often, podcasts that we've done before, often will say, if you're someone who gets cold... Hannah (30:20) Yeah. that's nice. Yeah. Jo McNamara (30:36) then and you know that you're going to get cold, then stick a hat on, stick some gloves on and you may look like a Wally for 20 minutes in your MRI scanner, but you're not cold. Hannah (30:43) Yeah. Yeah. And no one else is there. Absolutely. I think the problem that I have answering this is that every centre will have different rules. And there are rules about what you can and cannot wear in MRI, depending on where you are. So I think at the very least ask for a blanket. I mean, I know in our centre we offer blankets as standard to everyone when they come in the room. When it comes to clothing in MRI, it is a bit more tricky. So first up, you don't want anything with anything metallic on it. So whether that be zips, buttons, even sparkly things as well, sequins, anything like that, anything kind of sparkly, you don't want to wear an MRI. Naman Julka-Anderson (31:33) I would love to see your face if a patient turned up wearing like full body sequins for their MRI scan. That's it. That would be amazing. Hannah (31:37) it's happened. It's happened. Yeah, it's happened. It's happened. Yeah, gosh, they were lovely. We didn't lose any sequins in the machine, though, you'll be happy to know. But the other issue that we're finding in MRI these days, though, one of the big ones is silver fabric in clothing. So leggings, underwear, tops, it's the sportswear, like the moisture wicking. And there have been reports of burns for patients that have these sports clothing items on that have the silver in them. So it's quite difficult to try it, because again, every center will have different rules. If you have and it's a lot of the branded stuff as well. So if you have branded sportswear From some, know, the the high end kind of athletic wear should we say? ⁓ if we can name That's yeah, absolutely. I didn't know whether we could say that but yeah, so things like lululemon sweaty betty anything like that. And that's and that's the issue. So so people come thinking i've dressed in my mri i've got no metal on me, but actually Jo McNamara (32:38) Should we go Sweaty, Betty and ALO and see if we get a sponsorship deal? you Hannah (32:54) Where we are, we will still get you to change, which can, you know, people can get a bit upset by that. And I get it. You've, you know, you've done what you're told, but it's, you know, with, you know, there are more and more reports of that kind of thing coming out. So I think, so that's why it's quite difficult to discuss what to wear in an MRI scanner, because it will depend on the center that you go to. But I think if it's anything, no pockets, because people, some centers will get you changed if you have pockets because people will tell you they've emptied their pockets and they have not emptied their pockets. So no pockets, no moisture wicking kind of material. Anything that's cotton, I guess, those kind of natural fibers, cotton. I know that we have some regular people with us who bring pajamas to wear and they get changed in their pajamas, especially like the pajama bottoms that are a bit thicker. So yeah, it's a, for such a... small question that's a very big answer. Naman Julka-Anderson (33:57) Do creams matter Jo McNamara (33:58) We love it. Naman Julka-Anderson (33:58) that have metals in them? Hannah (34:01) Oh, that's a good question. Don't know. Not had... Naman Julka-Anderson (34:04) because a lot of the high-end cosmetics seem to have lot of weird and wonderful stuff in it. And like, yeah. Hannah (34:08) Yeah, not I've not seen anything that's not to say that it's not an issue, but I haven't I mean of I'm looking thinking of the list that the society of radiographers had with all the that made with all the different things to tell you about things like eyelashes and You know, you know, obviously jewelry we know about jewelry things like that all that I doesn't have anything about creams or any lotions and potions on that so as far as i'm aware no, but Don't hold me to that. Jo McNamara (34:38) there's a, there's a PhD there somewhere isn't there? Hannah (34:41) There you go. See, you just got to find, you just got to chat. You just got to have a chat and you will find your, find your niche there. Absolutely. Jo McNamara (34:57) So Hannah, we could probably continue to ask you questions all night about MRI ⁓ and it's been really interesting to kind of hear about your perspective as a diagnostic radiographer but we do always end our ⁓ Rad Chat podcast episodes with top tips. Have you got any top tips for the listeners? Hannah (35:17) Top tip for, I guess for anyone going for an MRI scan, I guess the top tip will be to read your appointment letter front to back the entire thing, not just the date and time. Any information, each center will do things differently. So it's hard to be like, well, I've had a scan here, so therefore the same works over here. It doesn't work like that. So. I would say read your appointment letter, the whole thing. And also actually, now I think of it. If you have something inside you that you weren't born with and you have never been to that MRI site before, take the information with you. So most people will have an implant card given to them or they can find out kind of, you know, what they've had done. Every new hospital trust will need that information. And have, you know, I work at, I've worked at two tertiary referral centers here in London. A lot of people we are seeing are not having implants, putting them at our trust. And if you come to us and we need that information to be able to scan you, you might have had scans safely and without issue at your local MRI center. But if they know what's in you, they know what scan conditions they need to make sure they can scan you properly. So I think the most important thing is if you're going to a new site, always take your implant information. The MRI radiographers will love you for it. I think that would be that's the biggest top tip actually because that that would save so much time. It saves the phone calls. It saves trying to find teams in different trusts trying to find this information. If you have that information make sure you take it with you. Jo McNamara (36:59) Amazing. Amazing. It's like when we say to patients, keep those consent forms because it gives you all that information. It's exactly the same, isn't it? Hannah, it's been an absolute pleasure to have you on the podcast. Thank you so much. A huge thank you to Hannah Barnsley as part of our Education and Workforce Development series talking about her research and her role as an MRI. Hannah (37:16) 100 Thank you. Jo McNamara (37:31) diagnostic radiographer. Thank you all for listening to Rad Chat with myself Jo McNamara and Naman Julka-Anderson Thank you very much. Jo McNamara Rad Chat Host (37:37) So what do you do now? Well you can use this episode as part of our free continual professional development accredited content which offers flexible learning that fits your busy schedule. Just check out the show notes for the reflective questions, links to literature and resources and link to the completed form to receive your accredited certificate. Naman Julka-Anderson (37:56) Stay up to date with the latest radiotherapy and oncology advancements by liking and following us on social media and hitting subscribe wherever you get your podcasts. Jo McNamara Rad Chat Host (38:06) Please do join our supportive community designed by professionals who understand the unique challenges of working within radiotherapy and oncology. Follow us across all of our social media channels and make sure to check out our website www.radchat.co.uk. Together we're actively working to improve our profession and make a lasting positive impact on cancer care. Naman Julka-Anderson (38:29) It goes without saying that we can't achieve this alone. It takes all of us working together to create real change. That's why we value every voice and every contribution. We ask that you listen and learn and spread the word, share your story with us and connect with us. Jo McNamara Rad Chat Host (38:44) And if you have liked this content, why not buy us a coffee? Go to our website and drop us some love. Thank you all for listening and take care.