Liver MRI : Head first or Feet first?

When performing MRI of abdominal organs such as the Liver, I know it is possible to scan subjects positioned to go into the bore either feet first or head first. I was wondering what orientation is preferred and why?

It would be great to hear what other members do at their imaging facilities.

I might be wrong but I would say it doesn’t matter from an MR perspective.

So I would choose the orientation that allows the coil cables wrap around the patient in the most comfortable way. This will depend on the particular scanner model.

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We would prefer feet first since it gives a sense of reassurance to claustrophobic patients when informed that they would go with their feet in first, but nevertheless the scan can be performed in either directions. Some scan makes have an effect on the peak SAR values based on the landmark used and anatomical area scanned as in below paper.

The limits for the maximal SAR depend on the patient position inside the scanner. If the position is not known, the lowest SAR limit along the body, which is in the neck area, is to be set to the global limit [1]. Determining the patient position within the MR scanner enables to impose an SAR model, adaptive to the body region, and consequently, to exploit the maximal image resolution

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feet first and hands up for convenience of power injector also to avoid aliasing; and head first for other patient unable/in pain with arms up; some scanners having the fan on the opposite end so patient wont sweat with regards to SAR issues, otherwise very comfortable with feet first.

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@Sunilpwr @Rainier I was wondering what scanners you use to perform feet first scanning?

It would be interesting to see if orientation choice is dependent on scanner model as @RuiPedroTeixeira mentioned.

Siemens aera and skyra

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We imaged livers with the subject going in head first in a 3T GE Signa PETMR at a facility I worked at previously. There were two surface phased array coils (for upper and lower body imaging). We were having trouble with the lower array at the time which may have been why we chose head first orientation.

GE discovery 750w and GE voyager

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That’s interesting @Sunilpwr , like @UCLjames we did head first in our GE. However, this may also depend on whether contrast is being used i.e. is it easier to use a power injector if patient has gone in feet first?

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