Magnetic resonance imaging (MRI) continues to play an increasingly vital role in modern healthcare, with advancements in technology, expanding clinical applications and growing patient demand shaping how imaging departments operate. From improving patient comfort and safety to navigating staffing challenges and optimizing workflow, today’s MRI leaders are balancing innovation with efficiency in a rapidly evolving landscape. In this Director’s Circle roundtable, industry experts share insights, strategies and best practices for managing MRI services. Participants in this Director’s Circle article are:
- AdventHealth Central Florida Director of Operations and Imaging Safety Cory Whitehouse;
- Scripps Memorial Hospital La Jolla MRI Supervisor Megan Comia; and
- University Hospitals of Cleveland MRI Research Technologist Martin Allen Ayres.
Q: MRI utilization continues to grow across many specialties. What clinical applications or service lines are driving the most growth in MRI at your organization right now?
WHITEHOUSE: In our community, orthopedics and sports medicine (knee, shoulder, hip), neuro-spine and brain, and oncology (prostate, breast, liver) and a high number of abdomen and pelvis scans are where we see the most demand and growth. In our ambulatory imaging centers, we are seeing growth in MRI year over year. In 2025, our 13 ambulatory imaging centers cared for 13.5% more community members requiring an MRI than in 2024.
COMIA: One of the biggest areas of growth for us right now is cardiac MRI. As technology and protocols continue to improve, we’re able to support more advanced cardiac imaging that provides detailed functional and structural information for cardiology teams. Another major driver of growth has been imaging patients with implanted devices. As more patients present with pacemakers, defibrillators, and other implants, we’ve spent a lot of time refining our workflows and standard processes to safely accommodate these exams. Through close collaboration with cardiology, radiologists, and device representatives, we’ve been able to expand access to MRI for many patients who previously may not have been considered candidates. That has significantly broadened the types of patients we’re able to serve.
AYERS: Growth is strongest in neuro, musculoskeletal (MSK) and oncology imaging. Neurology demand continues to rise for stroke evaluation, MS monitoring and cognitive assessment. Neurosurgical volume also remains steady, particularly for preoperative planning, postoperative follow-up and complex anatomical imaging. MSK imaging continues to be robust as orthopedic practices rely on MRI for soft tissue injuries and surgical planning. We’re also seeing growth in imaging for device patients, including those with pacemakers and other MR conditional implants. As more devices receive MR conditional labeling and protocols become standardized, providers are increasingly comfortable referring these patients for MRI.
Q: Patient experience has become a major focus in imaging. What steps has your department taken to improve comfort, reduce anxiety or make MRI exams more patient-friendly?
WHITEHOUSE: Patient comfort and anxiety are priorities in our MRI departments because we know that a relaxed patient leads to better image quality and better overall experience. We’ve taken a multi-step approach that starts before the patient even enters the scanner. First, we focus on communication and education. We explain the exam clearly and set expectations about noise and scan times and encourage patients to ask questions. For anxious PT or first timers, we walk them through the process step by step so there are no surprises. Inside the MRI suite, we use comfort focused tools such as earplugs, headphones with music, positioning cushions, covers and careful coil placement to minimize discomfort. We also give every patient a call button and reinforce that they can stop the exam at any time if they feel uncomfortable. To help reduce claustrophobia, we use shorter scan protocols, when possible, offer mirrors as visual aids when available, and maintain regular communication during th scan to reassure the patient and keep them informed of progress. We also adjust our approach based on individual needs such as allowing extra time or adjusting times for pediatric or elderly patients. We sometimes recommend a mild sedation before proceeding as well. Overall, our goal is to treat each patient as an individual, combine technical excellence with empathy, and create an MRI experience that feels safe, respectful and patient centered.
COMIA: MRI can be an intimidating exam for many patients, so patient experience really starts with the technologist. Our team has many experienced technologists who are very skilled at coaching patients through the exam, explaining what to expect and recognizing when someone may need extra reassurance. That level of experience and communication makes a big difference in helping patients feel comfortable and confident during the scan. We’re also fortunate to have care team assistants and a dedicated MRI nurse who help support patient preparation and coordination. This allows our technologists to stay focused on the exam while ensuring patients feel supported throughout the entire process. From an operational standpoint, we also focus on keeping workflows efficient, so patients aren’t waiting unnecessarily or spending longer in the scanner than needed. For patients who struggle with anxiety or claustrophobia, we’ve also explored simple supportive tools such as aromatherapy tabs that can help create a calmer environment during the exam. Often the biggest difference comes down to preparation, communication and having a team that is confident guiding patients through the process.
AYERS: We’ve made patient comfort a central part of the MRI process. Clear communication, thorough instructions, and opportunities to ask questions help set expectations before the exam begins. During the scan, we provide music, blankets and additional padding for comfort. Patients may use mirrors to reduce the feeling of being enclosed or choose to keep their eyes covered if they prefer. For those with claustrophobia or anxiety, technologists take a slower, more supportive approach and offer reassurance throughout the exam. A screened support person may accompany the patient when appropriate. We offer designated slots for conscious sedation and can coordinate anesthesia for patients who require it due to anxiety, claustrophobia or pain. In pediatric cases, our team works closely with sedation services and child life specialists to provide age-appropriate support and make the imaging process less intimidating.
Q: Staffing remains a challenge for many imaging departments. What strategies have you found effective for recruiting, training or retaining skilled MRI technologists?
WHITEHOUSE: As the demand for our MRI techs grow because of extraordinary growth and demand in the Central Florida community, we sought ways to allow our techs to focus more time on scanning while limiting the additional duties such as IV insertion, room turnover and walking patients back to the rooms. We began hiring paramedics for these tasks in late 2025. We continue to hire paramedics for our 13 locations. We have implemented an extensive cross training program where we offer tech training in our centers while they continue to earn a paycheck. Once they complete competencies through ARRT, we pay their fees to sit for their registry. We also offer non-clinical team members the ability to get their ARMIT through Tesla Institute which we fully pay for, and they use our sites in a clinical location. We are also encouraging our paramedics to also grow to become MRI techs utilizing the Tesla Institute as well.
COMIA: One of the most important things for retention is creating an environment where technologists feel respected, supported and genuinely enjoy coming to work. MRI can be a demanding modality, so building a strong team culture makes a big difference. I make it a priority to stay connected with the team, whether that’s checking in during the day, celebrating wins, or creating opportunities for staff to share ideas and contribute to improving workflows. When technologists feel like their experience and input matter, they tend to take pride and ownership in the department. We also focus heavily on mentorship and cross-training so technologists can continue expanding their skills, particularly with more complex exams and devices. Investing in technologists and supporting their growth helps build confidence and keeps the team engaged long-term. At the end of the day, people want to work in a place where they feel valued and where they can continue to grow, and that’s something we actively try to cultivate in our department.
AYERS: Promoting a positive and supportive workplace has been essential for attracting and retaining skilled MRI technologists. Flexible scheduling options help reduce burnout and support a healthier work-life balance. We encourage professional development through continuing education, involvement in quality initiatives and participation in protocol-related projects. A culture centered on respect, open communication and shared goals continues to play a major role in long-term retention. To further strengthen day-to-day workflow, we’ve added MRI tech extenders on all shifts. They assist with routine tasks and help maintain steady operations. Each extender is currently enrolled in an imaging program with plans to become an MRI technologist, creating a clear internal pathway for developing future staff while supporting current operational needs.
Q: MRI safety is always evolving as more implants and devices become MR-conditional. How is your team managing screening, safety protocols and technologist education to keep patients safe?
WHITEHOUSE: MRI safety continues to advance quickly – especially with the rise of MRI “conditional implants” such as pacemakers, neurostimulators, ortho hardware, ear implants and more. Keeping patients safe requires a combination of rigorous screening, updated safety SOPs and ongoing tech training supported by governing bodies like the ACR and recent safety literature. Tech education also plays a central role, with ongoing training required to keep pace with new implant designs and updated standards. The latest guidance highlights the importance of understanding MR‑safe, MR‑conditional and MR‑unsafe classifications, as well as the potential hazards posed by thermal injuries, projectile risks and device interactions. Continuous learning – supported by ACR resources and real‑world safety articles – ensures techs are prepared to make informed decisions and respond appropriately to emerging challenges in the MRI environment. As implants become increasingly MRI‑compatible, a combination of thorough screening, robust protocols and ongoing education remains essential to protecting patients and maintaining the highest standard of MRI safety. We also encourage our MRI techs to get their MRSO certification which we fully fund.
COMIA: MRI safety is something we take very seriously, especially as more patients present with implanted devices and complex medical histories. Our approach is built around strong screening processes and collaboration across multiple teams. We work closely with cardiology, radiologists, device representatives and referring physicians to ensure each case is reviewed carefully before scanning. Education is also a big part of our safety culture. We have MR safety officers on our team and encourage technologists to attend safety seminars and stay engaged with current literature. Sharing new information and articles with the team helps ensure everyone stays informed as guidelines and device recommendations continue to evolve. MRI safety is always changing, so maintaining open communication and ongoing education helps us keep patients and staff safe.
AYERS: Our team follows a comprehensive screening process for every implant or device before an exam is scheduled. All required conditions – such as magnet strength, coil restrictions, SAR or B1+rms limits, spatial gradient considerations, and any time or positioning requirements – are outlined on a dedicated MRI implant clearance document for technologists. Schedulers receive any special instructions needed for a safe visit, such as bringing a device controller or using a specific magnet. For more complex cases, technologists collaborate with radiologists, our MRSE and other clinical partners to ensure all safety criteria are met before imaging begins. Ongoing safety education is prioritized through refreshers, in-service training and vendor-supported learning. A centralized Microsoft Teams channel gives staff quick access to device manuals, manufacturer guidance, gradient maps, SOPs and other safety tools, ensuring up-to-date and consistent practice.
Q: How are workflow tools such as remote scanning, protocol standardization or advanced scheduling systems helping your team handle higher MRI volumes?
WHITEHOUSE: Our most utilized protocols were obtained and reviewed by subject matter expert MRI techs. Recommendations were made for revisions by decreasing the number of sequences and obtaining the section chief input and approval with the goal of shaving off unnecessary sequences. On top of that, we are preparing to install software that will allow us greater efficiency and clearer images. We are also preparing for a pilot with two AI software organizations and finally, the implementation of remote scanning to solve for sick calls and other staffing strains. We believe that when these initiatives are combined, we will see greater efficiencies, clearer images and less time on the table for the patients, allowing us to increase our community access. Our plan is to measure each initiative’s impact on the scan time as they are implemented.
COMIA: Protocol standardization has been one of the biggest tools for improving workflow. When protocols are consistent across scanners, it helps technologists move efficiently between exams while maintaining diagnostic quality and consistency. With seven MRI scanners across our campus, we’re also constantly refining scheduling strategies at each location to balance inpatient, outpatient and specialty exams. The goal is to maintain strong volume while still creating a workflow that allows technologists to move through exams efficiently and seamlessly. MRI operations can be complex, so thoughtful scheduling, clear communication and standardized protocols help ensure we maintain both quality and efficiency across the department. We are currently exploring remote scanning however we have not implemented it yet.
AYERS: Standardizing protocols across scanners has helped streamline exams, minimize variation and maintain consistent image quality. Improved scheduling tools ensure exam length, location and resources are appropriately matched, reducing delays and creating a smoother patient flow. Remote support capabilities – recently implemented at one of our sites – allow experienced technologists to provide real-time assistance or adjust protocols as needed. This improves responsiveness, consistency and overall efficiency as imaging volumes continue to grow.
Q: What else would you like to share with readers regarding MRI?
WHITEHOUSE: Some vendors are offering AI to improve efficiency and accuracy. Some talk about up to 75% decrease in scan time with AI reconstruction. There is more than one player in the radiology tech remote scanning arena and should be compared for their lead time to staff, cost and minimum number of hours per week. If considering remote scanning, one may want to consider training one’s own team internally first and allow them to reap the benefits of additional hours versus a more costly approach of outsourcing. Look for smaller footprint MRIs. With the high cost of construction and helium-free or reduced helium magnet design to save costs if you must suddenly squelch the system.
COMIA: MRI is a very special modality in that it’s constantly evolving, both in technology and in the clinical questions it can answer. As capabilities continue to expand, so does the importance of strong collaboration between technologists, radiologists, nurses, physicians and operational leaders. When teams communicate well and work together, MRI can be incredibly powerful, not only in the quality of diagnostic information it provides, but in the experience we create for patients along the way. It’s a modality that requires both technical expertise and teamwork, and when those come together, the impact on patient care is significant.
AYERS: MRI technology continues to advance quickly, offering increasingly precise diagnostic information. As capabilities expand, maintaining high safety standards, strong imaging quality, and a positive patient experience becomes even more important. The expertise of MRI technologists – supported by teamwork, collaboration and ongoing education – remains central to providing safe, high-quality care. •
