[MRI can be prescribed in patients with implanted cardiac devices (pacemaker, defibrillator) to optimize radiotherapy planning]

Purpose: MRI is sometimes critical to optimal radiotherapy planning but may be contraindicated in increasing numbers of patients who carry an implantable cardiac device (ICD, pacemaker or defibrillator).

Material and methods: This literature search reviews studies of MRI in DCI patients, morbidity and procedures for the different types of ICD.

Results: Several retrospective studies and two recent large prospective studies have shown that the use of an ICD is not an absolute contraindication to MRI, given that specific DCI monitoring is performed under the tridisciplinary supervision of the oncologist, radiologist and cardiologist for MRI≤1.5T. The rate of major complications is less than 5% unless probe replacement is performed. When it can be anticipated, new MRI-compatible ICD can be implanted rather than conventional ICD, but probe replacement is not currently recommended. Data for MRI beyond 1.5T and in case of MRI repeatability in the context of MRI-Linac treatments are lacking.

Conclusions: MRI may be performed in ICD patients, as the risk of morbidity is very low; provided that tridisciplinary evaluation is performed.