A pre‐MRI checklist must undertaken for all patients to identify risks from implanted devices that may be harmful to the patient or that may severely degrade the image quality (Chernecky and Berger [32], Pagana and Pagana [177], Shellock and Spinazzi [227]).

The patient may require intravenous access for contrast injection, most often of a gadolinium‐based contrast agent. This is used to enhance areas of suspected pathology, to define tumour bulk or to improve the efficacy of the scan by delineation or characterization of a pathological process. It is important to be aware of potential allergies and that gadolinium‐based contrasts have been linked to nephrogenic fibrosing dermopathy (NFD) and nephrogenic systemic fibrosis (NSF) (Pagana and Pagana [177]; Runge et al. [214]). These contrast agents may be contraindicated in patients with poor renal function and therefore recent blood tests – such as for creatinine, glomerular filtration rate (GFR) and/or blood urea nitrogen (BUN) – may be required to demonstrate adequate renal function (Pagana and Pagana [177]). It is also routine practice in some centres to administer antispasmodic agents prior to abdominal or pelvic scans to reduce bowel peristalsis and improve image quality.

Claustrophobia can also be an issue and in some cases patients may require an oral sedative to relax them during the procedure. In severe claustrophobia or when scanning young children or individuals with learning difficulties, sedation or a general anaesthetic may be necessary. This will require specialist nursing and anaesthetic support with continuous vital sign monitoring and predominantly support by the emergency or critical care teams.

The scanner is very noisy so it is mandatory that patients are given ear protection during the scan. If the patient feels mildly claustrophobic but not enough to consider pharmacological support, there are strategies to manage this, such as:

Apart from safety checking, for most scans there is no preparation. However, for certain body scans the patient may have to abstain from food but may drink clear (non‐caffeine) fluids to ensure their bladder does not fill too quickly, resulting in movement artefacts (Chernecky and Berger [32]).

Patients must be able to lie very still, usually on their back, for significant time periods. Patient comfort is paramount so patients requiring pain relief should continue with pain medication as normal.