Operational Excellence

Rethinking the MRI Suite: Innovative Staffing Models for a Workforce in Crisis

A Workforce in Crisis

MRI has become the diagnostic backbone of modern medicine, indispensable to neurology, oncology, orthopedics, and cardiology. Yet the professionals who make it possible are in shorter supply than at any point in recent memory. For imaging leaders, the question is no longer whether to rethink how the MRI suite is staffed, but how quickly that rethinking becomes reality.

The premise is straightforward: The work has expanded faster than the workforce can absorb, and MRI feels it most acutely. Demand rises as clinicians substitute MRI for modalities that use ionizing radiation, even as aging populations and expanding indications lift imaging volumes overall. On the supply side, MRI draws from a smaller, harder-to-replace pool than general radiography, because its technologists carry MR-specific safety obligations and a longer path to independent practice, and that pool is contracting amid measurably elevated burnout.1,2

The consequences are familiar: open shifts, reliance on travel technologists, longer wait times, and idle off-hours capacity. The staffing model itself was never designed for current patient demand or for technology, such as remote scanning and artificial intelligence, that is redrawing where and how the work is done.

The Anatomy of the MRI Workforce Crisis

The 2025 ASRT Radiologic Sciences Staffing and Workplace Survey concerns every imaging administrator. Vacancy rates across imaging remain above 2020 levels, and MRI is no exception: The MRI technologist vacancy rate rose from 16.2% in 2023 to 17.4% in 2025, near its all-time high.3 These figures align with U.S. Bureau of Labor Statistics projections; combined employment of radiologic and MRI technologists is projected to grow about 5% from 2024 to 2034, generating roughly 15,400 openings a year, many from retirements rather than new positions.4 Demand is rising at the same time. One claims-based analysis projects MRI utilization roughly 17% higher by 2055 than 2023 levels, driven mainly by population growth and aging.5

Burnout is particularly corrosive in MRI, where the work is physically demanding and emotionally taxing amid claustrophobia, language barriers, and complex protocols. Radiographer surveys document high emotional exhaustion and depersonalization, with workload, support, and environment as primary contributors.1,6 A meta-analysis identified emotional exhaustion as the dominant dimension and linked staffing shortages to both the cause and the consequence of attrition,2 and cohort evidence connects burnout to intent-to-leave and absence behavior.7

The pipeline issue is structural: a multiyear credentialing pathway, limited program seats, and a six- to 12-month interval before a new hire reaches independent practice. The 2024 Consensus Committee on the Future of Medical Imaging and Radiation Therapy identified intersecting causes including an aging workforce, declining program enrollment, retirements, and chronic burnout.8 Layered atop these are MR-specific compounding conditions: the always-on static field, the lethality of screening errors, the Level 2 MR Personnel requirement, increasing protocol complexity, and contrast supervision requirements.9

Nine Innovative Staffing Models

If the traditional one-technologist-per-scanner model cannot be sustained, the work itself must be redesigned. The most successful organizations are not chasing a single solution; they layer several complementary innovations.

The nine models below are a menu, not mutually exclusive options. The first eight are proactive redesigns of how the work is organized; the ninth, contingent staffing, is the bridge most departments use while the others mature.

Model 1: Bifurcated Teams and the ARRT Imaging Assistant, Magnetic Resonance

The most consequential structural change available to leaders separates the credentialed technologist's work from the patient-facing support around it. In a bifurcated model, a registered MR technologist concentrates on protocol selection, acquisition, and quality oversight, while a trained support staff member handles patient screening, patient preparation, and positioning, and environmental readiness. Until recently, that on-site partner had no standardized national credential. That changed on July 28, 2025, when ARRT announced the Imaging Assistant, Magnetic Resonance, I.A.(MR)(ARRT) credential, with the first examination set for fall 2026.10

The credential is intentionally designed: Imaging assistants do not perform imaging or scanning. Their scope supports MR Level 2 safety screening, patient preparation and positioning, preparation of contrast materials and assistance with administration but not independent contrast administration, and patient-flow management across the safety zones.10,11 Eligibility requirements include a high school diploma or equivalent, ARRT ethics compliance, structured education with mandatory MRI safety content, and clinical competency verification by a qualified MR professional.10,11 ARRT framed the credential as a response to how teleradiology and remote scanning are reshaping delivery, and it aligns with the 2024 Consensus Committee recommendation to establish an entry-level imaging support role within a pipeline strategy.8,10

For leaders, the bifurcated model rests on three governance elements:

  1. A written scope-of-practice document
  2. A safety screening protocol
  3. An unambiguous escalation pathway to the technologist or radiologist 9

Model 2: Remote Scanning and Teleradiology

Remote scanning decouples the expert technologist from the physical scanner. A credentialed MR technologist operates the console from a command center, on another floor or across the country, while a trained on-site team member manages the patient and magnet. An early multisite evaluation in an oncology practice found that complex examinations could be performed remotely with no measurable acquisition-time penalty compared to the same studies on-site.13 Adoption is real but early: The 2025 AHRA Remote Scanning Survey found that use of remote scanning is growing but still limited, with MRI the modality most commonly scanned remotely; the total number of remote MRI sites nationally is not yet established.14 One principle frames everything that follows: Remote scanning redistributes where the expert technologist sits, but it does not remove the requirement for a qualified technologist to be physically on-site with the patient.

Two regulatory developments accelerated adoption. FDA 510(k) clearance now covers vendor-agnostic platforms that centralize operation of MR, CT, PET/CT, and ultrasound from a command center, and Centers for Medicare & Medicaid Services (CMS) made virtual direct supervision permanent in the CY 2026 Physician Fee Schedule Final Rule, effective January 1, 2026.15

For managers, the essential distinction is among what is permitted, what is endorsed, and what is operationally feasible. Permitted: CMS allows virtual direct supervision. Endorsed is narrower: the ASRT amended its 2025 Practice Standards to require that contrast be administered only when a licensed practitioner is physically present, and the American College of Radiology (ACR) similarly limits virtual contrast supervision, so a configuration that Medicare permits may still fall outside professional standards that state inspectors cite.16,17

The ACR remote scanning position statement, updated March 20, 2025, supports the technology with explicit safeguards: one remote technologist per scan, a trained on-site individual with clear visibility to the scan room, real-time two-way audio and video, and documented contingency plans for connectivity loss.17

The Intersocietal Accreditation Commission, a CMS-deemed accreditation organization, released its revised MRI standards, approved by CMS and published on November 20, 2024. These standards define division-of-responsibility requirements between sites, mandate contingency policies for equipment and connectivity failure, and require that a registered technologist always remain with the patient during a remote scan.18

The other two remaining CMS-deemed accreditors have moved in parallel. The Joint Commission folded imaging safety into National Performance Goal 13, effective January 1, 2026, requiring defined staff qualifications, restricted MR site access, and screening policies.19 RadSite launched a CMS-approved Remote Scanning Accreditation Program in July 2025 covering staffing, operations, and quality.20

Operationally feasible is narrower still: AHRA's MR Remote Scanning Consideration Guidance Document consolidates the staffing, safety, accreditation, and regulatory requirements and affirms that remote examinations be completed with at least one technologist on-site.21 Both the ACR and ASRT decline to endorse leaving a technologist alone on-site. The ARRT I.A.(MR) does not resolve this, because it supports rather than replaces the required technologist; how to staff sites that lack a second technologist remains an open question.10,17

The 2026 ACR Manual on MR Safety sets the floor at a minimum of three MR personnel when remote scanning is employed: the remote technologist, an on-site Level 2 technologist, and at least one additional on-site staff member, with a dedicated individual assigned to monitor each patient in Zone IV.9,22 There are three options for staffing the patient side of the magnet, none of which are interchangeable.

  1. The first is a second registered MR technologist on-site: The most capable but also the scarcest and most expensive, the one the shortage makes hardest to sustain.
  2. The second is an ARRT I.A.(MR), a nationally credentialed assistant who supports Level 2 safety, preparation, and positioning but does not scan.
  3. The third option is an IBMRS MRST, a certification from the International Board of Magnetic Resonance Safety (formerly ABMRS). The issuing body positions the MRST as the primary party overseeing site-access restrictions, emergency response, and cryogen management at sites without a full MR technologist present. However, because the issuer publishes no entry prerequisites for education or clinical experience, a manager should weigh whether it can assume sole on-site safety responsibility, a scope not recognized by accreditors that require a registered technologist to be physically on-site.18,22

Whichever option is chosen, the on-site presence requirement stated above governs; the open question is which credential meets it.11,23 The ACR Manual is also explicit that scanning more than one patient remotely at once is not recommended, advising it only with staffing and procedures that in no way compromise safety or diagnostic quality.9,17,18,22

Model 3: Modality Cross-Training

Cross-training technologists across modalities, most commonly between CT and MRI, creates an elastic workforce that can be redeployed to match demand and cover absences while retaining experienced staff already acculturated to the organization. A systematic review of radiography workforce models found that service managers favor recruiting multiskilled, cross-trained staff as a deliberate cost-containment and flexibility strategy, and called for new multimodality education routes aligned with evolving clinical demands.24

The defining caution is that cross-training works only when the source modality is also adequately staffed; pulling a CT technologist into MRI without backfilling the CT vacancy simply relocates the shortage. Effective programs protect training time, use a preceptor model with explicit competency benchmarks, and set clear post-certification deployment expectations.25 Cross-training a credentialed technologist into MRI runs through the ARRT post-primary pathway, which requires an ARRT credential in a supporting discipline, structured education, documented clinical experience, and the R.T.(MR) examination; an uncredentialed hire must instead complete the primary pathway, an associate degree or higher and a programmatically accredited MRI education program.26

Model 4: Registered Apprenticeships and Grow-Your-Own Pipelines

Registered apprenticeship is no longer a fringe concept in imaging. The U.S. Department of Labor (DOL) recognizes MRI technologist as an approved registered apprenticeship occupation, and a growing number of health systems have built structured, paid programs combining classroom education with supervised clinical training over roughly 12 to 18 months, some recruiting high school students into multiyear radiology pathways.25 An apprenticeship does not by itself confer certification: To sit for the ARRT primary examination, the trainee must still complete a programmatically accredited MRI education program and hold an associate degree or higher, so a durable pipeline embeds, rather than replaces, that accredited academic pathway.26

These programs distinguish themselves from traditional recruitment by paying candidates during training, creating commitments on both sides, and widening the pool to candidates who cannot afford full-time, day-only clinical education. The 2024 Consensus Committee specifically recommended expanded student education, articulated career pathways, and pipeline programs beginning in middle and high school.8

Managers without resources for a multiyear program can still tap the pipeline through clinical externs, community college partnerships, and tuition-reimbursement contracts; DOL-registered programs may also unlock workforce-development funding.25

Model 5: Advanced Practice and Career Laddering

Retention is closely tied to perceived growth, and the Consensus Committee recommendations include explicit career ladders within imaging.8 In MRI, the ladder typically runs from staff technologist to senior or lead, then to supervisor, and on to chief technologist or imaging director, with optional specialist rungs for clinical educator, applications specialist, MR safety officer, and cardiac MRI specialist, each carrying a defined competency benchmark and often a pay differential.25 With transparent criteria, the ladder gives mid-career technologists a reason to stay rather than leave for travel work.

Model 6: Artificial Intelligence as a Force Multiplier

AI is not a substitute for MRI technologists, but it can materially reduce the work that technologists must perform. A 2024 review documented AI reducing scan times across multiple stages, including automated positioning, deep-learning reconstruction, and protocol selection.27 A peer-reviewed evaluation found deep-learning reconstruction roughly halved scan time across routine neuroradiologic examinations while preserving image quality, part of a broader intelligent-imaging shift across acquisition and reconstruction.28,29

For imaging managers, the impact is concrete. A 30-minute knee MRI reduced to 15 minutes lessens daily physical and cognitive load, opens capacity for high-acuity cases, makes late-day add-ons feasible without overtime, and shortens a new hire's time to independence.

Realizing these benefits requires deliberate protocol redesign: Buying the technology is not the same as deploying it, and the freed time should be reinvested strategically rather than absorbed silently.

Model 7: Facility and Workflow Redesign

Staffing efficiency is shaped not only by who is on the schedule but by the physical environment. Optimized facility design, including multibay configurations with dockable tables and dedicated preparation bays, can meaningfully reduce table turnaround and cycle times.

A study of outpatient abdominal MRI found that an optimized design reduced workflow times compared with a conventional layout,30 and a person-centered simulation of a breast MRI screening facility modeled a near-doubling of patients per hour.31 For build and renovation decisions, this means evaluating workflow architecture alongside scanner selection, because layout can amplify or squander the gains from every other model.

Model 8: Schedule Innovation

Schedule flexibility is among the most powerful retention tools available, requiring no new technology or capital. Compressed workweeks, weekend-focused shift packages, and self-scheduling platforms have all shown benefits in imaging settings.

A study of 12-hour shifts among radiographers found that staff valued the longer rest days, with favorable sick-leave and image-rejection patterns, tempered by a caution about fatigue.32 A 2025 systematic review of compressed-workweek arrangements found that outcomes vary by shift length and arrangement. Variances included: predominantly negative health effects when long shifts replace fixed eight-hour days, mixed effects relative to other patterns, and improved shift satisfaction across most configurations.33

The practical lesson is that the schedule must be matched to local context and evaluated against outcomes rather than adopted wholesale. Longer shifts can extend a department's daily reach without added headcount, but require attention to fatigue, ergonomic risk, and state-specific overtime rules that can trigger daily overtime even when weekly hours stay at 40. Leaders should partner with human resources and legal counsel before implementation.

Model 9: Strategic Use of Agency, Travel, and Per Diem Staffing

Travel and per diem technologists remain part of the MRI staffing mix; the question is not whether to use them but how to do so without destabilizing permanent staff.

Used deliberately, it covers acute gaps in days rather than the months a pipeline requires, and supplies competencies a department lacks. Used reflexively, it becomes a recurring premium that crowds out the cross-training, apprenticeship, and retention investments that reduce future reliance.

Three practices distinguish high-functioning strategies:

  1. Transparent communication about when travelers are used
  2. Pairing them with senior staff for orientation
  3. Tracking agency spending against the all-in cost of permanent hires

The Financial Case: Comparing Models by Cost and Return

For imaging managers, staffing decisions are fiscal decisions. An open MRI position is not cost-neutral: it represents lost contribution margin from idle scanner time, overtime to cover the gap, and burnout-driven turnover. Evaluating each model on its all-in cost, not its headline wage, separates a durable strategy from an expensive reflex.

The reference point is the cost of permanent staff. The U.S. Bureau of Labor Statistics reports a median annual wage of $88,180 for MRI technologists as of May 2024, higher in premium markets such as California, Massachusetts, and Washington.4 Against that baseline, contingent labor is the most expensive option per hour worked, carrying a substantial premium over permanent rates once stipends are included. This is why it belongs in the budget as a defined bridge, not a standing line item.

For many administrators, the most persuasive case is a model that pays for itself through retention before affecting productivity. A large share of imaging departments report turnover each year, with burnout among the leading reasons stated for leaving.8 A technologist-specific replacement cost is not well established. Still, each departure compounds recruitment and onboarding expense, lost productivity during a months-long credentialing interval, overtime for remaining staff, and premium contract coverage in the interim. A single retention-oriented intervention, such as a career ladder, a flexible schedule, or an imaging-assistant tier, can recoup its cost by preventing one or two departures per year.

The internal models invert the economics within a 12-month horizon. Cross-training retains experienced staff, reduces costs relative to external hiring, and improves flexibility.24 Apprenticeships have the lowest long-run labor costs because graduates enter at permanent rates and tend to stay, and DOL-registered programs can offset training costs with workforce development funding.25 The bifurcated model shifts the lowest-acuity tasks to a lower wage tier, raising the throughput of credentialed staff a department already employs.10

Remote scanning and facility redesign are capital-forward rather than labor-forward, each justified by recurring returns: recovered scanner availability from reduced room closures and idle hours, and shorter table turnaround from optimized layouts.30,31 AI sits between the two, a capital purchase whose payback depends on converting shortened scan times into higher-acuity throughput rather than letting the saved minutes dissipate.28 The practical recommendation is to model each option against figures the finance office already tracks: cost per scanner-hour of downtime, all-in cost of a permanent hire versus a traveler, the technology's capital and recurring cost, and payback period.

Adjacent Considerations for the Imaging Manager

Four adjacent dimensions determine whether any chosen model succeeds in practice.

MR Safety as the Operational Floor

Each model reorganizes work around the patient and magnet, but none reorganizes accountability. Every innovation must satisfy the same obligations: zone management and ferromagnetic screening, contrast safety and consent, and emergency and quench response. The evidence is concrete: Radiofrequency thermal injuries account for a substantial share of FDA-reported MRI adverse events, most preventable through disciplined remove-insulate-communicate practices.34 Departments deploying remote scanning must confirm that on-site responders meet ACR expectations for Level 2 personnel and that escalation paths are tested.9

Licensure, Liability, and Reimbursement in Remote Scanning

Remote scanning raises questions an administrator must resolve with compliance and legal counsel before launch.

  1. Licensure is a policy matter. MRI requirements differ by state: most accept the ARRT(MR) credential alone, but some require licensure where the patient and scanner are physically located. A multisite program may need several state licenses.4 
  2. Liability: The IAC standards distinguish the local facility, where the patient is present, from the remote facility participating in acquisition. Define responsibility contractually, with coverage confirmed for both.18
  3. Reimbursement: the permanent CMS virtual direct supervision definition resolves the supervision question for many services but does not determine which entity may bill the technical component, which should be validated against payer policy.15

None of these is a reason to avoid remote scanning, but each is a question a prepared administrator answers before launch.

Patient Experience and Examination Completion

Claustrophobia and procedural anxiety drive incomplete and repeated examinations, and the radiographer's communication skills are among the factors most strongly associated with exam completion.35 Cycle-time targets that compress this interaction risk lowering completion rates, so a throughput gain on paper becomes a loss in practice. Any model that shortens preparation time for an anxious patient should be judged against completion and repeat-rate data, not scan counts.

Equipment Strategy and Distributed Access

Equipment and staffing decisions are inseparable. The 2026 ACR MR Safety update acknowledges that low-field and point-of-care systems have different safety zones and training needs,9, and that any distributed-access model is only as strong as the scanners, connectivity, and on-site personnel that anchor it.

Leading the Change: Communication and Culture

Workflow redesign without cultural redesign tends to fail and is the dimension imaging leaders most often underestimate. Every model alters how technologists understand their own value. Remote scanning can feel like a step toward replacement, introducing an imaging assistant like an encroachment on scope, and adopting AI like an erosion of hard-earned expertise. Left unaddressed, those perceptions can harden into resistance that no technology investment can overcome.

The most reliable framing positions each change as an expansion of what the team can do, not a substitution. Remote scanning extends an expert technologist's reach to sites that would otherwise close. The imaging assistant returns scanning time to the technologist by absorbing screening and turnover tasks. AI can remove repetitive acquisition burdens so the technologist can focus on complex cases.

The mechanism that makes these credible is participation. Inviting senior technologists to help write the imaging-assistant scope, validate AI outputs, and design the remote-scanning protocols can turn the staff most likely to resist into the staff most invested in success. The burnout literature is consistent in confirming that leadership behavior, including transparency and involvement, outweighs compensation alone as a driver of retention.6,25

In practice, this argues for a deliberate sequence:

  1. Explain the workforce problem using the department's own data before introducing any solution.
  2. Name each change honestly.
  3. Involve frontline staff in the design rather than presenting a finished plan.
  4. Pilot with explicit success criteria.
  5. Report results back to the team.

The same discipline imaging managers apply to information management elsewhere applies here. The message, its timing, and its messenger determine whether a sound plan survives contact with those who must execute it.

An Implementation Framework for the Imaging Manager

No single model resolves a 17.4% vacancy rate; the strongest responses braid several together. The following five-part framework offers a sequence.

  1. Match the model to the context. Begin with a current-state audit covering vacancy rate, overtime burden, contract-labor spend, technologist tenure, off-hours utilization, patient wait times, and self-reported burnout on a validated instrument. The audit should determine which models fit.

For capital purchases such as remote scanning platforms or AI acceleration, a time-limited vendor pilot with department-defined success metrics lets leaders verify performance in their own setting before committing, rather than relying on vendor-reported results.

  1. Build the safety case first. Every redesign must answer two questions at every moment of the patient encounter: who has eyes on the patient, and who is the Level 2 MR Personnel responsible for safety? The 2026 ACR Manual on MR Safety is the operative reference.9
  2. Invest in change management. Frame each change as role expansion, involve frontline staff in design, and remember that leadership behavior outweighs compensation alone in retention.6,2
  3. Measure and iterate. Maintain a dashboard of leading and lagging indicators, including:
  • Throughput per scanner-hour
  • On-time start rate
  • Cancellation and no-show rates
  • Repeat-scan rate
  • Contrast-event rate
  • Overtime per full-time employee
  • Agency utilization as a share of total staffing
  • Voluntary turnover
  • Time-to-fill
  • Training-to-independence interval

Benchmark each indicator against pre-implementation baselines and review quarterly.

  1. Sequence the changes and engage radiology partners. Start with foundational protections of existing staff, including safety governance, the career ladder, and recognition, before structural changes. Align with section chiefs and quality leadership through joint design and shared metrics, so imaging and physician practices move together.

Matching the Mix to the Department

Because the right combination depends on the setting, three common archetypes illustrate how the menu narrows and which model to adopt first.

The rural or critical-access hospital, often running a single scanner with limited coverage, should start with remote scanning to extend an expert technologist's reach, paired with an on-site imaging assistant to meet the presence standard, then add contingent staffing for acute gaps and an apprenticeship tie to a regional program for the long term.

The urban academic medical center, with high volume and complex protocols, should start with career laddering and cross-training to retain subspecialty expertise, then layer in AI-accelerated protocols, facility redesign where capital permits, and an imaging-assistant tier that frees technologists for the most complex work.

The multisite outpatient network should start with a centralized remote scanning hub that standardizes protocols across locations, on-site coverage at each spoke meeting the same presence standard, and centrally managed contingent staffing.

In every archetype, the presence standard, the broader safety floor, and the change-management discipline are constant; only the model mix shifts.

Looking Ahead

The MRI workforce shortage is not a passing storm. ASRT, ARRT, JRCERT, AHRA, and the broader imaging community have aligned on a multiyear agenda spanning pipeline expansion, career laddering, advanced credentialing, AI integration, and workforce diversification.8

Imaging leaders operate where strategy meets execution and are well-positioned to redesign how MRI work is organized. That position carries accountability. Whichever models a department adopts, its leaders remain responsible for maintaining the safety floor, verifying that staff hold the appropriate credential and competence for the role, and confirming compliance with applicable state licensure. Leaders must also understand reimbursement rules and accreditation standards, and track outcomes so that each change is validated against measurable results rather than assumed to work.

The leaders who define that future will be the ones willing to redesign their staffing models today, not because the existing model has failed, but because the demands on it have outgrown what any single technologist working alone can reasonably be asked to bear.

References

AMA Manual of Style, 10th edition. References in order of appearance. All sources published 2021–2026 and verified against primary or publisher sources. Accessed June 2026.

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2. Hassankhani A, Amoukhteh M, Valizadeh P, et al. A meta-analysis of burnout in radiology trainees and radiologists: insights from the Maslach Burnout Inventory. Acad Radiol. 2024;31(3):1198-1216.doi:10.1016/j.acra.2023.10.046.

3. American Society of Radiologic Technologists. ASRT staffing and workplace survey shows vacancy rate increases near record highs, aligning with overall healthcare profession trends. ASRT News. July 24, 2025. https://www.asrt.org/main/news-publications/news/article/2025/07/24/asrt-staffing-and-workplace-survey-shows-vacancy-rate-increases-near-record-highs-aligning-with-overall-health-care-profession-trends

4. U.S. Bureau of Labor Statistics. Radiologic and MRI technologists. Occupational Outlook Handbook. Updated 2025. https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm

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7. Sipos D, Jenei T, Kövesdi OL, et al. Burnout and occupational stress among Hungarian radiographers working in emergency and non-emergency departments during COVID-19. Radiography. 2023;29(3):466-472. doi:10.1016/j.radi.2023.02.013.

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15. Centers for Medicare & Medicaid Services. Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F). October 31, 2025. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f

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