Volume 53, Issue 2 pp. 599-610

Original Research

Effect of Device Configuration and Patient's Body Composition on the RF Heating and Nonsusceptibility Artifact of Deep Brain Stimulation Implants During MRI at 1.5T and 3T

Bhumi Bhusal PhD,

Bhumi Bhusal PhD

orcid.org/0000-0002-4404-9784

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Bach T. Nguyen PhD,

Bach T. Nguyen PhD

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Pia P. Sanpitak BS,

Pia P. Sanpitak BS

Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Jasmine Vu BS,

Jasmine Vu BS

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Behzad Elahi MD, PhD,

Behzad Elahi MD, PhD

Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Joshua Rosenow MD,

Joshua Rosenow MD

Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Mark J. Nolt PhD,

Mark J. Nolt PhD

Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Roberto Lopez-Rosado PhD,

Roberto Lopez-Rosado PhD

Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Julie Pilitsis MD, PhD,

Julie Pilitsis MD, PhD

orcid.org/0000-0002-6488-9692

Department of Neurosciences and Experimental Therapeutics, Albany Medical College, Albany, New York, USA

Search for more papers by this author

Marisa DiMarzio PhD,

Marisa DiMarzio PhD

Department of Neurosciences and Experimental Therapeutics, Albany Medical College, Albany, New York, USA

Search for more papers by this author

Laleh Golestanirad PhD,

Corresponding Author

Laleh Golestanirad PhD

[email protected]

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA

Address reprint requests to: L.G., Department of Radiology, Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60660, USA. E-mail: [email protected]

Search for more papers by this author

Bhumi Bhusal PhD,

Bhumi Bhusal PhD

orcid.org/0000-0002-4404-9784

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Bach T. Nguyen PhD,

Bach T. Nguyen PhD

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Pia P. Sanpitak BS,

Pia P. Sanpitak BS

Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Jasmine Vu BS,

Jasmine Vu BS

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Behzad Elahi MD, PhD,

Behzad Elahi MD, PhD

Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Joshua Rosenow MD,

Joshua Rosenow MD

Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Mark J. Nolt PhD,

Mark J. Nolt PhD

Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Roberto Lopez-Rosado PhD,

Roberto Lopez-Rosado PhD

Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA

Search for more papers by this author

Julie Pilitsis MD, PhD,

Julie Pilitsis MD, PhD

orcid.org/0000-0002-6488-9692

Department of Neurosciences and Experimental Therapeutics, Albany Medical College, Albany, New York, USA

Search for more papers by this author

Marisa DiMarzio PhD,

Marisa DiMarzio PhD

Department of Neurosciences and Experimental Therapeutics, Albany Medical College, Albany, New York, USA

Search for more papers by this author

Laleh Golestanirad PhD,

Corresponding Author

Laleh Golestanirad PhD

[email protected]

Department of Radiology, Northwestern University, Chicago, Illinois, USA

Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA

Address reprint requests to: L.G., Department of Radiology, Northwestern University, 737 N Michigan Ave, Suite 1600, Chicago, IL 60660, USA. E-mail: [email protected]

Search for more papers by this author

First published: 28 August 2020

https://doi.org/10.1002/jmri.27346

Citations: 22

Contract grant sponsor: NIH; Contract grant numbers: R00EB021320 and R03EB025344.

Share a link

Email
Wechat
Bluesky

Abstract

Background

Patients with deep brain stimulation (DBS) implants have limited access to MRI due to safety concerns associated with RF-induced heating. Currently, MRI in these patients is allowed in 1.5T horizontal bore scanners utilizing pulse sequences with reduced power. However, the use of 3T MRI in such patients is increasingly reported based on limited safety assessments. Here we present the results of comprehensive RF heating measurements for two commercially available DBS systems during MRI at 1.5T and 3T.

Purpose

To assess the effect of imaging landmark, DBS lead configuration, and patient's body composition on RF heating of DBS leads during MRI at 1.5T and 3T.

Study Type

Phantom and ex vivo study.

Population/Subjects/Phantom/Specimen/Animal Model

Gel phantoms and cadaver brain.

Field Strength/Sequence

1.5T and 3T, T₁-weighted turbo spin echo.

Assessment

RF heating was measured at the tips of DBS leads implanted in brain-mimicking gel. Image artifact was assessed in a cadaver brain implanted with an isolated DBS lead.

Statistical Tests

Descriptive.

Results

We observed substantial fluctuation in RF heating, mainly affected by phantom composition and DBS lead configuration, ranging from 0.14°C to 23.73°C at 1.5T, and from 0.10°C to 7.39°C at 3T. The presence of subcutaneous fat substantially altered RF heating at the electrode tips (3.06°C < ∆T < 19.05° C). Introducing concentric loops in the extracranial portion of the lead at the surgical burr hole reduced RF heating by up to 89% at 1.5T and up to 98% at 3T compared to worst-case heating scenarios.

Data Conclusion

Device configuration and patient's body composition substantially altered the RF heating of DBS leads during MRI. Interestingly, certain lead trajectories consistently reduced RF heating and image artifact.

Level of Evidence 1

Technical Efficacy Stage 1

J. MAGN. RESON. IMAGING 2021;53:599–610.

Supporting Information

References

1Mayberg HS, Lozano AM, Voon V, et al. Deep brain stimulation for treatment-resistant depression. Neuron 2005; 45: 651-660.
10.1016/j.neuron.2005.02.014
CAS PubMed Web of Science® Google Scholar
2Kupsch A, Benecke R, Müller J, et al. Pallidal deep-brain stimulation in primary generalized or segmental dystonia. N Engl J Med 2006; 355: 1978-1990.
10.1056/NEJMoa063618
CAS PubMed Web of Science® Google Scholar
3Benabid AL. Deep brain stimulation for Parkinson's disease. Curr Opin Neurobiol 2003; 13: 696-706.
10.1016/j.conb.2003.11.001
CAS PubMed Web of Science® Google Scholar
4Bot M, Schuurman PR, Odekerken VJ, et al. Deep brain stimulation for Parkinson's disease: Defining the optimal location within the subthalamic nucleus. J Neurol Neurosurg Psychiatry 2018; 89: 493-498.
10.1136/jnnp-2017-316907
PubMed Web of Science® Google Scholar
5Cheng C-H, Huang H-M, Lin H-L, Chiou S-M. 1.5T versus 3T MRI for targeting subthalamic nucleus for deep brain stimulation. Br J Neurosurg 2014; 28: 467-470.
10.3109/02688697.2013.854312
PubMed Web of Science® Google Scholar
6Ramani S, Schulte R, graeme M, Ashe J, Pilitsis J, Ileana H. Accurate localization of individual DBS contacts by MRI using zero-TE phase images. Proc Intl Soc Magn Reson Med 2018; 26: 2687.
Google Scholar
7Wang Y, Wang Q, Liu J, et al. On the development of equivalent medium for active implantable device radiofrequency safety assessment. Magn Reson Med 2019; 82: 1164-1176.
10.1002/mrm.27785
PubMed Web of Science® Google Scholar
8Nitz WR, Oppelt A, Renz W, Manke C, Lenhart M, Link J. On the heating of linear conductive structures as guide wires and catheters in interventional MRI. J Magn Reson Imaging 2001; 13: 105-114.
10.1002/1522-2586(200101)13:1<105::AID-JMRI1016>3.0.CO;2-0
CAS PubMed Web of Science® Google Scholar
9Kozlov M, Kainz W. Lead electromagnetic model to evaluate RF-induced heating of a coax lead: A numerical case study at 128 MHz. IEEE J Electromagn RF Microwaves Med Biol 2018; 2: 286-293.
10.1109/JERM.2018.2865459
Google Scholar
10Bhusal B, Bhattacharyya P, Baig T, Jones S, Martens M. Measurements and simulation of RF heating of implanted stereo-electroencephalography electrodes during MR scans. Magn Reson Med 2018; 80: 1676-1685.
10.1002/mrm.27144
PubMed Web of Science® Google Scholar
11 Medtronic. MRI guidelines for Medtronic deep brain stimulation systems. Minneapolis, MN: Medtronic; 2015. Available from http://manuals.medtronic.com/content/dam/emanuals/neuro/M006536C_a_001_view.pdf.
Google Scholar
12 St. Jude Medical. MRI procedure information for St. Jude Medical MR conditional deep brain stimulation system. Plano, TX: St. Jude Medical; 2018. Available from https://manuals.sjm.com.
Google Scholar
13Franceschi AM, Wiggins GC, Mogilner AY, Shepherd T, Chung S, Lui YW. Optimized, minimal specific absorption rate MRI for high-resolution imaging in patients with implanted deep brain stimulation electrodes. Am J Neuroradiol 2016; 37: 1996-2000.
10.3174/ajnr.A4865
CAS PubMed Web of Science® Google Scholar
14Boutet A, Rashid T, Hancu I, et al. Functional MRI safety and artifacts during deep brain stimulation: Experience in 102 patients. Radiology 2019; 293: 174-183.
10.1148/radiol.2019190546
PubMed Web of Science® Google Scholar
15Hancu I, Boutet A, Fiveland E, et al. On the (non-)equivalency of monopolar and bipolar settings for deep brain stimulation fMRI studies of Parkinson's disease patients. J Magn Reson Imaging 2019; 49: 1736-1749.
10.1002/jmri.26321
PubMed Web of Science® Google Scholar
16Golestanirad L, Kazemivalipour E, Lampman D, et al. RF heating of deep brain stimulation implants in open-bore vertical MRI systems: A simulation study with realistic device configurations. Magn Reson Med 2020; 83: 2284-2292.
10.1002/mrm.28049
PubMed Web of Science® Google Scholar
17McElcheran CE, Golestanirad L, Iacono MI, et al. Numerical simulations of realistic lead trajectories and an experimental verification support the efficacy of parallel radiofrequency transmission to reduce heating of deep brain stimulation implants during MRI. Sci Rep 2019; 9: 1-14.
10.1038/s41598-018-38099-w
CAS PubMed Web of Science® Google Scholar
18Golestanirad L, Kazemivalipour E, Keil B, et al. Reconfigurable MRI coil technology can substantially reduce RF heating of deep brain stimulation implants: First in-vitro study of RF heating reduction in bilateral DBS leads at 1.5T. PloS One 2019; 14:e0220043.
10.1371/journal.pone.0220043
CAS PubMed Web of Science® Google Scholar
19Kazemivalipour E, Keil B, Vali A, et al. Reconfigurable MRI technology for low-SAR imaging of deep brain stimulation at 3T: Application in bilateral leads, fully-implanted systems, and surgically modified lead trajectories. Neuroimage 2019; 199: 18-29.
10.1016/j.neuroimage.2019.05.015
PubMed Web of Science® Google Scholar
20Bhusal B, Baig T, Bhattacharyya P, Jones S, Martens M. Resonant heating study of a partially immersed implant in ASTM phantom and human model. Proc Intl Soc Magn Reson Med 2018; 26: 1471.
Google Scholar
21Golestanirad L, Kirsch J, Bonmassar G, et al. RF-induced heating in tissue near bilateral DBS implants during MRI at 1.5T and 3T: The role of surgical lead management. Neuroimage 2019; 184: 566-576.
10.1016/j.neuroimage.2018.09.034
PubMed Web of Science® Google Scholar
22Alon L, Deniz CM, Carluccio G, Brown R, Sodickson DK, Collins CM. Effects of anatomical differences on electromagnetic fields, SAR, and temperature change. Concepts Magn Reson Part B Magn Reson Eng 2016; 46: 8-18.
10.1002/cmr.b.21317
CAS PubMed Web of Science® Google Scholar
23Fujimoto K, Angelone LM, Lucano E, Rajan SS, Iacono MI. Radio-frequency safety assessment of stents in blood vessels during magnetic resonance imaging. Front Physiol 2018; 9: 1439.
10.3389/fphys.2018.01439
PubMed Web of Science® Google Scholar
24Camacho CR, Plewes DB, Henkelman RM. Nonsusceptibility artifacts due to metallic objects in MR imaging. J Magn Reson Imaging 1995; 5: 75-88.
10.1002/jmri.1880050115
CAS PubMed Web of Science® Google Scholar
25Graf H, Lauer UA, Berger A, Schick F. RF artifacts caused by metallic implants or instruments which get more prominent at 3T: An in vitro study. Magn Reson Imaging 2005; 23: 493-499.
10.1016/j.mri.2004.12.009
PubMed Web of Science® Google Scholar
26Griffin GH, Anderson KJ, Celik H, Wright GA. Safely assessing radiofrequency heating potential of conductive devices using image-based current measurements. Magn Reson Med 2015; 73: 427-441.
10.1002/mrm.25103
PubMed Web of Science® Google Scholar
27Golestanirad L, Iacono MI, Keil B, et al. Construction and modeling of a reconfigurable MRI coil for lowering SAR in patients with deep brain stimulation implants. Neuroimage 2017; 147: 577-588.
10.1016/j.neuroimage.2016.12.056
PubMed Web of Science® Google Scholar
28Overall WR, Pauly JM, Stang PP, Scott GC. Ensuring safety of implanted devices under MRI using reversed RF polarization. Magn Reson Med 2010; 64: 823-833.
10.1002/mrm.22468
PubMed Web of Science® Google Scholar
29Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging 2012; 30: 1323-1341.
10.1016/j.mri.2012.05.001
PubMed Web of Science® Google Scholar
30Baker KB, Tkach J, Hall JD, Nyenhuis JA, Shellock FG, Rezai AR. Reduction of magnetic resonance imaging-related heating in deep brain stimulation leads using a lead management device. Operat Neurosurg 2005; 57: ONS-392.
10.1227/01.NEU.0000176877.26994.0C
Web of Science® Google Scholar
31Golestanirad L, Keil B, Angelone LM, Bonmassar G, Mareyam A, Wald LL. Feasibility of using linearly polarized rotating birdcage transmitters and close-fitting receive arrays in MRI to reduce SAR in the vicinity of deep brain simulation implants. Magn Reson Med 2017; 77: 1701-1712.
10.1002/mrm.26220
PubMed Web of Science® Google Scholar
32McElcheran CE, Yang B, Anderson KJ, Golestanirad L, Graham SJ. Parallel radiofrequency transmission at 3 Tesla to improve safety in bilateral implanted wires in a heterogeneous model. Magn Reson Med 2017; 78: 2406-2415.
10.1002/mrm.26622
CAS PubMed Web of Science® Google Scholar
33Ladd ME, Quick HH. Reduction of resonant RF heating in intravascular catheters using coaxial chokes. Magn Reson Med 2000; 43: 615-619.
10.1002/(SICI)1522-2594(200004)43:4<615::AID-MRM19>3.0.CO;2-B
CAS PubMed Web of Science® Google Scholar
34Golestanirad L, Angelone LM, Kirsch J, et al. Reducing RF-induced heating near implanted leads through high-dielectric capacitive bleeding of current (CBLOC). IEEE Trans Microwave Theor Tech 2019; 67: 1265-1273.
10.1109/TMTT.2018.2885517
PubMed Web of Science® Google Scholar
35Golestanirad L, Angelone LM, Iacono MI, Katnani H, Wald LL, Bonmassar G. Local SAR near deep brain stimulation (DBS) electrodes at 64 and 127 MHz: A simulation study of the effect of extracranial loops. Magn Reson Med 2017; 78: 1558-1565.
10.1002/mrm.26535
PubMed Web of Science® Google Scholar
36Yeung CJ, Susil RC, Atalar E. RF heating due to conductive wires during MRI depends on the phase distribution of the transmit field. Magn Reson Med 2002; 48: 1096-1098.
10.1002/mrm.10310
PubMed Web of Science® Google Scholar
37Finelli DA, Rezai AR, Ruggieri PM, et al. MR imaging-related heating of deep brain stimulation electrodes: in vitro study. Am J Neuroradiol 2002; 23: 1795-1802.
PubMed Web of Science® Google Scholar
38Park S-M, Kamondetdacha R, Nyenhuis JA. Calculation of MRI-induced heating of an implanted medical lead wire with an electric field transfer function. J Magn Reson Imaging 2007; 26: 1278-1285.
10.1002/jmri.21159
CAS PubMed Web of Science® Google Scholar
39Rezai AR, Finelli D, Nyenhuis JA, et al. Neurostimulation systems for deep brain stimulation: in vitro evaluation of magnetic resonance imaging–related heating at 1.5 Tesla. J Magn Reson Imaging 2002; 15: 241-250.
10.1002/jmri.10069
PubMed Web of Science® Google Scholar
40 ISO TS 10974. Assessment of the safety of magnetic resonance imaging for patients with an active implantable medical device. Geneva, Switzerland: International Organization for Standardization; 2018.
Google Scholar

Citing Literature

Volume53, Issue2

February 2021

Pages 599-610

Effect of Device Configuration and Patient's Body Composition on the RF Heating and Nonsusceptibility Artifact of Deep Brain Stimulation Implants During MRI at 1.5T and 3T

Abstract

Background

Purpose

Study Type

Population/Subjects/Phantom/Specimen/Animal Model

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Supporting Information

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Effect of Device Configuration and Patient's Body Composition on the RF Heating and Nonsusceptibility Artifact of Deep Brain Stimulation Implants During MRI at 1.5T and 3T

Abstract

Background

Purpose

Study Type

Population/Subjects/Phantom/Specimen/Animal Model

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Supporting Information

References

Citing Literature

References

Related

Information