Magnetic resonance imaging scans in patients with dorsal root ganglion stimulation

Abstract

Objective: Patients fitted with a neurostimulator face a greater need to undergo magnetic resonance imaging (MRI) scans. Given the lack of literature in this regard, this study aims to review our experience with MRI examinations on patients implanted with a dorsal root ganglion stimulation (DRG-S) system and their potential adverse events. Materials and Methods:We conducted a retrospective analysis of the prospective treatment documentation gathered from November 2011 to October 2020. We identified 259 MRI registrations for patients with an implanted neurostimulation system; the MRI examinations were performed using a 1.5 Tesla MRI system in accordance with a structured scheme.Results: Among the 259 MRI registrations identified in this study, 28 corresponded to patients with an implanted DRG-S system. In 2 cases, no MRI scan was performed, and thus, only 26 MRI examinations were evaluated in detail. The DRG-S device was approved for the requested MRI scans in only 2 of these 26 cases (7.7%).In addition, 2 minor adverse events (syncopal episode and connection problem) were identified, and only the second problem (3.8%) was related to neurostimulator operation.Conclusions: Necessary MRI examinations in patients with DRG-S systems are rarely covered by the European CE/US Food and Drug Administration (CE/FDA) approval. Although the manufacturer recommendations are against the use of MRI in patients with implanted DRG-S in certain conditions, we performed these scans without causing injury to the patient or damaging the device. Given that data on safety are limited, MRIs should be conducted study related. We provide recommendations for the procedure that should be followed when an MRI is needed urgently.

Dorsal root ganglion stimulator—A targeted therapy for post‐herpetic neuralgia: The Middle East Experience

“…MRI compatibility is also an important limitation and needs to be considered before decision‐making. Manufacturers recommend against the use of MRI in patients with DRG‐s but, Reining et al 17 . in their retrospective analysis reported limited safety.…”

Bedarf und Vorhersagbarkeit von Magnetresonanztomographieuntersuchungen bei Patienten mit implantiertem Neurostimulator

“…Auskunft hierzu geben die Bedienungsanleitungen oder einschlägige Übersichtsarbeiten [ 18 , 19 ]. Aufgrund dieser vielfältigen Einschränkungen sind nur wenige MRT-Untersuchungen innerhalb der Zulassung möglich [ 17 ].…”

“…Farber und Kollegen beschreiben einen hohen Bedarf an Bildgebung und einen geringeren Anteil an MRT-Bildgebung [ 9 ], diese Beobachtung können wir grundsätzlich bestätigen. Studien zur Sicherheit von MRT-Untersuchungen sind rar und beziehen sich mit unterschiedlicher Schwerpunktsetzung zumeist auf ältere, heute nur noch selten anzutreffende Implantate [ 4 , 13 , 14 , 17 , 22 ].…”