MR safety in patients with implanted deep brain stimulation systems (DBS)

Sharan, Ashwini; Rezai, Ali R.; Nyenhuis, J.A.; Hrdlicka, Greg; Tkach, Jean A.; Baker, Kenneth B.; Turbay, Massud; Rugieri, Paul; Phillips, Michael; Shellock, Frank G.

doi:10.1007/978-3-7091-6081-7_30

Cited by 40 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maciunas et al [11] demonstrated that stereotactic accuracy in CT is dependent on the slice thickness. In addition, several papers have discussed MRI safety concerns in patients with DBS electrodes, which are eliminated with the use of postoperative CT [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

Analysis of Stereotactic Accuracy of the Cosman-Robert-Wells Frame and Nexframe Frameless Systems in Deep Brain Stimulation Surgery

Kelman

Ramakrishnan

Davies

et al. 2010

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Introduction: The primary goal of stereotactic systems in deep brain stimulation (DBS) surgery is accurate delivery of a DBS lead to a target identified on imaging. Thus, it is critical to understand the accuracy of the stereotactic systems and the factors which may be associated with a decrease in accuracy. Methods: Ninety patients underwent microelectrode recording-guided placement of 139 DBS leads by a single surgeon using the Cosman-Roberts-Wells (CRW) frame (n = 70) or a frameless skull-mounted trajectory guide (Nexframe; n = 69). The final DBS location was identified on a postoperative CT fused to the preoperative CT and MRI scans. The difference between this final location and the expected location was calculated. Results: The vector error was 2.65 mm (standard error, 0.22) for the frame and 2.78 mm (standard error, 0.25) for the frameless methods (p = 0.69). There was a gradual decline in error for both systems over time, as the vector error of the last 20 implants was 1.99 for the CRW frame and 2.04 for the Nexframe (p = 0.86). Conclusions: This study shows that the CRW frame and Nexframe frameless systems have equivalent accuracy. Furthermore, the accuracy of both techniques improved over time, from 3 mm initially to 2 mm with current techniques.

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of Stereotactic Accuracy of the Cosman-Robert-Wells Frame and Nexframe Frameless Systems in Deep Brain Stimulation Surgery

Kelman

Ramakrishnan

Davies

et al. 2010

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

show abstract

“…Some 'controversies' such as the use of micro-recording to optimize placement [6] and the safety and use of post-operative MRI [7] were Results in mean 8 SD; n = 36 centers. both strongly endorsed by this survey.…”

Section: Discussionmentioning

confidence: 99%

The North American Survey of Placement and Adjustment Strategies for Deep Brain Stimulation

Ondo¹,

Brontë‐Stewart²

2005

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: Deep brain stimulation (DBS) is gaining wide acceptance as treatment for Parkinson’s disease (PD), essential tremor, and dystonia. Methods: A 40-item questionnaire commissioned by the DBS Study Group was sent to 46 centers that had performed at least 25 DBS implantations. These centers were identified through the DBS Study Group, other professional societies, and with the assistance of the Medtronic Corporation. The results were then tabulated and descriptive analyses were performed. Results: Thirty-six of 47 centers (77%) responded, they had implanted 4,553 patients. The timing for bilaterally implanted patients varied, as 13 sites almost always implanted simultaneously whereas 14 sites almost never implanted simultaneously. Stereotactic frames included Leksell (n = 19), CRW (n = 15) and Compass (n = 2). Post-placement imaging was routinely performed by almost all centers and included MRI (n = 23), CT (n = 4), CT/MRI variably (n = 5), and ventriculography (n = 1). Two centers used more than one electrode per side. The 34 centers that used a single electrode averaged 2.3 ± 1.4 passes per electrode (range: 1–18 passes). Most centers used macro-stimulation to confirm placement by assessing the intra-operative clinical response (n = 34), and to assess for adverse events (n = 26) at high voltages, averaging 6.7 ± 2.3 V (range: 4–10). The initial activation averaged 18 ± 12 days after electrode placement (average range: 11 ± 10 to 28 ± 18 days, absolute range: 1–90 days). Most sites had several programmers; however, the primary programmers were neurology staff (n = 15), the neurologist (n = 13), neurosurgery staff (n = 6), the neurosurgeon (n = 2), or a physiatrist (n = 1). Twelve centers automatically reduced PD medications on the day of initial activation, 9 centers reduced them variably, and 16 centers initially did not reduce them. Eventually, 80.4% of patients were reported to have some dose reduction, and 47.1% had a greater than 50% reduction of PD medications. Conclusions: Strategies regarding DBS placement and adjustment vary in North America.

show abstract

“…Numerous in vitro safety investigations have been described 19,33,35,39,[45][46][47][48][49][50][51][52] and reports of patient series 10,20,53-56 with few or no adverse incidents directly attributable to exposure to the MRI environment. Medtronic first released MRI guidelines for their DBS devices in 2002, with requirements including head-coil only transmit and SAR restricted to 0.4W/kg.…”

Section: A N U S C R I P Tmentioning

confidence: 99%

Technical challenges and safety of magnetic resonance imaging with in situ neuromodulation from spine to brain

Thornton

2017

European Journal of Paediatric Neurology

View full text Add to dashboard Cite

show abstract

MR safety in patients with implanted deep brain stimulation systems (DBS)

Cited by 40 publications

References 15 publications

Analysis of Stereotactic Accuracy of the Cosman-Robert-Wells Frame and Nexframe Frameless Systems in Deep Brain Stimulation Surgery

Analysis of Stereotactic Accuracy of the Cosman-Robert-Wells Frame and Nexframe Frameless Systems in Deep Brain Stimulation Surgery

The North American Survey of Placement and Adjustment Strategies for Deep Brain Stimulation

Technical challenges and safety of magnetic resonance imaging with in situ neuromodulation from spine to brain

Contact Info

Product

Resources

About