Reduction of Magnetic Resonance Imaging-related Heating in Deep Brain Stimulation Leads Using a Lead Management Device

Baker, Kenneth B.; Tkach, Jean A.; Hall, Julie; Nyenhuis, J.A.; Shellock, Frank G.; Rezai, Ali R.

doi:10.1227/01.neu.0000176877.26994.0c

Cited by 67 publications

(85 citation statements)

References 11 publications

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“…In contrast to this and other recent studies, where a fluoroptic probe was used, the temperature changes were measured with an infrared camera. These low temperature changes are in contrast to the study of Baker et al [3], who found temperature changes up to 10°C in their setup. The major difference seems to be the length of the used DBS leads.…”

Section: Discussioncontrasting

confidence: 99%

“…Several authors have investigated the effect of MRI on DBS [1,2,3,4,5,6,7,8] and spinal cord stimulation devices [7,9,10] using different field strengths, sequences and implanted devices. On the other hand, there are studies published where patients were examined without restricted protocols, exceeding the manufacturer's recommendations [11,12,13].…”

Section: Introductionmentioning

confidence: 99%

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Risk Assessment of Magnetic Resonance Imaging in Chronically Implanted Paddle Electrodes for Cortical Stimulation

Tronnier

Melchert²,

Petersen³

et al. 2015

Stereotact Funct Neurosurg

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Background: Cortical epidural stimulation is used for the treatment of different neuropsychiatric disorders such as chronic neuropathic pain, tinnitus, movement disorders, and psychiatric diseases. While preoperative magnetic resonance imaging (MRI) is considered the imaging tool of choice for planning the approach and electrode placement, postoperative MRI is still a contraindication with implanted paddle leads due to the risk of thermal damage or current induction creating seizures or neurological deficits. Objectives: In this feasibility in vitro study the temperature changes and induction were determined as well as the artifacts caused by 2 parallel paddle leads (Resume II, Model 3587 A; Medtronic, Minneapolis, Minn., USA), commonly used in clinical practice with and without a pulse generator (Prime Advanced, Model 7489; Medtronic). Methods: An ultrasound gel-filled head phantom with 2 paddle leads mimicking the surgical scenario was used to evaluate temperature changes as well as induced currents in a 1.5- and 3-tesla MR scanner. In addition, 1 patient underwent a 3-tesla MRI with an implanted subdural paddle lead. Results: Negligible temperature changes were detected with turbo spin echo sequences in the 1.5- and 3-tesla scanner using a head and body coil. Induced voltages up to 6 V were measured. The imaging artifacts in the phantom were well tolerable. The patient's imaging was uneventful under the settings which are accepted for deep brain stimulation imaging. Conclusion: MRI under the conditions described here seems to be safe with the implants used in this study. In particular, the induced temperature is much lower with paddle compared to conventional leads due to the different electrode design. The induced voltage does not carry any risks. However, these findings cannot automatically be transferred to other implants or other scanning conditions, and further studies are needed. The biomedical companies should be encouraged to develop MR-conditional paddle leads. Also, further research is necessary to study the mechanism of action of cortical stimulation in the future.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Assessment of Magnetic Resonance Imaging in Chronically Implanted Paddle Electrodes for Cortical Stimulation

Tronnier

Melchert²,

Petersen³

et al. 2015

Stereotact Funct Neurosurg

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“…For a wholebody averaged SAR of 3.9 W/kg, the rise was 25.3 • C for no loops in the lead and 6.1 • C when the leads were positioned with two small loops (approximately 2.5 cm in diameter) in an axial orientation at the top of the head portion of the phantom, simulating a loop near the burr hole cover. Similarly, Baker et al found that the presence of loops in the lead resulted in decreased temperature rise [35]. Kainz et al [36] also undertook a study of heating of neurostimulation systems.…”

Section: Review Of Heating Of Leads By the Rf Field Used For Mrimentioning

confidence: 99%

“…(The phantom used in [34], [35], and [37] yields a temperature rise similar to that of the greatest gelling agent concentration considered by Park et al) Differences in phantom material may thus account for some of the differences in RF-induced heating reported in the peer-reviewed literature.…”

Section: Review Of Heating Of Leads By the Rf Field Used For Mrimentioning

confidence: 99%

MRI and implanted medical devices: basic interactions with an emphasis on heating

Nyenhuis

Park

Kamondetdacha

et al. 2005

IEEE Trans. Device Mater. Relib.

168

133

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There are three principal magnetic fields in magnetic resonance imaging (MRI) that may interact with medical implants. The static field will induce force and torque on ferromagnetic objects. The pulsed gradients are of audio frequency and the implant may concentrate the induced currents, with a potential for nerve stimulation or electrical inference. The currents induced in the body by the radio frequency (RF) field may also be concentrated by an implant, resulting in potentially dangerous heating of surrounding tissues. This paper presents basic information about MRI interactions with implants with an emphasis on RF-induced heating of leads used for deep brain stimulation (DBS). The temperature rise at the electrodes was measured in vitro as a function of the overall length of a DBS lead at an RF frequency of 64 MHz. The maximal temperature rise occurred for an overall length of 41 cm. The method of moments was used to calculate the current induced in the lead. From the induced currents, the RF power deposition near the electrodes was calculated and the heat equation was used to model the temperature rise. The calculated temperature rises as a function of lead length were in good agreement with the measured values.

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“…Overall at 0.35T [103] and 1.5T it has been found that risks can be managed under specific configurations (low SAR sequences and often a head transmit-receive coil) and the production of heating is less when DBS equipment are fully implanted [34,59,[104][105][106][107][108][109][110][111][112][113]. In 3T MRI fields and higher [34,59,107,[109][110][111][114][115][116][117][118], similar results in terms of heating have been obtained but more caution is required when dealing with DBS implants and wires as well as pulse sequences in general require greater SAR. The summaries of the safety studies of DBS external electrodes and implants in MRI are listed in Table 2.…”

Section: Survey Of the Experimental Literature On The Safety Of Scalpmentioning

confidence: 99%

Safety of Simultaneous Scalp or Intracranial EEG during MRI: A Review

Hawsawi

Carmichael²,

Lemieux

2017

Front. Phys.

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Understanding the brain and its activity is one of the great challenges of modern science. Normal brain activity (cognitive processes, etc.) has been extensively studied using electroencephalography (EEG) since the 1930's, in the form of spontaneous fluctuations in rhythms, and patterns, and in a more experimentally-driven approach in the form of event-related potentials (ERPs) allowing us to relate scalp voltage waveforms to brain states and behavior. The use of EEG recorded during functional magnetic resonance imaging (EEG-fMRI) is a more recent development that has become an important tool in clinical neuroscience, for example for the study of epileptic activity. The purpose of this review is to explore the magnetic resonance imaging safety aspects specifically associated with the use of scalp EEG and other brain-implanted electrodes such as intracranial EEG electrodes when they are subjected to the MRI environment. We provide a theoretical overview of the mechanisms at play specifically associated with the presence of EEG equipment connected to the subject in the MR environment, and of the resulting health hazards. This is followed by a survey of the literature on the safety of scalp or invasive EEG-fMRI data acquisitions across field strengths, with emphasis on the practical implications for the safe application of the techniques; in particular, we attempt to summarize the findings in terms of acquisition protocols when possible.

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Reduction of Magnetic Resonance Imaging-related Heating in Deep Brain Stimulation Leads Using a Lead Management Device

Cited by 67 publications

References 11 publications

Risk Assessment of Magnetic Resonance Imaging in Chronically Implanted Paddle Electrodes for Cortical Stimulation

Risk Assessment of Magnetic Resonance Imaging in Chronically Implanted Paddle Electrodes for Cortical Stimulation

MRI and implanted medical devices: basic interactions with an emphasis on heating

Safety of Simultaneous Scalp or Intracranial EEG during MRI: A Review

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