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European Radiology
Published in: European Radiology 5/2020

01-05-2020 | Magnetic Resonance Imaging | Magnetic Resonance

MRI in patients with implanted active devices: how to combine safety and image quality using a limited transmission field?

Authors: Laura Lunden, Stephan Wolff, Sönke Peters, Catharina Drews, Christine Gierloff, Ulf Jensen-Kondering, Patrick Langguth, Jawid Madjidyar, Tim-Christian Piesch, Olav Jansen

Published in: European Radiology | Issue 5/2020

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Abstract

Objectives

Radio frequency (RF) pulses in magnetic resonance imaging (MRI) can interact with implanted devices and cause tissue damage. However, there are new devices that can safely perform measurements with liberal MRI conditions such as an RF transmission field B1+rms ≤ 2.0 μT. We investigated whether MRI in this case is limited for these technical reasons.

Methods

We selected typical MRI protocols of six body regions (brain, cervical spine, lumbar spine, knee, liver, heart) using two typical 1.5T MRI scanners. Overall, we adapted 62 sequences to B1+rms conditions and evaluated their diagnostic quality. For this, we measured signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR), and geometric deviation (GD) as quality parameters, using phantom studies. For questionnaire studies, we selected pairs of original and adapted sequences in healthy volunteers. Blinded radiologists rated the images as single sequence rating and in direct comparison.

Results

Roughly one-third of the checked sequences were below the B1+rms limit. Here, 56 of the 62 adapted sequences showed at least the same image quality in single ratings. A reduction in SNR and/or CNR was found with 31 sequences and only one sequence with considerably increased GD. Especially, sequences with original high B1+rms values, PD sequences, and sequences of the Siemens knee and heart protocol were difficult to adapt, whereas most TSE and IR sequences had no clinical limitations.

Conclusion

By limiting the transmission field to B1+rms ≤ 2.0 μT, clinically relevant MR sequences can be adapted with nearly no reduction in image quality. Despite limiting the transmission field, high-quality MR imaging is possible. We could derive strategies for adaptation.

Key Points

• Despite limiting the transmission field, high-quality MRI is possible.
• We could derive strategies for adapting the sequences to B 1+rms ≤ 2.0 μT.
• This enables high-quality MRI of different body regions for patients with AD.
Appendix
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Literature
1.
2.
Wodarg F, Herzog J, Reese R et al (2012) Stimulation site within the MRI-defined STN predicts postoperative motor outcome. Mov Disord 27:874–879CrossRef
3.
Cabot E, Lloyd T, Christ A et al (2013) Evaluation of the RF heating of a generic deep brain stimulator exposed in 1.5 T magnetic resonance scanners. Bioelectromagnetics 34:104–113CrossRef
4.
Cross NM, Hoff MN, Kanal KM (2018) Avoiding MRI-related accidents: a practical approach to implementing MR safety. J Am Coll Radiol 15:1738–1744CrossRef
5.
Shellock FG (2002) Magnetic resonance safety update 2002: implants and devices. J Magn Reson Imaging 16:485–496CrossRef
6.
Franceschi AM, Wiggins GC, Mogilner AY, Shepherd T, Chung S, Lui YW (2016) Optimized, minimal specific absorption rate MRI for high-resolution imaging in patients with implanted deep brain stimulation electrodes. AJNR Am J Neuroradiol 37:1996–2000
7.
8.
9.
Sarkar SN, Papavassiliou E, Rojas R et al (2014) Low-power inversion recovery MRI preserves brain tissue contrast for patients with Parkinson disease with deep brain stimulators. AJNR Am J Neuroradiol 35:1325–1329CrossRef
10.
Sarkar SN, Papavassiliou E, Hackney DB et al (2014) Three-dimensional brain MRI for DBS patients within ultra-low radiofrequency power limits. Mov Disord 29:546–549CrossRef
11.
12.
13.
Sarkar SN, Alsop DC, Madhuranthakam AJ et al (2011) Brain MR imaging at ultra-low radiofrequency power. Radiology 259:550–557CrossRef
14.
15.
Hamilton J, Franson D, Seiberlich N (2017) Recent advances in parallel imaging for MRI. Prog Nucl Magn Reson Spectrosc 101:71–95CrossRef
16.
Zrinzo L, Yoshida F, Hariz MI et al (2011) Clinical safety of brain magnetic resonance imaging with implanted deep brain stimulation hardware: large case series and review of the literature. World Neurosurg 76:164–172CrossRef
17.
Larson PS, Richardson RM, Starr PA, Martin AJ (2008) Magnetic resonance imaging of implanted deep brain stimulators: experience in a large series. Stereotact Funct Neurosurg 86:92–100
Metadata
Title
MRI in patients with implanted active devices: how to combine safety and image quality using a limited transmission field?
Authors
Laura Lunden
Stephan Wolff
Sönke Peters
Catharina Drews
Christine Gierloff
Ulf Jensen-Kondering
Patrick Langguth
Jawid Madjidyar
Tim-Christian Piesch
Olav Jansen
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06599-6

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