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; Bach T. Nguyen; Pia P. Sanpitak; Jasmine Vu; Behzad Elahi; Joshua Rosenow; Mark J. Nolt; Roberto Lopez-Rosado; Julie Pilitsis; Marisa DiMarzio; Laleh Golestanirad

doi:10.1002/jmri.27346

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, Bach T. Nguyen, Pia P. Sanpitak, Jasmine Vu, Behzad Elahi, Joshua Rosenow, Mark J. Nolt, Roberto Lopez-Rosado, Julie Pilitsis, Marisa DiMarzio, Laleh Golestanirad^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

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.

Original language	English (US)
Pages (from-to)	599-610
Number of pages	12
Journal	Journal of Magnetic Resonance Imaging
Volume	53
Issue number	2
DOIs	https://doi.org/10.1002/jmri.27346
State	Published - Feb 2021

Keywords

DBS MRI
RF heating
anthropomorphic phantom
image artifact
image segmentation
implant safety

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1002/jmri.27346

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Bhusal, B., Nguyen, B. T., Sanpitak, P. P., Vu, J., Elahi, B., Rosenow, J., Nolt, M. J., Lopez-Rosado, R., Pilitsis, J., DiMarzio, M., & Golestanirad, L. (2021). 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. Journal of Magnetic Resonance Imaging, 53(2), 599-610. https://doi.org/10.1002/jmri.27346

Bhusal, Bhumi ; Nguyen, Bach T. ; Sanpitak, Pia P. ; Vu, Jasmine ; Elahi, Behzad ; Rosenow, Joshua ; Nolt, Mark J. ; Lopez-Rosado, Roberto ; Pilitsis, Julie ; DiMarzio, Marisa ; Golestanirad, Laleh. / 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. In: Journal of Magnetic Resonance Imaging. 2021 ; Vol. 53, No. 2. pp. 599-610.

@article{d43fa8fc676443929b6eb8dcf24731cf,

title = "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: 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.",

keywords = "DBS MRI, RF heating, anthropomorphic phantom, image artifact, image segmentation, implant safety",

author = "Bhumi Bhusal and Nguyen, {Bach T.} and Sanpitak, {Pia P.} and Jasmine Vu and Behzad Elahi and Joshua Rosenow and Nolt, {Mark J.} and Roberto Lopez-Rosado and Julie Pilitsis and Marisa DiMarzio and Laleh Golestanirad",

note = "Funding Information: The authors thank Dr. Rangaprakash Deshpande for assistance in the experimental setup.",

year = "2021",

month = feb,

doi = "10.1002/jmri.27346",

language = "English (US)",

volume = "53",

pages = "599--610",

journal = "Journal of Magnetic Resonance Imaging",

issn = "1053-1807",

publisher = "John Wiley and Sons Inc.",

number = "2",

}

Bhusal, B, Nguyen, BT, Sanpitak, PP, Vu, J, Elahi, B, Rosenow, J, Nolt, MJ, Lopez-Rosado, R, Pilitsis, J, DiMarzio, M & Golestanirad, L 2021, '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', Journal of Magnetic Resonance Imaging, vol. 53, no. 2, pp. 599-610. https://doi.org/10.1002/jmri.27346

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. / Bhusal, Bhumi; Nguyen, Bach T.; Sanpitak, Pia P.; Vu, Jasmine; Elahi, Behzad; Rosenow, Joshua; Nolt, Mark J.; Lopez-Rosado, Roberto; Pilitsis, Julie; DiMarzio, Marisa; Golestanirad, Laleh.

In: Journal of Magnetic Resonance Imaging, Vol. 53, No. 2, 02.2021, p. 599-610.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

AU - Bhusal, Bhumi

AU - Nguyen, Bach T.

AU - Sanpitak, Pia P.

AU - Vu, Jasmine

AU - Elahi, Behzad

AU - Rosenow, Joshua

AU - Nolt, Mark J.

AU - Lopez-Rosado, Roberto

AU - Pilitsis, Julie

AU - DiMarzio, Marisa

AU - Golestanirad, Laleh

N1 - Funding Information: The authors thank Dr. Rangaprakash Deshpande for assistance in the experimental setup.

PY - 2021/2

Y1 - 2021/2

N2 - 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.

AB - 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.

KW - DBS MRI

KW - RF heating

KW - anthropomorphic phantom

KW - image artifact

KW - image segmentation

KW - implant safety

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