OBJECTIVE: To survey the safety of MRI in PD patients implanted with DBS devices. BACKGROUND: MRI in patients with DBS implants is useful to confirm electrode placement, optimize programming and investigating complications. However, several medical centers do not perform MRI studies in DBS patients because of safety concerns. The safety profile of MRI in DBS patients has not been documented in large clinical series. METHODS: 42 NPF Centers of Excellence (COEs) were asked to complete a questionnaire on MRI use and DBS. RESULTS: Investigators from 40 of 42 (95%) NPF COEs completed the survey and 23 (58%) reported that they were currently performing brain MRI in DBS patients, while 3 (7.5%) had done it in the past. The 17 COEs currently not performing post-operative MRI for DBS listed the following reasons: 1) industry guidelines and/or warnings (53%); 2) decision deferred to outside department (29%); 3) liability/risk/safety (18%); 4) no active DBS program (18%); 5) no available MRI (12%); and 6) insurance and reimbursement concerns (6%). A total of 3304 PD patients with one or more DBS leads had a brain MRI scan, and 177 DBS patients had MRI of other body regions. In one case MRI was associated with an IPG failure without neurological sequelae after IPG replacement. No other complications were reported. CONCLUSIONS: these data provide evidence for a favorable risk/benefit ratio for brain MRI in patients with DBS implants. Further studies will need to address whether a re-assessment of more restrictive recommendations (i.e. very low SAR values) may be warranted.
OBJECTIVE: To survey the safety of MRI in PDpatients implanted with DBS devices. BACKGROUND: MRI in patients with DBS implants is useful to confirm electrode placement, optimize programming and investigating complications. However, several medical centers do not perform MRI studies in DBSpatients because of safety concerns. The safety profile of MRI in DBSpatients has not been documented in large clinical series. METHODS: 42 NPF Centers of Excellence (COEs) were asked to complete a questionnaire on MRI use and DBS. RESULTS: Investigators from 40 of 42 (95%) NPF COEs completed the survey and 23 (58%) reported that they were currently performing brain MRI in DBSpatients, while 3 (7.5%) had done it in the past. The 17 COEs currently not performing post-operative MRI for DBS listed the following reasons: 1) industry guidelines and/or warnings (53%); 2) decision deferred to outside department (29%); 3) liability/risk/safety (18%); 4) no active DBS program (18%); 5) no available MRI (12%); and 6) insurance and reimbursement concerns (6%). A total of 3304 PDpatients with one or more DBS leads had a brain MRI scan, and 177 DBSpatients had MRI of other body regions. In one case MRI was associated with an IPG failure without neurological sequelae after IPG replacement. No other complications were reported. CONCLUSIONS: these data provide evidence for a favorable risk/benefit ratio for brain MRI in patients with DBS implants. Further studies will need to address whether a re-assessment of more restrictive recommendations (i.e. very low SAR values) may be warranted.
Authors: Laleh Golestanirad; Maria Ida Iacono; Boris Keil; Leonardo M Angelone; Giorgio Bonmassar; Michael D Fox; Todd Herrington; Elfar Adalsteinsson; Cristen LaPierre; Azma Mareyam; Lawrence L Wald Journal: Neuroimage Date: 2016-12-21 Impact factor: 6.556
Authors: Laleh Golestanirad; Leonardo M Angelone; Maria Ida Iacono; Husam Katnani; Lawrence L Wald; Giorgio Bonmassar Journal: Magn Reson Med Date: 2016-10-31 Impact factor: 4.668
Authors: S N Sarkar; E Papavassiliou; R Rojas; D L Teich; D B Hackney; R A Bhadelia; J Stormann; R L Alterman Journal: AJNR Am J Neuroradiol Date: 2014-03-27 Impact factor: 3.825