Manuel Murbach1, Esra Neufeld1, Theodoros Samaras2, Juan Córcoles3, Fraser J Robb4, Wolfgang Kainz5, Niels Kuster1,6. 1. IT'IS Foundation, Zurich, Switzerland. 2. Department of Physics, Aristotle University of Thessaloniki, Thessaloniki, Greece. 3. Department of Electronic and Communication Technology, Universidad Autónoma de Madrid (UAM), Escuela Politécnica Superior, Madrid, Spain. 4. GE Healthcare, Aurora, Ohio, USA. 5. US Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH), Silver Spring, Maryland, USA. 6. Swiss Federal Institute of Technology (ETH), Zurich, Switzerland.
Abstract
PURPOSE: MRI is increasingly used to scan pregnant patients. We investigated the effect of 3 Tesla (T) two-port radiofrequency (RF) shimming in anatomical pregnant women models. THEORY AND METHODS: RF shimming improves B1+ uniformity, but may at the same time significantly alter the induced current distribution and result in large changes in both the level and location of the absorbed RF energy. In this study, we evaluated the electrothermal exposure of pregnant women in the third, seventh, and ninth month of gestation at various imaging landmarks in RF body coils, including modes with RF shimming. RESULTS: Although RF shimmed configurations may lower the local RF exposure for the mother, they can increase the thermal load on the fetus. In worst-case configurations, whole-body exposure and local peak temperatures-up to 40.8°C-are equal in fetus and mother. CONCLUSIONS: Two-port RF shimming can significantly increase the fetal exposure in pregnant women, requiring further research to derive a very robust safety management. For the time being, restriction to the CP mode, which reduces fetal SAR exposure compared with linear-horizontal polarization modes, may be advisable. Results from this study do not support scanning pregnant patients above the normal operating mode. Magn Reson Med 77:2048-2056, 2017.
PURPOSE: MRI is increasingly used to scan pregnant patients. We investigated the effect of 3 Tesla (T) two-port radiofrequency (RF) shimming in anatomical pregnant women models. THEORY AND METHODS: RF shimming improves B1+ uniformity, but may at the same time significantly alter the induced current distribution and result in large changes in both the level and location of the absorbed RF energy. In this study, we evaluated the electrothermal exposure of pregnant women in the third, seventh, and ninth month of gestation at various imaging landmarks in RF body coils, including modes with RF shimming. RESULTS: Although RF shimmed configurations may lower the local RF exposure for the mother, they can increase the thermal load on the fetus. In worst-case configurations, whole-body exposure and local peak temperatures-up to 40.8°C-are equal in fetus and mother. CONCLUSIONS: Two-port RF shimming can significantly increase the fetal exposure in pregnant women, requiring further research to derive a very robust safety management. For the time being, restriction to the CP mode, which reduces fetal SAR exposure compared with linear-horizontal polarization modes, may be advisable. Results from this study do not support scanning pregnant patients above the normal operating mode. Magn Reson Med 77:2048-2056, 2017.
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