Benjamin Davidson1,2,3, Fred Tam4, Benson Yang4, Ying Meng1,2,3, Clement Hamani1,2,3, Simon J Graham3,4,5, Nir Lipsman1,2,3. 1. Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. 2. Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada. 3. Sunnybrook Research Institute, Toronto, Canada. 4. Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada. 5. Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Deep brain stimulation (DBS) is a standard of care treatment for multiple neurologic disorders. Although 3-tesla (3T) magnetic resonance imaging (MRI) has become the gold-standard modality for structural and functional imaging, most centers refrain from 3T imaging in patients with DBS devices in place because of safety concerns. 3T MRI could be used not only for structural imaging, but also for functional MRI to study the effects of DBS on neurocircuitry and optimize programming. OBJECTIVE: To use an anthropomorphic phantom design to perform temperature and voltage safety testing on an activated DBS device during 3T imaging. METHODS: An anthropomorphic 3D-printed human phantom was constructed and used to perform temperature and voltage testing on a DBS device during 3T MRI. Based on the phantom assessment, a cohort study was conducted in which 6 human patients underwent MRI with their DBS device in an activated (ON) state. RESULTS: During the phantom study, temperature rises were under 2°C during all sequences, with the DBS in both the deactivated and activated states. Radiofrequency pulses from the MRI appeared to modulate the electrical discharge from the DBS, resulting in slight fluctuations of voltage amplitude. Six human subjects underwent MRI with their DBS in an activated state without any serious adverse events. One patient experienced stimulation-related side effects during T1-MPRAGE scanning with the DBS in an ON state because of radiofrequency-induced modulation of voltage amplitude. CONCLUSION: Following careful phantom-based safety testing, 3T structural and functional MRI can be safely performed in subjects with activated deep brain stimulators.
BACKGROUND: Deep brain stimulation (DBS) is a standard of care treatment for multiple neurologic disorders. Although 3-tesla (3T) magnetic resonance imaging (MRI) has become the gold-standard modality for structural and functional imaging, most centers refrain from 3T imaging in patients with DBS devices in place because of safety concerns. 3T MRI could be used not only for structural imaging, but also for functional MRI to study the effects of DBS on neurocircuitry and optimize programming. OBJECTIVE: To use an anthropomorphic phantom design to perform temperature and voltage safety testing on an activated DBS device during 3T imaging. METHODS: An anthropomorphic 3D-printed human phantom was constructed and used to perform temperature and voltage testing on a DBS device during 3T MRI. Based on the phantom assessment, a cohort study was conducted in which 6 humanpatients underwent MRI with their DBS device in an activated (ON) state. RESULTS: During the phantom study, temperature rises were under 2°C during all sequences, with the DBS in both the deactivated and activated states. Radiofrequency pulses from the MRI appeared to modulate the electrical discharge from the DBS, resulting in slight fluctuations of voltage amplitude. Six human subjects underwent MRI with their DBS in an activated state without any serious adverse events. One patient experienced stimulation-related side effects during T1-MPRAGE scanning with the DBS in an ON state because of radiofrequency-induced modulation of voltage amplitude. CONCLUSION: Following careful phantom-based safety testing, 3T structural and functional MRI can be safely performed in subjects with activated deep brain stimulators.
Authors: Ali R Rezai; Daniel Finelli; John A Nyenhuis; Greg Hrdlicka; Jean Tkach; Ashwini Sharan; Paul Rugieri; Paul H Stypulkowski; Frank G Shellock Journal: J Magn Reson Imaging Date: 2002-03 Impact factor: 4.813
Authors: Francesco Sammartino; Vibhor Krishna; Tejas Sankar; Jason Fisico; Suneil K Kalia; Mojgan Hodaie; Walter Kucharczyk; David J Mikulis; Adrian Crawley; Andres M Lozano Journal: J Neurosurg Date: 2016-12-23 Impact factor: 5.115
Authors: Alexandre Boutet; Robert Gramer; Christopher J Steele; Gavin J B Elias; Jürgen Germann; Ricardo Maciel; Walter Kucharczyk; Ludvic Zrinzo; Andres M Lozano; Alfonso Fasano Journal: Curr Neurol Neurosci Rep Date: 2019-05-30 Impact factor: 5.081
Authors: Alexandre Boutet; Gavin J B Elias; Robert Gramer; Clemens Neudorfer; Jürgen Germann; Asma Naheed; Nicole Bennett; Bryan Li; Dave Gwun; Clement T Chow; Ricardo Maciel; Alejandro Valencia; Alfonso Fasano; Renato P Munhoz; Warren Foltz; David Mikulis; Ileana Hancu; Suneil K Kalia; Mojgan Hodaie; Walter Kucharczyk; Andres M Lozano Journal: J Neurosurg Spine Date: 2020-02-14
Authors: Alexandre Boutet; Ileana Hancu; Utpal Saha; Adrian Crawley; David S Xu; Manish Ranjan; Eugen Hlasny; Robert Chen; Warren Foltz; Francesco Sammartino; Ailish Coblentz; Walter Kucharczyk; Andres M Lozano Journal: J Neurosurg Date: 2019-02-22 Impact factor: 5.115
Authors: Jörg Spiegel; Gerhard Fuss; Martin Backens; Wolfgang Reith; Tim Magnus; Georg Becker; Jean-Richard Moringlane; Ulrich Dillmann Journal: J Neurosurg Date: 2003-10 Impact factor: 5.115
Authors: Kenneth B Baker; Jean A Tkach; John A Nyenhuis; Michael Phillips; Frank G Shellock; Jorge Gonzalez-Martinez; Ali R Rezai Journal: J Magn Reson Imaging Date: 2004-08 Impact factor: 4.813
Authors: Laleh Golestanirad; John Kirsch; Giorgio Bonmassar; Sean Downs; Behzad Elahi; Alastair Martin; Maria-Ida Iacono; Leonardo M Angelone; Boris Keil; Lawrence L Wald; Julie Pilitsis Journal: Neuroimage Date: 2018-09-19 Impact factor: 6.556