Browsing by Author "Bhusal, B."
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Item Open Access Patient’s body composition can significantly affect RF power deposition in the tissue around DBS implants: ramifications for lead management strategies and MRI field-shaping techniques(Institute of Physics Publishing Ltd., 2021-01-13) Bhusal, B.; Keil, B.; Rosenow, J.; Kazemivalipour, Ehsan; Golestanirad, L.Patients with active implants such as deep brain stimulation (DBS) devices have limited access to magnetic resonance imaging (MRI) due to risks associated with RF heating of implants in MRI environment. With an aging population and increased prevalence of neurodegenerative disease, the indication for MRI exams in patients with such implants increases as well. In response to this growing need, many groups have investigated strategies to mitigate RF heating of DBS implants during MRI. These efforts fall into two main categories: MRI field-shaping methods, where the electric field of the MRI RF coil is modified to reduce the interaction with implanted leads, and lead management techniques where surgical modifications in the trajectory reduces the coupling with RF fields. Studies that characterize these techniques, however, have relied either on simulations with homogenous body models, or experiments with box-shaped single-material phantoms. It is well established, however, that the shape and heterogeneity of human body affects the distribution of RF electric fields, which by proxy, alters the heating of an implant inside the body. In this contribution, we applied numerical simulations and phantom experiments to examine the degree to which variations in patient's body composition affects RF power deposition. We then assessed effectiveness of RF-heating mitigation strategies under variant patient body compositions. Our results demonstrated that patient's body composition substantially alters RF power deposition in the tissue around implanted leads. However, both techniques based on MRI field-shaping and DBS lead management performed well under variant body types.Item Open Access RF heating of deep brain stimulation implants during MRI in 1.2 T vertical scanners versus 1.5 T horizontal systems: a simulation study with realistic lead configurations(Institute of Electrical and Electronics Engineers, 2020) Kazemivalipour, Ehsan; Vu, J.; Lin, S.; Bhusal, B.; Nguyen, B. T.; Kirsch, J.; Elahi, B.; Rosenow, J.; Atalar, Ergin; Golestanirad, L.Patients with deep brain stimulation (DBS) implants are often denied access to magnetic resonance imaging (MRI) due to safety concerns associated with RF heating of implants. Although MR-conditional DBS devices are available, complying with manufacturer guidelines has proved to be difficult as pulse sequences that optimally visualize DBS target structures tend to have much higher specific absorption rate (SAR) of radiofrequency energy than current guidelines allow. The MR-labeling of DBS devices, as well as the majority of studies on RF heating of conductive implants have been limited to horizontal close-bore MRI scanners. Vertical MRI scanners, originally introduced as open low-field MRI systems, are now available at 1.2 T field strength, capable of high-resolution structural and functional imaging. No literature exists on DBS SAR in this class of scanners which have a 90° rotated transmit coil and thus, generate a fundamentally different electric and magnetic field distributions. Here we present a simulation study of RF heating in a cohort of forty patient-derived DBS lead models during MRI in a commercially available vertical openbore MRI system (1.2 T OASIS, Hitachi) and a standard horizontal 1.5 T birdcage coil. Simulations were performed at two major imaging landmarks representing head and chest imaging. We calculated the maximum of 0.1g-averaged SAR (0.1g-SAR Max ) around DBS lead tips when a B 1 + = 4 μT was generated on an axial plane passing through patients body. For head landmark, 0.1g-SAR Max reached 220±188 W/kg in the 1.5 T birdcage coil, but only 14±11 W/kg in the OASIS coil. For chest landmark, 0.1g-SAR Max was 24±17 W/kg in the 1.5 T birdcage coil and 3±2 W/kg in the OASIS coil. A paired two-tail t-test revealed a significant reduction in SAR with a large effect-size during head MRI (p <; 1.5×10 -8 , Cohen's d = 1.5) as well as chest MRI (p <; 6.5×10 -10 , Cohen's d = 1.7) in 1.2 T Hitachi OASIS coil compared to a standard 1.5 T birdcage transmitter. Our findings suggest that open-bore vertical scanners may offer an untapped opportunity for MRI of patients with DBS implants.Item Open Access Vertical open-bore MRI scanners generate significantly less radiofrequency heating around implanted leads: A study of deep brain stimulation implants in 1.2T OASIS scanners versus 1.5T horizontal systems(John Wiley & Sons, Inc., 2021-04-07) Kazemivalipour, Ehsan; Bhusal, B.; Vu, J.; Lin, S.; Nguyen, B. T.; Kirsch, J.; Nowac, E.; Pilitsis, J.; Rosenow, J.; Atalar, Ergin; Golestanirad, L.Purpose Patients with active implants such as deep brain stimulation (DBS) devices are often denied access to MRI due to safety concerns associated with the radiofrequency (RF) heating of their electrodes. The majority of studies on RF heating of conductive implants have been performed in horizontal close-bore MRI scanners. Vertical MRI scanners which have a 90° rotated transmit coil generate fundamentally different electric and magnetic field distributions, yet very little is known about RF heating of implants in this class of scanners. We performed numerical simulations as well as phantom experiments to compare RF heating of DBS implants in a 1.2T vertical scanner (OASIS, Hitachi) compared to a 1.5T horizontal scanner (Aera, Siemens). Methods Simulations were performed on 90 lead models created from post-operative CT images of patients with DBS implants. Experiments were performed with wires and commercial DBS devices implanted in an anthropomorphic phantom. Results We found significant reduction of 0.1 g-averaged specific absorption rate (30-fold, P < 1 × 10−5) and RF heating (9-fold, P < .026) in the 1.2T vertical scanner compared to the 1.5T conventional scanner. Conclusion Vertical MRI scanners appear to generate lower RF heating around DBS leads, providing potentially heightened safety or the flexibility to use sequences with higher power levels than on conventional systems.