Browsing by Author "Golestanirad, L."

Now showing 1 - 7 of 7

Open Access
Effect of field strength on RF power deposition near conductive leads: a simulation study of SAR in DBS lead models during mri at 1.5 T-10.5 T
(Public Library of Science, 2023-01-26) Kazemivalipour, Ehsan; Sadeghi-Tarakameh, A.; Keil, B.; Eryaman, Y.; Atalar, Ergin; Golestanirad, L.
Background Since the advent of magnetic resonance imaging (MRI) nearly four decades ago, there has been a quest for ever-higher magnetic field strengths. Strong incentives exist to do so, as increasing the magnetic field strength increases the signal-to-noise ratio of images. However, ensuring patient safety becomes more challenging at high and ultrahigh field MRI (i.e., ≥3 T) compared to lower fields. The problem is exacerbated for patients with conductive implants, such as those with deep brain stimulation (DBS) devices, as excessive local heating can occur around implanted lead tips. Despite extensive effort to assess radio frequency (RF) heating of implants during MRI at 1.5 T, a comparative study that systematically examines the effects of field strength and various exposure limits on RF heating is missing. Purpose This study aims to perform numerical simulations that systematically compare RF power deposition near DBS lead models during MRI at common clinical and ultra-high field strengths, namely 1.5, 3, 7, and 10.5 T. Furthermore, we assess the effects of different exposure constraints on RF power deposition by imposing limits on either the B1+ or global head specific absorption rate (SAR) as these two exposure limits commonly appear in MRI guidelines. Methods We created 33 unique DBS lead models based on postoperative computed tomography (CT) images of patients with implanted DBS devices and performed electromagnetic simulations to evaluate the SAR of RF energy in the tissue surrounding lead tips during RF exposure at frequencies ranging from 64 MHz (1.5 T) to 447 MHz (10.5 T). The RF exposure was implemented via realistic MRI RF coil models created based on physical prototypes built in our institutions. We systematically examined the distribution of local SAR at different frequencies with the input coil power adjusted to either limit the B1+ or the global head SAR. Results The MRI RF coils at higher resonant frequencies generated lower SARs around the lead tips when the global head SAR was constrained. The trend was reversed when the constraint was imposed on B1+. Conclusion At higher static fields, MRI is not necessarily more dangerous than at lower fields for patients with conductive leads. Specifically, when a conservative safety criterion, such as constraints on the global SAR, is imposed, coils at a higher resonant frequency tend to generate a lower local SAR around implanted leads due to the decreased B1+ and, by proxy, E field levels.
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.
Open Access
Reconfigurable MRI coil technology can substantially reduce RF heating of deep brain stimulation implants: First in-vitro study of RF heating reduction in bilateral DBS leads at 1.5 T
(Public Library of Science, 2019-08) Golestanirad, L.; Kazemivalipour, Ehsan; Keil, B.; Downs, S.; Kirsch, J.; Elahi, B.; Pilitsis, J.; Wald, L. L.
Patients with deep brain stimulation (DBS) implants can significantly benefit from magnetic resonance imaging (MRI), however access to MRI is restricted in these patients because of safety concerns due to RF heating of the leads. Recently we introduced a patient-adjustable reconfigurable transmit coil for low-SAR imaging of DBS at 1.5T. A previous simulation study demonstrated a substantial reduction in the local SAR around single DBS leads in 9 unilateral lead models. This work reports the first experimental results of temperature measurement at the tips of bilateral DBS leads with realistic trajectories extracted from postoperative CT images of 10 patients (20 leads in total). A total of 200 measurements were performed to record temperature rise at the tips of the leads during 2 minutes of scanning with the coil rotated to cover all accessible rotation angles. In all patients, we were able to find an optimum coil rotation angle and reduced the heating of both left and right leads to a level below the heating produced by the body coil. An average heat reduction of 65% was achieved for bilateral leads. When considering each lead alone, an average heat reduction of 80% was achieved. Our results suggest that reconfigurable coil technology introduces a promising approach for imaging of patients with DBS implants.
Open Access
Reconfigurable MRI technology for low-SAR imaging of deep brain stimulation at 3T: application in bilateral leads, fully-implanted systems, and surgically modified lead trajectories
(Elsevier, 2019) Kazemivalipour, Ehsan; Keil, B.; Vali, A.; Rajan, S.; Elahi, B.; Atalar, Ergin; Wald, L.; Rosenow, J.; Pilitsis, J.; Golestanirad, L.
Patients with deep brain stimulation devices highly benefit from postoperative MRI exams, however MRI is not readily accessible to these patients due to safety risks associated with RF heating of the implants. Recently we introduced a patient-adjustable reconfigurable coil technology that substantially reduced local SAR at tips of single isolated DBS leads during MRI at 1.5 T in 9 realistic patient models. This contribution extends our work to higher fields by demonstrating the feasibility of scaling the technology to 3T and assessing its performance in patients with bilateral leads as well as fully implanted systems. We developed patient-derived models of bilateral DBS leads and fully implanted DBS systems from postoperative CT images of 13 patients and performed finite element simulations to calculate SAR amplification at electrode contacts during MRI with a reconfigurable rotating coil at 3T. Compared to a conventional quadrature body coil, the reconfigurable coil system reduced the SAR on average by 83% for unilateral leads and by 59% for bilateral leads. A simple surgical modification in trajectory of implanted leads was demonstrated to increase the SAR reduction efficiency of the rotating coil to >90% in a patient with a fully implanted bilateral DBS system. Thermal analysis of temperature-rise around electrode contacts during typical brain exams showed a 15-fold heating reduction using the rotating coil, generating <1C temperature rise during ∼4-min imaging with high-SAR sequences where a conventional CP coil generated >10C temperature rise in the tissue for the same flip angle.
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.
Open Access
RF heating of deep brain stimulation implants in open-bore vertical MRI systems: a simulation study with realistic device configurations
(International Society for Magnetic Resonance in Medicine, 2020) Golestanirad, L.; Kazemivalipour, Ehsan; Lampman, D.; Habara, H.; Atalar, Ergin; Rosenow, J.; Pilitsis, J.; Kirsch, J.
Purpose Patients with deep brain stimulation (DBS) implants benefit highly from MRI, however, access to MRI is restricted for these patients because of safety hazards associated with RF heating of the implant. To date, all MRI studies on RF heating of medical implants have been performed in horizontal closed‐bore systems. Vertical MRI scanners have a fundamentally different distribution of electric and magnetic fields and are now available at 1.2T, capable of high‐resolution structural and functional MRI. This work presents the first simulation study of RF heating of DBS implants in high‐field vertical scanners. Methods We performed finite element electromagnetic simulations to calculate specific absorption rate (SAR) at tips of DBS leads during MRI in a commercially available 1.2T vertical coil compared to a 1.5T horizontal scanner. Both isolated leads and fully implanted systems were included. Results We found 10‐ to 30‐fold reduction in SAR implication at tips of isolated DBS leads, and up to 19‐fold SAR reduction at tips of leads in fully implanted systems in vertical coils compared to horizontal birdcage coils. Conclusions If confirmed in larger patient cohorts and verified experimentally, this result can open the door to plethora of structural and functional MRI applications to guide, interpret, and advance DBS therapy.
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.