Purpose: To assess magnetic resonance imaging (MRI)-related heating for a neurostimulation system (Activa Tremor Control System, Medtronic, Minneapolis, MN) used for chronic deep brain stimulation (DBS). Materials and Methods:Different configurations were evaluated for bilateral neurostimulators (Soletra® Model 7426), extensions, and leads to assess worst-case and clinically relevant positioning scenarios. In vitro testing was performed using a 1.5-T/64-MHz MR system and a gelfilled phantom designed to approximate the head and upper torso of a human subject. MRI was conducted using the transmit/receive body and transmit/receive head radio frequency (RF) coils. Various levels of RF energy were applied with the transmit/receive body (whole-body averaged specific absorption rate (SAR); range, 0.98 -3.90 W/kg) and transmit/receive head (whole-body averaged SAR; range, 0.07-0.24 W/kg) coils. A fluoroptic thermometry system was used to record temperatures at multiple locations before (1 minute) and during (15 minutes) MRI.Results: Using the body RF coil, the highest temperature changes ranged from 2.5°-25.3°C. Using the head RF coil, the highest temperature changes ranged from 2.3°-7.1°C.Thus, these findings indicated that substantial heating occurs under certain conditions, while others produce relatively minor, physiologically inconsequential temperature increases. Conclusion:The temperature increases were dependent on the type of RF coil, level of SAR used, and how the lead wires were positioned. Notably, the use of clinically relevant positioning techniques for the neurostimulation system and low SARs commonly used for imaging the brain generated little heating. Based on this information, MR safety guidelines are provided. These observations are restricted to the tested neurostimulation system.

To prevent catastrophic incidents, the manufacturer's guidelines should be followed carefully because they are known to result in the safe performance of MRI examinations of patients with neurostimulation systems used for DBS.

Purpose:To compare the magnetic resonance imaging (MRI)-related heating per unit of whole body averaged specific absorption rate (SAR) of a conductive implant exposed to two different 1.5-Tesla/64 MHz MR systems. Materials and Methods:Temperature changes at the electrode contacts of a deep brain stimulation lead were measured using fluoroptic thermometry. The leads were placed in a typical surgical implant configuration within a gel-filled phantom of the human head and torso. MRI was performed using two different transmit/receive body coils on two different generation 1.5-Tesla MR systems from the same manufacturer. Temperature changes were normalized to whole body averaged SAR values and compared between the two scanners.Results: Depending on the landmark location, the normalized temperature change for the implant was significantly higher on one MR system compared to the other (P Ͻ 0.001). Conclusion:The findings revealed marked differences across two MR systems in the level of radiofrequency (RF)-induced temperature changes per unit of whole body SAR for a conductive implant. Thus, these data suggest that using SAR to guide MR safety recommendations for neurostimulation systems or other similar implants across different MR systems is unreliable and, therefore, potentially dangerous. Better, more universal, measures are required in order to ensure patient safety.

PURPOSE To implement pulmonary 3D radial ultrashort echo-time (UTE) MRI in non-sedated, free-breathing neonates and adults with retrospective motion-tracking of respiratory and intermittent bulk motion, to obtain diagnostic-quality, respiratory-gated images. METHODS Pulmonary 3D radial UTE MRI was performed at 1.5T during free-breathing in neonates and adult volunteers for validation. Motion-tracking waveforms were obtained from the time-course of each free induction decay’s initial point (i.e. k-space center), allowing for respiratory-gated image reconstructions that excluded data acquired during bulk motion. Tidal volumes were calculated from end-expiration and end-inspiration images. Respiratory rates were calculated from the Fourier transform of the motion-tracking waveform during quiet-breathing, with comparison to physiologic prediction in neonates and validation with spirometry in adults. RESULTS High-quality respiratory-gated anatomic images were obtained at inspiration and expiration, with less respiratory blurring at the expense of signal-to-noise for narrower gating windows. Inspiration-expiration volume differences agreed with physiologic predictions (neonates; Bland-Altman bias = 6.2 mL) and spirometric values (adults; bias = 0.11 L). MRI-measured respiratory rates compared well with observed rates (biases = −0.5 and 0.2 breaths/min for neonates and adults, respectively). CONCLUSIONS 3D radial pulmonary UTE MRI allows for retrospective respiratory self-gating and removal of intermittent bulk motion in free-breathing, non-sedated neonates and adults.

The authors discuss the appropriate FISP (fast imaging with steady-state precession) sequence structure to maintain constant phase at the radio-frequency pulse in the presence of motion. They present preliminary results of its application to head and spine imaging in an effort to maintain contrast between the cerebrospinal fluid (CSF) and the soft tissue. In the usual application of these FISP-like sequences, the gradient structure is modified to avoid unwanted signal (and contrast) variations due to field inhomogeneities. This change makes the signal sensitive to motion with a resulting decrease in signal intensity for moving tissue. The expected high contrast at large flip angles for tissues with low T1/T2 ratios such as CSF is not obtained. The technique discussed here overcomes the effects of field inhomogeneities and compensates for moving spins so that the transverse steady-state equilibrium and hence high contrast are obtained simultaneously.