EMF exposure variation among MRI sequences from pediatric examination protocols

Compressed SENSE in Pediatric Brain Tumor MR Imaging : Assessment of Image Quality, Examination Time and Energy Release

Purpose

To compare the image quality, examination time, and total energy release of a standardized pediatric brain tumor magnetic resonance imaging (MRI) protocol performed with and without compressed sensitivity encoding (C-SENSE). Recently introduced as an acceleration technique in MRI, we hypothesized that C‑SENSE would improve image quality, reduce the examination time and radiofrequency-induced energy release compared with conventional examination in a pediatric brain tumor protocol.

Methods

This retrospective study included 22 patients aged 2.33–18.83 years with different brain tumor types who had previously undergone conventional MRI examination and underwent follow-up C‑SENSE examination. Both examinations were conducted with a 3.0-Tesla device and included pre-contrast and post-contrast T1-weighted turbo-field-echo, T2-weighted turbo-spin-echo, and fluid-attenuated inversion recovery sequences. Image quality was assessed in four anatomical regions of interest (tumor area, cerebral cortex, basal ganglia, and posterior fossa) using a 5-point scale. Reader preference between the standard and C‑SENSE images was evaluated. The total examination duration and energy deposit were compared based on scanner log file analysis.

Results

Relative to standard examinations, C‑SENSE examinations were characterized by shorter total examination times (26.1 ± 3.93 vs. 22.18 ± 2.31 min; P = 0.001), reduced total energy deposit (206.0 ± 19.7 vs. 92.3 ± 18.2 J/kg; P < 0.001), and higher image quality (overall P < 0.001).

Conclusion

C‑SENSE contributes to the improvement of image quality, reduction of scan times and radiofrequency-induced energy release relative to the standard protocol in pediatric brain tumor MRI.

Supplementary Information

The online version of this article (10.1007/s00062-021-01112-3) contains supplementary material, which is available to authorized users.

Assessment of the Exposure to Gradient Magnetic Fields Generated by MRI Tomographs: Measurement Method, Verification of Limits and Clearance Areas through a Web-Based Platform

This work is the result of a campaign of measures of exposure levels to magnetic field gradients (GMF) generated by magnetic resonance imaging (MRI) tomographs, to which both healthcare staff and any persons accompanying patients who remain inside the magnet room are exposed while performing a diagnostic Investigation. The study was conducted on three MRI tomographs with a static magnetic induction field up to 1.5 T installed in two hospitals of Lombardy. The study aims to characterize electromagnetic emissions within the magnet room and the definition of a measurement method suitable for assessing the level of exposure of healthcare personnel and any persons accompanying patients. The measurements performed concerned the determination of the weighted peak index for magnetic induction, due to the diagnostic GMF, relating to the action levels for the workers and the reference levels for the general population, in force in the European Union. Thanks to the defined experimental setup, the use of two different measuring instruments, and the software resources of the WEBNIR platform, it was possible to identify, for both categories of exposed persons, the “clearance” space, i.e., the distance from the magnet of the tomograph that guarantees health protection concerning the exposure to GMF, according to the indications of the standards in force. The method used showed that the exposure levels to GMF are substantially safe for professionally exposed workers who do not carry specific risks. For workers particularly sensitive to the specific risk, as well as to individuals part of the population, it is however advisable to maintain a distance from the magnet of about one meter to prevent sensorial neuromuscular stimulation effects.

Exposure levels of radiofrequency magnetic fields and static magnetic fields in 1.5 and 3.0 T MRI units

Magnetic resonance imaging (MRI) staff is exposed to a complex mixture of electromagnetic fields from MRI units. Exposure to these fields results in the development of transient exposure-related symptoms. This study aimed to investigate the exposure levels of radiofrequency (RF) magnetic fields and static magnetic fields (SMFs) from 1.5 and 3.0 T MRI scanners in two public hospitals in the Mangaung Metropolitan region, South Africa. The exposure levels of SMFs and RF magnetic fields were measured using the THM1176 3-Axis hall magnetometer and TM-196 3 Axis RF field strength meter, respectively. Measurements were collected at a distance of 1 m (m) and 2 m from the gantry for SMFs when the brain, cervical spine and extremities were scanned. Measurements for RF magnetic fields were collected at a distance of 1 m with an average scan duration of six minutes. Friedman’s test was used to compared exposure mean values from two 1.5 T scanners, and Wilcoxon test with Bonferroni adjustment was used to identify where the difference between exist. The Shapiro–Wilk test was also used to test for normality between exposure levels in 1.5 and 3.0 T scanners. The measured peak values for SMFs from the 3.0 T scanner at hospital A were 1300 milliTesla (mT) and 726 mT from 1.5 T scanner in hospital B. The difference in terms of SMFs exposure levels was observed between two 1.5 T scanners at a distance of 2 m. The difference between 1.5 T scanners at 1 m was also observed during repeated measurements when brain, cervical spine and extremities scans were performed. Scanners’ configurations, magnet type, clinical setting and location were identified as factors that could influence different propagation of SMFs between scanners of the same nominal B0. The RF pulse design, sequence setting flip-angle and scans performed influenced the measured RF magnetic fields. Three scanners were complaint with occupational exposure guidelines stipulated by the ICNIRP; however, peak levels that exist at 1 m could be managed through adoption of occupational health and safety programs.

Spectral density constraints on wireless communication

Environmental exposure to man-made electromagnetic field (EMF) has been rising as modern technologies have grown and changes in social behavior have generated more synthetic sources. For safety of human health, EMF levels need to be regulated. The level of EMF should be well below levels where there might be harm, hence we do not expect to see any health effects at these levels. Current regulations fail to place a strict limit on EMF in situations where multiple nearby devices transmit simultaneously. The way these regulations are expressed needs great care because it will have an effect on the design of wireless communication systems. In this paper, it is argued that transmitted power constraints on wireless communication devices should be expressed in a different way, namely that devices should limit the EMF spectral density that they generate to the difference between the maximum allowed, by the standard, and the amount currently present, as measured by the device, in the spectral region where it is active. Note that the limit on EMF should be expressed in terms of its EMF spectral density rather than as a total EMF over each of a series of separate bands. If all devices limit their own EMF spectral density, in the spectral region where they are active, in such a way that total EMF spectral density is below the regulated limit in that region, then it is certain that the aggregate EMF spectral density will be below the regulated limit at all frequencies.

Valid Exposure Protocols Needed in Magnetic Resonance Imaging Genotoxic Research

Several in vitro and in vivo studies have investigated if a magnetic resonance imaging (MRI) examination can cause DNA damage in human blood cells. However, the electromagnetic field (EMF) exposure that the cells received in the MR scanner was not sufficiently described. The first studies looking into this could be regarded as hypothesis-generating studies. However, for further exploration into the role of MRI exposure on DNA integrity, the exposure itself cannot be ignored. The lack of sufficient method descriptions makes the early experiments difficult, if not impossible, to repeat. The golden rule in all experimental work is that a study should be repeatable by someone with the right knowledge and equipment, and this is simply not the case with many of the recent studies on MRI and genotoxicity. Here we discuss what is lacking in previous studies, and how we think the next generation of in vitro and in vivo studies on MRI and genotoxicity should be performed. Bioelectromagnetics. © 2020 Bioelectromagnetics Society.

Magnetic Resonance Examinations of Patients With Implanted Active Devices. A Low-Cost Approach in Slew Rate Evaluation

Time-varying magnetic field gradients involved in magnetic resonance examinations can damage implanted electronic systems. The quantity related to this side effect is the gradient slew rate, which is usually not directly available on magnetic resonance console. The present study proposes a low-cost approach in slew rate assessment, which is useful in risks versus benefits evaluation as well as in sequences optimization. The experimental method is based on an analog circuit, which senses the output voltage of the scanner waveform generator. This allows taking easy and reliable slew rate measurements, even during clinical examinations on patients. Whereas previous studies required managing a considerable amount of data, the present work addresses only the maximal slew rate of any clinical sequence. Experimental results show that the smooth gradient mode, selectable on the two scanners examined, is very effective in patient safety improvement. In particular, it reduces slew rate values in the range from 52.4 up to 132.4 T m^-1 s^-1 , i.e. far below the interval 216-346 T m^-1 s^-1 , indicated as slew rate tolerance limit of modern implanted electronic devices. Bioelectromagnetics. 2019;40:512-521. © 2019 Bioelectromagnetics Society.

Non-Ionizing Radiation in Swedish Health Care-Exposure and Safety Aspects

The main aim of the study was to identify and describe methods using non-ionizing radiation (NIR) such as electromagnetic fields (EMF) and optical radiation in Swedish health care. By examining anticipated exposure levels and by identifying possible health hazards we also aimed to recognize knowledge gaps in the field. NIR is mainly used in health care for diagnosis and therapy. Three applications were identified where acute effects cannot be ruled out: magnetic resonance imaging (MRI), transcranial magnetic stimulation (TMS) and electrosurgery. When using optical radiation, such as class 3 and 4 lasers for therapy or surgical procedures and ultra-violet light for therapy, acute effects such as unintentional burns, photo reactions, erythema and effects on the eyes need to be avoided. There is a need for more knowledge regarding long-term effects of MRI as well as on the combination of different NIR exposures. Based on literature and after consulting staff we conclude that the health care professionals' knowledge about the risks and safety measures should be improved and that there is a need for clear, evidence-based information from reliable sources, and it should be obvious to the user which source to address.