Controlling radiofrequency-induced currents in guidewires using parallel transmit

Investigation of alternative RF power limit control methods for 0.5T, 1.5T, and 3T parallel transmission cardiac imaging: A simulation study

PURPOSE

To investigate safety and performance aspects of parallel-transmit (pTx) RF control-modes for a body coil atB 0 ≤ 3 T $$ {B}_0\le 3\mathrm{T} $$ .

METHODS

Electromagnetic simulations of 11 human voxel models in cardiac imaging position were conducted forB 0 = 0.5 T $$ {B}_0=0.5\mathrm{T} $$ ,1.5 T $$ 1.5\mathrm{T} $$ and3 T $$ 3\mathrm{T} $$ and a body coil with a configurable number of transmit channels (1, 2, 4, 8, 16). Three safety modes were considered: the 'SAR-controlled mode' (SCM), where specific absorption rate (SAR) is limited directly, a 'phase agnostic SAR-controlled mode' (PASCM), where phase information is neglected, and a 'power-controlled mode' (PCM), where the voltage amplitude for each channel is limited. For either mode, safety limits were established based on a set of 'anchor' simulations and then evaluated in 'target' simulations on previously unseen models. The comparison allowed to derive safety factors accounting for varying patient anatomies. All control modes were compared in terms of theB 1 + $$ {B}_1^{+} $$ amplitude and homogeneity they permit under their respective safety requirements.

RESULTS

Large safety factors (approximately five) are needed if only one or two anchor models are investigated but they shrink with increasing number of anchors. The achievableB 1 + $$ {B}_1^{+} $$ is highest for SCM but this advantage is reduced when the safety factor is included. PCM appears to be more robust against variations of subjects. PASCM performance is mostly in between SCM and PCM. Compared to standard circularly polarized (CP) excitation, pTx offers minorB 1 + $$ {B}_1^{+} $$ improvements if local SAR limits are always enforced.

CONCLUSION

PTx body coils can safely be used atB 0 ≤ 3 T $$ {B}_0\le 3\mathrm{T} $$ . Uncertainties in patient anatomy must be accounted for, however, by simulating many models.

Wirelessly interfacing sensor-equipped implants and MR scanners for improved safety and imaging

PURPOSE

To investigate a novel reduced RF heating method for imaging in the presence of active implanted medical devices (AIMDs) which employs a sensor-equipped implant that provides wireless feedback.

METHODS

The implant, consisting of a generator case and a lead, measures RF-inducedE $$ E $$ -fields at the implant tip using a simple sensor in the generator case and transmits these values wirelessly to the MR scanner. Based on the sensor signal alone, parallel transmission (pTx) excitation vectors were calculated to suppress tip heating and maintain image quality. A sensor-based imaging metric was introduced to assess the image quality. The methodology was studied at 7T in testbed experiments, and at a 3T scanner in an ASTM phantom containing AIMDs instrumented with six realistic deep brain stimulation (DBS) lead configurations adapted from patients.

RESULTS

The implant successfully measured RF-inducedE $$ E $$ -fields (Pearson correlation coefficient squared [R2 ] = 0.93) and temperature rises (R2  = 0.95) at the implant tip. The implant acquired the relevant data needed to calculate the pTx excitation vectors and transmitted them wirelessly to the MR scanner within a single shot RF sequence (<60 ms). Temperature rises for six realistic DBS lead configurations were reduced to 0.03-0.14 K for heating suppression modes compared to 0.52-3.33 K for the worst-case heating, while imaging quality remained comparable (five of six lead imaging scores were ≥0.80/1.00) to conventional circular polarization (CP) images.

CONCLUSION

Implants with sensors that can communicate with an MR scanner can substantially improve safety for patients in a fast and automated manner, easing the current burden for MR personnel.

Implant-friendly MRI of deep brain stimulation electrodes at 7 T

PURPOSE

The purpose of this study is to present a strategy to calculate the implant-friendly (IF) excitation modes-which mitigate the RF heating at the contacts of deep brain stimulation (DBS) electrodes-of multichannel RF coils at 7 T.

METHODS

An induced RF current on an implantable electrode generates a scattered magnetic field whose left-handed circularly polarizing component (B 1 + $$ B{1}^{+} $$ ) is approximated using aB 1 + $$ B{1}^{+} $$ -mapping technique and subsequently used as a gauge for the electrode's induced current. Using this approach, the relative induced currents resulting from each channel of a multichannel RF coil on the DBS electrode were calculated. The IF modes of the corresponding multichannel coil were determined by calculating the null space of the relative induced currents. The proposed strategy was tested and validated for unilateral and bilateral commercial DBS electrodes (directional lead; Infinity DBS system, Abbott Laboratories) placed inside a uniform phantom by performing heating and imaging studies on a 7T MRI scanner using a 16-channel transceive RF coil.

RESULTS

Neither individual IF modes nor shim solutions obtained from IF modes induced significant temperature increase when used for a high-power turbo spin-echo sequence. In contrast, shimming with the scanner's toolbox (i.e., based on per-channelB 1 + $$ B{1}^{+} $$ fields) resulted in a more than 2°C temperature increase for the same amount of input power.

CONCLUSION

A strategy for calculating the IF modes of a multichannel RF coil is presented. This strategy was validated using a 16-channel RF coil at 7 T for unilateral and bilateral commercial DBS electrodes inside a uniform phantom.

A machine learning-based approach for RF transfer function modeling of active implantable medical electrodes at 3T MRI

Objective.The objective of this work is to propose a machine learning-based approach to rapidly and efficiently model the radiofrequency (RF) transfer function of active implantable medical (AIM) electrodes, and to overcome the limitations and drawbacks of traditional measurement methods when applied to heterogeneous tissue environments.Approach.AIM electrodes with different geometries and proximate tissue distributions were considered, and their RF transfer functions were modeled numerically. Machine learning algorithms were developed and trained with the simulated transfer function datasets for homogeneous and heterogeneous tissue distributions. The performance of the method was analyzed statistically and validated experimentally and numerically. A comprehensive uncertainty analysis was performed and uncertainty budgets were derived.Main results.The proposed method is able to predict the RF transfer function of AIM electrodes under different tissue distributions, with mean correlation coefficientsrof 0.99 and 0.98 for homogeneous and heterogeneous environments, respectively. The results were successfully validated by experimental measurements (e.g. the uncertainty of less than 0.9 dB) and numerical simulation (e.g. transfer function uncertainty <1.6 dB and power deposition uncertainty <1.9 dB). Up to 1.3 dBin vivopower deposition underestimation was observed near generic pacemakers when using a simplified homogeneous tissue model.Significance.Provide an efficient alternative of transfer function modeling, which allows a more realistic tissue distribution and the potential underestimation ofin vivoRF-induced power deposition near the AIM electrode can be reduced.

Towards an integrated radiofrequency safety concept for implant carriers in MRI based on sensor-equipped implants and parallel transmission

To protect implant carriers in MRI from excessive radiofrequency (RF) heating it has previously been suggested to assess that hazard via sensors on the implant. Other work recommended parallel transmission (pTx) to actively mitigate implant-related heating. Here, both ideas are integrated into one comprehensive safety concept where native pTx safety (without implant) is ensured by state-of-the-art field simulations and the implant-specific hazard is quantified in situ using physical sensors. The concept is demonstrated by electromagnetic simulations performed on a human voxel model with a simplified spinal-cord implant in an eight-channel pTx body coil at 3 T . To integrate implant and native safety, the sensor signal must be calibrated in terms of an established safety metric (e.g., specific absorption rate [SAR]). Virtual experiments show that E -field and implant-current sensors are well suited for this purpose, while temperature sensors require some caution, and B 1 probes are inadequate. Based on an implant sensor matrix Q s , constructed in situ from sensor readings, and precomputed native SAR limits, a vector space of safe RF excitations is determined where both global (native) and local (implant-related) safety requirements are satisfied. Within this safe-excitation subspace, the solution with the best image quality in terms of B 1 + magnitude and homogeneity is then found by a straightforward optimization algorithm. In the investigated example, the optimized pTx shim provides a 3-fold higher mean B 1 + magnitude compared with circularly polarized excitation for a maximum implant-related temperature increase ∆ T imp ≤ 1 K . To date, sensor-equipped implants interfaced to a pTx scanner exist as demonstrator items in research labs, but commercial devices are not yet within sight. This paper aims to demonstrate the significant benefits of such an approach and how this could impact implant-related RF safety in MRI. Today, the responsibility for safe implant scanning lies with the implant manufacturer and the MRI operator; within the sensor concept, the MRI manufacturer would assume much of the operator's current responsibility.

RF-induced heating of interventional devices at 23.66 MHz

OBJECTIVE

Low-field MRI systems are expected to cause less RF heating in conventional interventional devices due to lower Larmor frequency. We systematically evaluate RF-induced heating of commonly used intravascular devices at the Larmor frequency of a 0.55 T system (23.66 MHz) with a focus on the effect of patient size, target organ, and device position on maximum temperature rise.

MATERIALS AND METHODS

To assess RF-induced heating, high-resolution measurements of the electric field, temperature, and transfer function were combined. Realistic device trajectories were derived from vascular models to evaluate the variation of the temperature increase as a function of the device trajectory. At a low-field RF test bench, the effects of patient size and positioning, target organ (liver and heart) and body coil type were measured for six commonly used interventional devices (two guidewires, two catheters, an applicator and a biopsy needle).

RESULTS

Electric field mapping shows that the hotspots are not necessarily localized at the device tip. Of all procedures, the liver catheterizations showed the lowest heating, and a modification of the transmit body coil could further reduce the temperature increase. For common commercial needles no significant heating was measured at the needle tip. Comparable local SAR values were found in the temperature measurements and the TF-based calculations.

CONCLUSION

At low fields, interventions with shorter insertion lengths such as hepatic catheterizations result in less RF-induced heating than coronary interventions. The maximum temperature increase depends on body coil design.

Ultra-high field MRI: parallel-transmit arrays and RF pulse design

This paper reviews the field of multiple or parallel radiofrequency (RF) transmission for magnetic resonance imaging (MRI). Currently the use of ultra-high field (UHF) MRI at 7 tesla and above is gaining popularity, yet faces challenges with non-uniformity of the RF field and higher RF power deposition. Since its introduction in the early 2000s, parallel transmission (pTx) has been recognized as a powerful tool for accelerating spatially selective RF pulses and combating the challenges associated with RF inhomogeneity at UHF. We provide a survey of the types of dedicated RF coils used commonly for pTx and the important modeling of the coil behavior by electromagnetic (EM) field simulations. We also discuss the additional safety considerations involved with pTx such as the specific absorption rate (SAR) and how to manage them. We then describe the application of pTx with RF pulse design, including a practical guide to popular methods. Finally, we conclude with a description of the current and future prospects for pTx, particularly its potential for routine clinical use.

A workflow for predicting temperature increase at the electrical contacts of deep brain stimulation electrodes undergoing MRI

Purpose

The purpose of this study is to present a workflow for predicting the radiofrequency (RF) heating around the contacts of a deep brain stimulation (DBS) lead during an MRI scan.

Methods

The induced RF current on the DBS lead accumulates electric charge on the metallic contacts, which may cause a high local specific absorption rate (SAR), and therefore, heating. The accumulated charge was modeled by imposing a voltage boundary condition on the contacts in a quasi‐static electromagnetic (EM) simulation allowing thermal simulations to be performed with the resulting SAR distributions. Estimating SAR and temperature increases from a lead in vivo through EM simulation is not practical given anatomic differences and variations in lead geometry. To overcome this limitation, a new parameter, transimpedance, was defined to characterize a given lead. By combining the transimpedance, which can be measured in a single calibration scan, along with MR‐based current measurements of the lead in a unique orientation and anatomy, local heating can be estimated. Heating determined with this approach was compared with results from heating studies of a commercial DBS electrode in a gel phantom with different lead configurations to validate the proposed method.

Results

Using data from a single calibration experiment, the transimpedance of a commercial DBS electrode (directional lead, Infinity DBS system, Abbott Laboratories, Chicago, IL) was determined to be 88 Ω. Heating predictions using the DBS transimpedance and rapidly acquired MR‐based current measurements in 26 different lead configurations resulted in a <23% (on average 11.3%) normalized root‐mean‐square error compared to experimental heating measurements during RF scans.

Conclusion

In this study, a workflow consisting of an MR‐based current measurement on the DBS lead and simple quasi‐static EM/thermal simulations to predict the temperature increase around a DBS electrode undergoing an MRI scan is proposed and validated using a commercial DBS electrode.

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Exposure Optimization Trial for Patients With Medical Implants During MRI Exposure: Balance Between the Completeness and Efficiency

Elongated conductors, such as pacemaker leads, can couple to the MRI radio-frequency (RF) field during MRI scan and cause dangerous tissue heating. By selecting proper RF exposure conditions, the RF-induced power deposition can be suppressed. As the RF-induced power deposition is a complex function of multiple clinical factors, the problem remains how to perform the exposure selection in a comprehensive and efficient way. The purpose of this work is to demonstrate an exposure optimization trail that allows a comprehensive optimization in an efficient and traceable manner. The proposed workflow is demonstrated with a generic 40 cm long cardio pacemaker, major components of the clinical factors are decoupled from the redundant data set using principle component analysis, the optimized exposure condition can not only reduce the in vivo power deposition but also maintain good image quality.

An 8 channel parallel transmit system with current sensor feedback for MRI-guided interventional applications

Background.Parallel transmit (pTx) has introduced many benefits to magnetic resonance imaging (MRI) with regard to decreased specific absorption rates and improved transmit field homogeneity, of particular importance in applications at higher magnetic field strengths. PTx has also been proposed as a solution to mitigating dangerous RF induced heating of elongated conductive devices such as those used in cardiac interventions. In this work we present a system that can augment a conventional scanner with pTx, in particular for use in interventional MRI for guidewire safety, by adjusting the amplitude and phase of each channel right before the start of the imaging pulses.Methods.The pTx system was designed to work in-line with a 1.5 T MRI while the RF synthesis and imaging control was maintained on the host MR scanner. The add-on pTx system relies on the RF transmit signal, unblanking pulse, and a protocol driven trigger from the scanner. The RF transmit was split into multiple fully modulated transmit signals to drive an array of custom transceiver coils. The performance of the 8-channel implementation was tested with regards to active and real-time control of RF induced currents on a standard guidewire, heating mitigation tests, and anatomical imaging in sheep.Results. The pTx system was intended to update RF shims in real-time and it was demonstrated that the safe RF shim could be determined while the guidewire is moved. The anatomical imaging demonstrated that cardiac anatomy and neighbouring superficial structures could be fully characterized with the pTx system inline.Conclusion.We have presented the design and performance of a real-time feedback control pTx system capable of adding such capabilities to a conventional MRI with the focus of guidewire imaging in cardiac interventional MRI applications.

Safety and image quality at 7T MRI for deep brain stimulation systems: Ex vivo study with lead-only and full-systems

Ultra-high field MRI at 7 T can produce much better visualization of sub-cortical structures compared to lower field, which can greatly help target verification as well as overall treatment monitoring for patients with deep brain stimulation (DBS) implants. However, use of 7 T MRI for such patients is currently contra-indicated by guidelines from the device manufacturers due to the safety issues. The aim of this study was to provide an assessment of safety and image quality of ultra-high field magnetic resonance imaging at 7 T in patients with deep brain stimulation implants. We performed experiments with both lead-only and complete DBS systems implanted in anthropomorphic phantoms. RF heating was measured for 43 unique patient-derived device configurations. Magnetic force measurements were performed according to ASTM F2052 test method, and device integrity was assessed before and after experiments. Finally, we assessed electrode artifact in a cadaveric brain implanted with an isolated DBS lead. RF heating remained below 2°C, similar to a fever, with the 95% confidence interval between 0.38°C-0.52°C. Magnetic forces were well below forces imposed by gravity, and thus not a source of concern. No device malfunctioning was observed due to interference from MRI fields. Electrode artifact was most noticeable on MPRAGE and T2*GRE sequences, while it was minimized on T2-TSE images. Our work provides the safety assessment of ultra-high field MRI at 7 T in patients with DBS implants. Our results suggest that 7 T MRI may be performed safely in patients with DBS implants for specific implant models and MRI hardware.

Rapid safety assessment and mitigation of radiofrequency induced implant heating using small root mean square sensors and the sensor matrix Qs

PURPOSE

Rapid detection and mitigation of radiofrequency (RF)-induced implant heating during MRI based on small and low-cost embedded sensors.

THEORY AND METHODS

A diode and a thermistor are embedded at the tip of an elongated mock implant. RF-induced voltages or temperature change measured by these root mean square (RMS) sensors are used to construct the sensor Q-Matrix (Q_S ). Hazard prediction, monitoring and parallel transmit (pTx)-based mitigation using these sensors is demonstrated in benchtop measurements at 300 MHz and within a 3T MRI.

RESULTS

Q_S acquisition and mitigation can be performed in <20 ms demonstrating real-time capability. The acquisitions can be performed using safe low powers (<3 W) due to the high reading precision of the diode (126 µV) and thermistor (26 µK). The orthogonal projection method used for pTx mitigation was able to reduce the induced signals and temperatures in all 155 investigated locations. Using the Q_S approach in a pTx capable 3T MRI with either a two-channel body coil or an eight-channel head coil, RF-induced heating was successfully assessed, monitored and mitigated while the image quality outside the implant region was preserved.

CONCLUSION

Small (<1.5 mm³ ) and low-cost (<1 €) RMS sensors embedded in an implant can provide all relevant information to predict, monitor and mitigate RF-induced heating in implants, while preserving image quality. The proposed pTx-based Q_S approach is independent of simulations or in vitro testing and therefore complements these existing safety assessments.

Interventional cardiac MRI using an add-on parallel transmit MR system: In vivo experience in sheep

PURPOSE

We present in vivo testing of a parallel transmit system intended for interventional MR-guided cardiac procedures.

METHODS

The parallel transmit system was connected in-line with a conventional 1.5 Tesla MRI system to transmit and receive on an 8-coil array. The system used a current sensor for real-time feedback to achieve real-time current control by determining coupling and null modes. Experiments were conducted on 4 Charmoise sheep weighing 33.9-45.0 kg with nitinol guidewires placed under X-ray fluoroscopy in the atrium or ventricle of the heart via the femoral vein. Heating tests were done in vivo and post-mortem with a high RF power imaging sequence using the coupling mode. Anatomical imaging was done using a combination of null modes optimized to produce a useable B₁ field in the heart.

RESULTS

Anatomical imaging produced cine images of the heart comparable in quality to imaging with the quad mode (all channels with the same amplitude and phase). Maximum observed temperature increases occurred when insulation was stripped from the wire tip. These were 4.1℃ and 0.4℃ for the coupling mode and null modes, respectively for the in vivo case; increasing to 6.0℃ and 1.3℃, respectively for the ex vivo case, because cooling from blood flow is removed. Heating < 0.1℃ was observed when insulation was not stripped from guidewire tips. In all tests, the parallel transmit system managed to reduce the temperature at the guidewire tip.

CONCLUSION

We have demonstrated the first in vivo usage of an auxiliary parallel transmit system employing active feedback-based current control for interventional MRI with a conventional MRI scanner.

A fast MR-thermometry method for quantitative assessment of temperature increase near an implanted wire

PURPOSE

To propose a MR-thermometry method and associated data processing technique to predict the maximal RF-induced temperature increase near an implanted wire for any other MRI sequence.

METHODS

A dynamic single shot echo planar imaging sequence was implemented that interleaves acquisition of several slices every second and an energy deposition module with adjustable parameters. Temperature images were processed in real time and compared to invasive fiber-optic measurements to assess accuracy of the method. The standard deviation of temperature was measured in gel and in vivo in the human brain of a volunteer. Temperature increases were measured for different RF exposure levels in a phantom containing an inserted wire and then a MR-conditional pacemaker lead. These calibration data set were fitted to a semi-empirical model allowing estimation of temperature increase of other acquisition sequences.

RESULTS

The precision of the measurement obtained after filtering with a 1.6x1.6 mm2 in plane resolution was 0.2°C in gel, as well as in the human brain. A high correspondence was observed with invasive temperature measurements during RF-induced heating (0.5°C RMSE for a 11.5°C temperature increase). Temperature rises of 32.4°C and 6.5°C were reached at the tip of a wire and of a pacemaker lead, respectively. After successful fitting of temperature curves of the calibration data set, temperature rise predicted by the model was in good agreement (around 5% difference) with measured temperature by a fiber optic probe, for three other MRI sequences.

CONCLUSION

This method proposes a rapid and reliable quantification of the temperature rise near an implanted wire. Calibration data set and resulting fitting coefficients can be used to estimate temperature increase for any MRI sequence as function of its power and duration.

MR safety watchdog for active catheters: Wireless impedance control with real-time feedback

PURPOSE

To dynamically minimize radiofrequency (RF)-induced heating of an active catheter through an automatic change of the termination impedance.

METHODS

A prototype wireless module was designed that modifies the input impedance of an active catheter to keep the temperature rise during MRI below a threshold, ΔT_max . The wireless module (MR safety watchdog; MRsWD) measures the local temperature at the catheter tip using either a built-in thermistor or external data from a fiber-optical thermometer. It automatically changes the catheter input impedance until the temperature rise during MRI is minimized. If ΔT_max is exceeded, RF transmission is blocked by a feedback system.

RESULTS

The thermistor and fiber-optical thermometer provided consistent temperature data in a phantom experiment. During MRI, the MRsWD was able to reduce the maximum temperature rise by 25% when operated in real-time feedback mode.

CONCLUSION

This study demonstrates the technical feasibility of an MRsWD as an alternative or complementary approach to reduce RF-induced heating of active interventional devices. The automatic MRsWD can reduce heating using direct temperature measurements at the tip of the catheter. Given that temperature measurements are intrinsically slow, for a clinical implementation, a faster feedback parameter would be required such as the RF currents along the catheter or scattered electric fields at the tip.

Parallel transmission to reduce absorbed power around deep brain stimulation devices in MRI: Impact of number and arrangement of transmit channels

PURPOSE

To assess the mean and variance performance of parallel transmission (pTx) coils for reduction of the absorbed power around electrodes (APAE) in patients implanted with deep brain stimulation (DBS) devices.

METHODS

We simulated 4 pTx coils (8 and 16 channels, head and body coils) and a birdcage body coil. We characterized the RF safety risk using the APAE, which is the integral of the deposited power (in Watts) in a small cylindrical volume of brain tissue surrounding the electrode tips. We assessed the APAE mean and variance by simulation of 5 realistic DBS patient models that include the full DBS implant length, extracranial loops, and implanted pulse generator.

RESULTS

PTx coils with 8 (16) channels were able to reduce the APAE by >18× (>169×) compared to the birdcage coil in average for all patient models, at no cost in term of flip angle uniformity or global specific absorption rate (SAR). Moreover, local pTx coils performed significantly better than body arrays.

CONCLUSION

PTx is a possible solution to the problem of RF heating of DBS patients when performing MRI, but the large interpatient variability of the APAE indicates that patient-specific safety monitoring may be needed.

Safe guidewire visualization using the modes of a PTx transmit array MR system

Purpose

MRI‐guided cardiovascular intervention using standard metal guidewires can produce focal tissue heating caused by induced radiofrequency guidewire currents. It has been shown that safe operation is made possible by using parallel transmit radiofrequency coils driven in the null current mode, which does not induce radiofrequency currents and hence allows safe tissue visualization. We propose that the maximum current modes, usually considered unsafe, be used at very low power levels to visualize conductive wires, and we investigate pulse sequences best suited for this application.

Methods

Spoiled gradient echo, balanced steady‐state free precession, and turbo spin echo sequences were evaluated for their ability to visualize a conductive guidewire embedded in a gel phantom when run in maximum current modes at very low power level. Temperature at the guidewire tip was monitored for safety assessment.

Results

Excellent guidewire visualization could be achieved using maximum current modes excitation, with the turbo spin echo sequence giving the best image quality. Although turbo spin echo is usually considered to be a high‐power sequence, our method reduced all pulses to 1% amplitude (0.01% power), and heating was not detected. In addition, visualization of background tissue can be achieved using null current mode, also with no recorded heating at the guidewire tip even when running at 100% (reported) specific absorption rate.

Conclusion

Parallel transmit is a promising approach for both guidewire and tissue visualization using maximum and null current modes, respectively, for interventional cardiac MRI. Such systems can switch excitation mode instantaneously, allowing for flexible integration into interactive sequences.

It's the little things: On the complexity of planar electrode heating in MRI

Neurological disorders are increasingly analysed and treated with implantable electrodes, and patients with such electrodes are studied with MRI despite the risk of radio-frequency (RF) induced heating during the MRI exam. Recent clinical research suggests that electrodes with smaller diameters of the electrical interface between implant and tissue are beneficial; however, the influence of this electrode contact diameter on RF-induced heating has not been investigated. In this work, electrode contact diameters between 0.3 and 4 mm of implantable electrodes appropriate for stimulation and electrocorticography were evaluated in a 1.5 T MRI system. In situ temperature measurements adapted from the ASTM standard test method were performed and complemented by simulations of the specific absorption rate (SAR) to assess local SAR values, temperature increase and the distribution of dissipated power. Measurements showed temperature changes between 0.8 K and 53 K for different electrode contact diameters, which is well above the legal limit of 1 K. Systematic errors in the temperature measurements are to be expected, as the temperature sensors may disturb the heating pattern near small electrodes. Compared to large electrodes, simulations suggest that small electrodes are subject to less dissipated power, but more localized power density. Thus, smaller electrodes might be classified as safe in current certification procedures but may be more likely to burn adjacent tissue. To assess these local heating phenomena, smaller temperature sensors or new non-invasive temperature sensing methods are needed.

Evolution of UHF Body Imaging in the Human Torso at 7T: Technology, Applications, and Future Directions

The potential value of ultrahigh field (UHF) magnetic resonance imaging (MRI) and spectroscopy to biomedical research and in clinical applications drives the development of technologies to overcome its many challenges. The increased difficulties of imaging the human torso compared with the head include its overall size, the dimensions and location of its anatomic targets, the increased prevalence and magnitude of physiologic effects, the limited availability of tailored RF coils, and the necessary transmit chain hardware. Tackling these issues involves addressing notoriously inhomogeneous transmit B1 (B1) fields, limitations in peak B1, larger spatial variations of the static magnetic field B0, and patient safety issues related to implants and local RF power deposition. However, as research institutions and vendors continue to innovate, the potential gains are beginning to be realized. Solutions overcoming the unique challenges associated with imaging the human torso are reviewed as are current studies capitalizing on the benefits of UHF in several anatomies and applications. As the field progresses, strategies associated with the RF system architecture, calibration methods, RF pulse optimization, and power monitoring need to be further integrated into the MRI systems making what are currently complex processes more streamlined. Meanwhile, the UHF MRI community must seize the opportunity to build upon what have been so far proof of principle and feasibility studies and begin to further explore the true impact in both research and the clinic.

Parallel Transmission for Ultrahigh Field MRI

Magnetic resonance imaging (MRI) has been driven toward ultrahigh magnetic fields (UHF) in order to benefit from correspondingly higher signal-to-noise ratio and spectral resolution. Technological challenges associated with UHF, such as increased radiofrequency (RF) energy deposition and RF excitation inhomogeneity, limit realization of the full potential of these benefits. Parallel RF transmission (pTx) enables decreases in the inhomogeneity of RF excitations and in RF energy deposition by using multiple-transmit RF coils driven independently and operating simultaneously. pTx plays a fundamental role in UHF MRI by bringing the potential applications of UHF into reality. In this review article, we review the recent developments in pTx pulse design and RF safety in pTx. Simultaneous multislice imaging and inner volume imaging using pTx are reviewed with a focus on UHF applications. Emerging pTx design approaches using improved pTx design frameworks and calibrations are reviewed together with calibration-free approaches that remove the necessity of time-consuming calibrations necessary for successful pTx. Lastly, we focus on the safety of pTx that is improved by using intersubject variability analysis, proactively managing pTx and temperature-based pTx approaches.

Numerical Simulations of Realistic Lead Trajectories and an Experimental Verification Support the Efficacy of Parallel Radiofrequency Transmission to Reduce Heating of Deep Brain Stimulation Implants during MRI

Patients with deep brain stimulation (DBS) implants may be subject to heating during MRI due to interaction with excitatory radiofrequency (RF) fields. Parallel RF transmit (pTx) has been proposed to minimize such RF-induced heating in preliminary proof-of-concept studies. The present work evaluates the efficacy of pTx technique on realistic lead trajectories obtained from nine DBS patients. Electromagnetic simulations were performed using 4- and 8-element pTx coils compared with a standard birdcage coil excitation using patient models and lead trajectories obtained by segmentation of computed tomography data. Numerical optimization was performed to minimize local specific absorption rate (SAR) surrounding the implant tip while maintaining spatial homogeneity of the transmitted RF magnetic field (B1+), by varying the input amplitude and phase for each coil element. Local SAR was significantly reduced at the lead tip with both 4-element and 8-element pTx (median decrease of 94% and 97%, respectively), whereas the median coefficient of spatial variation of B1+ inhomogeneity was moderately increased (30% for 4-element pTx and 20% for 8-element pTx) compared to that of the birdcage coil (17%). Furthermore, the efficacy of optimized 4-element pTx was verified experimentally by imaging a head phantom that included a wire implanted to approximate the worst-case lead trajectory for localized heating, based on the simulations. Negligible temperature elevation was observed at the lead tip, with reasonable image uniformity in the surrounding region. From this experiment and the simulations based on nine DBS patient models, optimized pTx provides a robust approach to minimizing local SAR with respect to lead trajectory.

Numerical Simulations of Realistic Lead Trajectories and an Experimental Verification Support the Efficacy of Parallel Radiofrequency Transmission to Reduce Heating of Deep Brain Stimulation Implants during MRI

Patients with deep brain stimulation (DBS) implants may be subject to heating during MRI due to interaction with excitatory radiofrequency (RF) fields. Parallel RF transmit (pTx) has been proposed to minimize such RF-induced heating in preliminary proof-of-concept studies. The present work evaluates the efficacy of pTx technique on realistic lead trajectories obtained from nine DBS patients. Electromagnetic simulations were performed using 4- and 8-element pTx coils compared with a standard birdcage coil excitation using patient models and lead trajectories obtained by segmentation of computed tomography data. Numerical optimization was performed to minimize local specific absorption rate (SAR) surrounding the implant tip while maintaining spatial homogeneity of the transmitted RF magnetic field (B₁⁺), by varying the input amplitude and phase for each coil element. Local SAR was significantly reduced at the lead tip with both 4-element and 8-element pTx (median decrease of 94% and 97%, respectively), whereas the median coefficient of spatial variation of B₁⁺ inhomogeneity was moderately increased (30% for 4-element pTx and 20% for 8-element pTx) compared to that of the birdcage coil (17%). Furthermore, the efficacy of optimized 4-element pTx was verified experimentally by imaging a head phantom that included a wire implanted to approximate the worst-case lead trajectory for localized heating, based on the simulations. Negligible temperature elevation was observed at the lead tip, with reasonable image uniformity in the surrounding region. From this experiment and the simulations based on nine DBS patient models, optimized pTx provides a robust approach to minimizing local SAR with respect to lead trajectory.

A simple geometric analysis method for measuring and mitigating RF induced currents on Deep Brain Stimulation leads by multichannel transmission/reception

The purpose of this work is to present a new method that can be used to estimate and mitigate RF induced currents on Deep Brain Stimulation (DBS) leads. Here, we demonstrate the effect of RF induced current mitigation on both RF heating and image quality for a variety of brain MRI sequences at 3 T. We acquired pre-scan images around a DBS lead (in-situ and ex-vivo) using conventional Gradient Echo Sequence (GRE) accelerated by parallel imaging (i.e GRAPPA) and quantified the magnitude and phase of RF induced current using the relative location of the B1+ null with respect to the lead position. We estimated the RF induced current on a DBS lead implanted in a gel phantom as well as in a cadaver head study for a variety of RF excitation patterns. We also measured the increase in tip temperature using fiber-optic probes for both phantom and cadaver studies. Using the magnitude and phase information of the current induced separately by two transmit channels of the body coil, we calculated an implant friendly (IF) excitation. Using the IF excitation, we acquired T1, T2 weighted Turbo Spin Echo (TSE), T2 weighted SPACE-Dark Fluid, and Ultra Short Echo Time (UTE) sequences around the lead. Our induced current estimation demonstrated linear relationship between the magnitude of the induced current and the square root SAR at the tip of the lead as measured in phantom studies. The "IF excitation pattern" calculated after the pre-scan mitigated RF artifacts and increased the image quality around the lead. In addition, it reduced the tip temperature significantly in both phantom and cadaver studies compared to a conventional quadrature excitation while keeping equivalent overall image quality. We present a relatively fast method that can be used to calculate implant friendly excitation, reducing image artifacts as well as the temperature around the DBS electrodes. When combined with a variety of MR sequences, the proposed method can improve the image quality and patient safety in clinical imaging scenarios.

Thermo-Acoustic Ultrasound for Detection of RF-Induced Device Lead Heating in MRI

Patients who have implanted medical devices with long conductive leads are often restricted from receiving MRI scans due to the danger of RF-induced heating near the lead tips. Phantom studies have shown that this heating varies significantly on a case-by-case basis, indicating that many patients with implanted devices can receive clinically useful MRI scans without harm. However, the difficulty of predicting RF-induced lead tip heating prior to scanning prevents numerous implant recipients from being scanned. Here, we demonstrate that thermo-acoustic ultrasound (TAUS) has the potential to be utilized for a pre-scan procedure assessing the risk of RF-induced lead tip heating in MRI. A system was developed to detect TAUS signals by four different TAUS acquisition methods. We then integrated this system with an MRI scanner and detected a peak in RF power absorption near the tip of a model lead when transmitting from the scanner's body coil. We also developed and experimentally validated simulations to characterize the thermo-acoustic signal generated near lead tips. These results indicate that TAUS is a promising method for assessing RF implant safety, and with further development, a TAUS pre-scan could allow many more patients to have access to MRI scans of significant clinical value.

Real-time MRI guidance of cardiac interventions

Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages. Rapid intraprocedural image analysis can extract and highlight critical information about interventional targets and outcomes. In some cases, real-time interactive imaging is used to provide a continuous stream of images displayed to interventionalists for dynamic device navigation. Alternatively, devices are navigated relative to a roadmap of major cardiac structures generated through fast segmentation and registration. Interventional devices can be visualized and tracked throughout a procedure with specialized imaging methods. In a clinical setting, advanced imaging must be integrated with other clinical tools and patient data. In order to perform these complex procedures, interventional cardiac MR relies on customized equipment, such as interactive imaging environments, in-room image display, audio communication, hemodynamic monitoring and recording systems, and electroanatomical mapping and ablation systems. Operating in this sophisticated environment requires coordination and planning. This review provides an overview of the imaging technology used in MRI-guided cardiac interventions. Specifically, this review outlines clinical targets, standard image acquisition and analysis tools, and the integration of these tools into clinical workflow.

LEVEL OF EVIDENCE

1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2017;46:935-950.

Direct SAR mapping by thermoacoustic imaging: A feasibility study

PURPOSE

To develop a new method capable of directly measuring specific absorption rate (SAR) deposited in tissue using the thermoacoustic signal induced by short radiofrequency (RF) pulse excitation.

THEORY

A detailed model based on the thermoacoustic wave generation and propagation is presented.

METHODS

We propose a new concept for direct measurement of SAR, to be used as a safety assessment/monitoring tool for MRI. The concept involves the use of short bursts of RF energy and the measurement of the resulting thermoacoustic excitation pattern by an array of ultrasound transducers, followed by image reconstruction to yield the 3D SAR distribution. We developed a simulation framework to model this thermoacoustic SAR mapping concept and verified the concept in vitro.

RESULTS

Simulations show good agreement between reconstructed and original SAR distributions with an error of 4.2, 7.2, and 8.4% of the mean SAR values in axial, sagittal, and coronal planes and support the feasibility of direct experimental mapping of SAR distributions in vivo. The in vitro experiments show good agreement with theory (r2  = 0.52).

CONCLUSIONS

A novel thermoacoustic method for in vivo mapping of local SAR patterns in MRI has been proposed and verified in simulation and in a phantom experiment. Magn Reson Med 78:1599-1606, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Miniaturizing Floating Traps to Increase RF Safety of Magnetic-Resonance-Guided Percutaneous Procedures

OBJECTIVE

MRI in the area of cardiovascular catheter-based interventional procedures is an active field. A common intervention-revascularization of chronic total occlusions, requires a conductive guidewire for revascularization. The mechanical properties of guidewires are paramount to the successful execution of such procedures. Furthermore to benefit from MRI techniques, additional conductors are required to transmit signal from the tip of a catheter. Long thin conductors in MRI systems pose a safety risk in the form of RF heating due to induced RF currents on the conductors. Unfortunately many existing techniques to mitigate this risk require physical modification of the conductors, inevitably resulting in detrimental mechanical tradeoffs in the guidewire. This manuscript proposes a novel application and miniaturization of an existing device, the floating RF trap. The RF trap couples strongly to any thin conductor passing through the trap lumen inducing significant series impedance. This results in reduction of induced RF currents, and thus, heating.

METHODS AND RESULTS

This study shows theoretical and experimental analysis of induced impedance as well as theoretical reduction in heating due to various distributions of traps along the length of a catheter. Results of measuring induced current and heating in phantom experiments are also presented. Through comparison with commercial simulation packages and results of phantom experiments, it is shown that miniaturized RF traps can be modeled accurately, including their induced series impedance and effect on induced RF current.

CONCLUSION AND SIGNIFICANCE

It was demonstrated that floating RF traps present a feasible method to mitigate RF heating while maintaining important mechanical properties of guidewires.

Electromagnetic computation and modeling in MRI

Electromagnetic (EM) computational modeling is used extensively during the development of a Magnetic Resonance Imaging (MRI) scanner, its installation, and use. MRI, which relies on interactions between nuclear magnetic moments and the applied magnetic fields, uses a range of EM tools to optimize all of the magnetic fields required to produce the image. The main field magnet is designed to exacting specifications but challenges in manufacturing, installation, and use require additional tools to maintain target operational performance. The gradient magnetic fields, which provide the primary signal localization mechanism, are designed under another set of complex design trade-offs which include conflicting imaging performance specifications and patient physiology. Gradients are largely impervious to external influences, but are also used to enhance main field operational performance. The radiofrequency (RF) magnetic fields, which are used to elicit the signals fundamental to the MR image, are a challenge to optimize for a host of reasons that include patient safety, image quality, cost optimization, and secondary signal localization capabilities. This review outlines these issues and the EM modeling used to optimize MRI system performance.

SAR Simulations & Safety

At ultra-high fields, the assessment of radiofrequency (RF) safety presents several new challenges compared to low-field systems. Multi-channel RF transmit coils in combination with parallel transmit techniques produce time-dependent and spatially varying power loss densities in the tissue. Further, in ultra-high-field systems, localized field effects can be more pronounced due to a transition from the quasi stationary to the electromagnetic field regime. Consequently, local information on the RF field is required for reliable RF safety assessment as well as for monitoring of RF exposure during MR examinations. Numerical RF and thermal simulations for realistic exposure scenarios with anatomical body models are currently the only practical way to obtain the requisite local information on magnetic and electric field distributions as well as tissue temperature. In this article, safety regulations and the fundamental characteristics of RF field distributions in ultra-high-field systems are reviewed. Numerical methods for computation of RF fields as well as typical requirements for the analysis of realistic multi-channel RF exposure scenarios including anatomical body models are highlighted. In recent years, computation of the local tissue temperature has become of increasing interest, since a more accurate safety assessment is expected because temperature is directly related to tissue damage. Regarding thermal simulation, bio-heat transfer models and approaches for taking into account the physiological response of the human body to RF exposure are discussed. In addition, suitable methods are presented to validate calculated RF and thermal results with measurements. Finally, the concept of generalized simulation-based specific absorption rate (SAR) matrix models is discussed. These models can be incorporated into local SAR monitoring in multi-channel MR systems and allow the design of RF pulses under constraints for local SAR.

MRI-based transfer function determination for the assessment of implant safety

PURPOSE

We introduce a new MR-based method to determine the transfer function (TF) for radiofrequency (RF) safety assessment of active implantable medical devices. Transfer functions are implant-specific measures that relate the incident tangential electric field on an (elongated) implant to a scattered electric field at its tip. The proposed method allows for TF determination with a high spatial resolution in relatively fast measurements without requiring dedicated bench setups from MRI images.

THEORY AND METHODS

The principle of reciprocity is used in conjunction with the potential to measure currents with MRI to determine TF. Low-flip angle 3D dual gradient echo MRI data are acquired with an implant as transceive antenna, which requires minimal hardware adaptations. The implant-specific TF is determined from the acquired MRI data, with two different postprocessing methods for comparison.

RESULTS

TFs of linear and helical implants can be determined accurately (with a Pearson correlation coefficient R ≥ 0.7 between measurements and simulations, and a difference in field at the tip ΔEtip ≤ 19%) from relatively quick (t < 20 minutes) MRI acquisitions with (several) millimeter spatial resolution.

CONCLUSION

Transfer function determination with MRI for RF safety assessment of implantable medical devices is possible. The proposed MR-based method allows for TF determination in more realistic exposure scenarios and solid media. Magn Reson Med 78:2449-2459, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Local Multi-Channel RF Surface Coil versus Body RF Coil Transmission for Cardiac Magnetic Resonance at 3 Tesla: Which Configuration Is Winning the Game?

INTRODUCTION

The purpose of this study was to demonstrate the feasibility and efficiency of cardiac MR at 3 Tesla using local four-channel RF coil transmission and benchmark it against large volume body RF coil excitation.

METHODS

Electromagnetic field simulations are conducted to detail RF power deposition, transmission field uniformity and efficiency for local and body RF coil transmission. For both excitation regimes transmission field maps are acquired in a human torso phantom. For each transmission regime flip angle distributions and blood-myocardium contrast are examined in a volunteer study of 12 subjects. The feasibility of the local transceiver RF coil array for cardiac chamber quantification at 3 Tesla is demonstrated.

RESULTS

Our simulations and experiments demonstrate that cardiac MR at 3 Tesla using four-channel surface RF coil transmission is competitive versus current clinical CMR practice of large volume body RF coil transmission. The efficiency advantage of the 4TX/4RX setup facilitates shorter repetition times governed by local SAR limits versus body RF coil transmission at whole-body SAR limit. No statistically significant difference was found for cardiac chamber quantification derived with body RF coil versus four-channel surface RF coil transmission. Our simulation also show that the body RF coil exceeds local SAR limits by a factor of ~2 when driven at maximum applicable input power to reach the whole-body SAR limit.

CONCLUSION

Pursuing local surface RF coil arrays for transmission in cardiac MR is a conceptually appealing alternative to body RF coil transmission, especially for patients with implants.

Parallel transmission for ultrahigh-field imaging

The development of MRI systems operating at or above 7 T has provided researchers with a new window into the human body, yielding improved imaging speed, resolution and signal-to-noise ratio. In order to fully realise the potential of ultrahigh-field MRI, a range of technical hurdles must be overcome. The non-uniformity of the transmit field is one of such issues, as it leads to non-uniform images with spatially varying contrast. Parallel transmission (i.e. the use of multiple independent transmission channels) provides previously unavailable degrees of freedom that allow full spatial and temporal control of the radiofrequency (RF) fields. This review discusses the many ways in which these degrees of freedom can be used, ranging from making more uniform transmit fields to the design of subject-tailored RF pulses for both uniform excitation and spatial selection, and also the control of the specific absorption rate. © 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.

W(h)ither human cardiac and body magnetic resonance at ultrahigh fields? technical advances, practical considerations, applications, and clinical opportunities

The objective of this study was to document and review advances and groundbreaking progress in cardiac and body MR at ultrahigh fields (UHF, B0 ≥ 7.0 T) with the goal to attract talent, clinical adopters, collaborations and resources to the biomedical and diagnostic imaging communities. This review surveys traits, advantages and challenges of cardiac and body MR at 7.0 T. The considerations run the gamut from technical advances to clinical opportunities. Key concepts, emerging technologies, practical considerations, frontier applications and future directions of UHF body and cardiac MR are provided. Examples of UHF cardiac and body imaging strategies are demonstrated. Their added value over the kindred counterparts at lower fields is explored along with an outline of research promises. The achievements of cardiac and body UHF-MR are powerful motivators and enablers, since extra speed, signal and imaging capabilities may be invested to overcome the fundamental constraints that continue to hamper traditional cardiac and body MR applications. If practical obstacles, concomitant physics effects and technical impediments can be overcome in equal measure, sophisticated cardiac and body UHF-MR will help to open the door to new MRI and MRS approaches for basic research and clinical science, with the lessons learned at 7.0 T being transferred into broad clinical use including diagnostics and therapy guiding at lower fields. Copyright © 2015 John Wiley & Sons, Ltd.

Investigation of Parallel Radiofrequency Transmission for the Reduction of Heating in Long Conductive Leads in 3 Tesla Magnetic Resonance Imaging

Deep Brain Stimulation (DBS) is increasingly used to treat a variety of brain diseases by sending electrical impulses to deep brain nuclei through long, electrically conductive leads. Magnetic resonance imaging (MRI) of patients pre- and post-implantation is desirable to target and position the implant, to evaluate possible side-effects and to examine DBS patients who have other health conditions. Although MRI is the preferred modality for pre-operative planning, MRI post-implantation is limited due to the risk of high local power deposition, and therefore tissue heating, at the tip of the lead. The localized power deposition arises from currents induced in the leads caused by coupling with the radiofrequency (RF) transmission field during imaging. In the present work, parallel RF transmission (pTx) is used to tailor the RF electric field to suppress coupling effects. Electromagnetic simulations were performed for three pTx coil configurations with 2, 4, and 8-elements, respectively. Optimal input voltages to minimize coupling, while maintaining RF magnetic field homogeneity, were determined for all configurations using a Nelder-Mead optimization algorithm. Resulting electric and magnetic fields were compared to that of a 16-rung birdcage coil. Experimental validation was performed with a custom-built 4-element pTx coil. In simulation, 95-99% reduction of the electric field at the tip of the lead was observed between the various pTx coil configurations and the birdcage coil. Maximal reduction in E-field was obtained with the 8-element pTx coil. Magnetic field homogeneity was comparable to the birdcage coil for the 4- and 8-element pTx configurations. In experiment, a temperature increase of 2±0.15°C was observed at the tip of the wire using the birdcage coil, whereas negligible increase (0.2±0.15°C) was observed with the optimized pTx system. Although further research is required, these initial results suggest that the concept of optimizing pTx to reduce DBS heating effects holds considerable promise.

Medusa: a scalable MR console using USB

Magnetic resonance imaging (MRI) pulse sequence consoles typically employ closed proprietary hardware, software, and interfaces, making difficult any adaptation for innovative experimental technology. Yet MRI systems research is trending to higher channel count receivers, transmitters, gradient/shims, and unique interfaces for interventional applications. Customized console designs are now feasible for researchers with modern electronic components, but high data rates, synchronization, scalability, and cost present important challenges. Implementing large multichannel MR systems with efficiency and flexibility requires a scalable modular architecture. With Medusa, we propose an open system architecture using the universal serial bus (USB) for scalability, combined with distributed processing and buffering to address the high data rates and strict synchronization required by multichannel MRI. Medusa uses a modular design concept based on digital synthesizer, receiver, and gradient blocks, in conjunction with fast programmable logic for sampling and synchronization. Medusa is a form of synthetic instrument, being reconfigurable for a variety of medical/scientific instrumentation needs. The Medusa distributed architecture, scalability, and data bandwidth limits are presented, and its flexibility is demonstrated in a variety of novel MRI applications.