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

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.

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.

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.

A 20-gauge active needle design with thin-film printed circuitry for interventional MRI at 0.55T

PURPOSE

This work aims to fabricate RF antenna components on metallic needle surfaces using biocompatible polyester tubing and conductive ink to develop an active interventional MRI needle for clinical use at 0.55 Tesla.

METHODS

A custom computer numeric control-based conductive ink printing method was developed. Based on electromagnetic simulation results, thin-film RF antennas were printed with conductive ink and used to fabricate a medical grade, 20-gauge (0.87 mm outer diameter), 90-mm long active interventional MRI needle. The MRI visibility performance of the active needle prototype was tested in vitro in 1 gel phantom and in vivo in 1 swine. A nearly identical active needle constructed using a 44 American Wire Gauge insulated copper wire-wound RF receiver antenna was a comparator. The RF-induced heating risk was evaluated in a gel phantom per American Society for Testing and Materials (ASTM) 2182-19.

RESULTS

The active needle prototype with printed RF antenna was clearly visible both in vitro and in vivo under MRI. The maximum RF-induced temperature rise of prototypes with printed RF antenna and insulated copper wire antenna after a 3.96 W/kg, 15 min. long scan were 1.64°C and 8.21°C, respectively. The increase in needle diameter was 98 µm and 264 µm for prototypes with printed RF antenna and copper wire-wound antenna, respectively.

CONCLUSION

The active needle prototype with conductive ink printed antenna provides distinct device visibility under MRI. Variations on the needle surface are mitigated compared to use of a 44 American Wire Gauge copper wire. RF-induced heating tests support device RF safety under MRI. The proposed method enables fabrication of small diameter active interventional MRI devices having complex geometries, something previously difficult using conventional methods.

Multi-parameter Analytical Method for B1 and SNR Analysis (MAMBA): An open source RF coil design tool

In Magnetic Resonance Imaging (MRI), radio frequency (RF) coils of different forms and shapes are used to maximize signal-to-noise ratio (SNR). RF coils are designed for clinical applications and have dimensions comparable with the target body part to be imaged, and they perform best when loaded by human tissue majority of which have conductivity values higher than 0.5 S/m. However, they are not properly tuned and matched for samples having low conductivity such as solid samples with low water content. Moreover, for samples with low filling factor and low conductivity, the noise in MRI is dominated by RF coil losses. In this case, RF coil design can be optimized to improve image SNR. Here, a new software tool (Multi-parameter Analytical Method for B1 and SNR Analysis) MAMBA is presented to design and compare volume coils of birdcage, solenoid, and loop-gap design for these samples. The input parameters of the tool are the sample properties, the coil design and the hardware properties, of which a relative SNR is determined. For that, a figure of merit is calculated from the coil sensitivity, applied resonant frequency and the resistive losses of sample, coil and capacitive components. The tool was tested in an ancient Egyptian mummy head which represents an extreme case of MRI with short T2*. Two optimized birdcage coils were designed using MAMBA, constructed and compared to a commercial transmit receive head coil. Calculated relative SNR values are in good agreement with the measurements.

Catheter-based Arterial Input Function Determination for Myocardial Perfusion Measurements

The quantification of myocardial perfusion with contrast agent (CA) tracers requires the precise knowledge of the arterial input function (AIF). In this study a method for MR-guided vascular interventions is evaluated that determines the AIF via an active tracking catheter during targeted CA injection. A phantom experiment with a dialysis filter was conducted to measure the AIF using an active catheter and a dynamic image series as reference. To compensate for dilution and coil sensitivity effects, correction methods were developed for the catheter-based AIF determination. From the dynamic MR measurements in the perfusion phantom quantitative perfusion maps were calculated by a deconvolution of the measured CA concentration with the AIF, and additional flow measurements were used to normalize the perfusion map. The signal-time-curves of the measured AIF using the catheter-based and imaging-based methods agree while the absolute values differ by a scaling factor of about 9. After normalization to the surrounding flow, both perfusion techniques are in excellent agreement. Catheter-based AIF measurements are feasible but require an additional normalization which can be determined from a flow measurement. The technique might enable faster perfusion measurements during cardiovascular interventions.