Parallel transmission medical implant safety testbed: Real‐time mitigation of RF induced tip heating using time‐domain E‐field sensors

Open-source magnetic resonance imaging: Improving access, science, and education through global collaboration

Open-source practices and resources in magnetic resonance imaging (MRI) have increased substantially in recent years. This trend started with software and data being published open-source and, more recently, open-source hardware designs have become increasingly available. These developments towards a culture of sharing and establishing nonexclusive global collaborations have already improved the reproducibility and reusability of code and designs, while providing a more inclusive approach, especially for low-income settings. Community-driven standardization and documentation efforts are further strengthening and expanding these milestones. The future of open-source MRI is bright and we have just started to discover its full collaborative potential. In this review we will give an overview of open-source software and open-source hardware projects in human MRI research.

Complementary analysis of specific absorption rate safety for an 8Tx/16Rx array with central symmetry of elements for magnetic resonance imaging of the human heart and abdominopelvic organs at 7 T

A complementary safety assessment of the specific absorption rate (SAR) of the electromagnetic energy was performed in a prototype 8Tx/16Rx RF array for cardiac magnetic resonance imaging (MRI) at 7 T. The study aimed to address two critical aspects of 7-T SAR safety not always explicitly examined by coil vendors: (i) the influence of an RF-array position on a peak SAR value, and (ii) the risk of exceeding the permitted maximal SAR in the tissue surrounding conductive passive implants. The full-wave 3D electromagnetic simulations for the thorax with shifted array position and the whole-body volume in the presence of a dental retainer, an intrauterine contraceptive device (IUD), and a hip joint implant, were performed for two human voxel models. The effect of the array displacement on the SAR was simulated for seven array locations on the thorax shifted from the central position in different directions on 50 mm. The peak SAR values for both models were analyzed for the three phase-only transmit vectors optimized for B1 + homogeneity and transmit efficiency. Peak SAR values due to the shifts of the array position increase up to ≈50%. The worst-case peak SAR value for a dental retainer was found to be in the range of 10% of the maximal SAR in the tissue within the array's borders. For the IUD and artificial hip joint implants the effect was found to be negligible (peak SAR < 1% of the SAR within array borders). In addition to simulations for cardiac MRI, we performed a preliminary B1 + shimming and SAR-safety analysis for the same RF-array at various positions lower on the body trunk to assess a potential application in imaging abdominopelvic organs (prostate, kidney, and liver). The most promising target for an ad hoc alternative application of the array was found to be the prostate.

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.

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.

MRI of Implantation Sites Using Parallel Transmission of an Optimized Radiofrequency Excitation Vector

Postoperative care of orthopedic implants is aided by imaging to assess the healing process and the implant status. MRI of implantation sites might be compromised by radiofrequency (RF) heating and RF transmission field (B1+) inhomogeneities induced by electrically conducting implants. This study examines the applicability of safe and B1+-distortion-free MRI of implantation sites using optimized parallel RF field transmission (pTx) based on a multi-objective genetic algorithm (GA). Electromagnetic field simulations were performed for eight eight-channel RF array configurations (f = 297.2 MHz), and the most efficient array was manufactured for phantom experiments at 7.0 T. Circular polarization (CP) and orthogonal projection (OP) algorithms were applied for benchmarking the GA-based shimming. B1+ mapping and MR thermometry and imaging were performed using phantoms mimicking muscle containing conductive implants. The local SAR10g of the entire phantom in GA was 12% and 43.8% less than the CP and OP, respectively. Experimental temperature mapping using the CP yielded ΔT = 2.5-3.0 K, whereas the GA induced no extra heating. GA-based shimming eliminated B1+ artefacts at implantation sites and enabled uniform gradient-echo MRI. To conclude, parallel RF transmission with GA-based excitation vectors provides a technical foundation en route to safe and B1+-distortion-free MRI of implantation sites.

Radiofrequency induced heating of biodegradable orthopaedic screw implants during magnetic resonance imaging

Magnesium (Mg)-based implants have re-emerged in orthopaedic surgery as an alternative to permanent implants. Literature reveals little information on how the degradation of biodegradable implants may introduce safety implications for patient follow-up using medical imaging. Magnetic resonance imaging (MRI) benefits post-surgery monitoring of bone healing and implantation sites. Previous studies demonstrated radiofrequency (RF) heating of permanent implants caused by electromagnetic fields used in MRI. Our investigation is the first to report the effect of the degradation layer on RF-induced heating of biodegradable orthopaedic implants. WE43 orthopaedic compression screws underwent in vitro degradation. Imaging techniques were applied to assess the corrosion process and the material composition of the degraded screws. Temperature measurements were performed to quantify implant heating with respect to the degradation layer. For comparison, a commercial titanium implant screw was used. Strongest RF induced heating was observed for non-degraded WE43 screw samples. Implant heating had shown to decrease with the formation of the degradation layer. No statistical differences were observed for heating of the non-degraded WE43 material and the titanium equivalent. The highest risk of implant RF heating is most pronounced for Mg-based screws prior to degradation. Amendment to industry standards for MRI safety assessment is warranted to include biodegradable materials.

Gradient coil and radiofrequency induced heating of orthopaedic implants in MRI: influencing factors

Patients with implanted orthopaedic devices represent a growing number of subjects undergoing magnetic resonance imaging (MRI) scans each year. MRI safety labelling is required for all implants under the EU Medical Device Regulations to ensure regulatory compliance, with each device assessed through standardised testing procedures. In this paper, we employ parametric studies to assess a range of clinically relevant factors that cause tissue heating, performing simulations with both radiofrequency (RF) and gradient coil (GC) switching fields, the latter of which is often overlooked in the literature. A series of 'worst-case' scenarios for both types of excitation field is discussed. In the case of GC fields, large volume implants and large plate areas with the field orientated perpendicular to the plane cause the highest heating levels, along with sequences with high rates of field switching. Implant heating from RF fields is driven primarily from the 'antenna effect', with thin, linear implants of resonant length resulting in the highest temperature rises. In this work, we show that simplifications may be made to the field sequence and in some cases the device geometry without significantly compromising the accuracy of the simulation results, enabling the possibility for generic estimates of the implant heating for orthopaedic device manufacturers and opportunities to simplify the safety compliance process.

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.

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.