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Canzi P, Carlotto E, Zanoletti E, Frijns JHM, Borsetto D, Caruso A, Chiapparini L, Ciorba A, Conte G, Creber N, Criscuolo S, Di Lella F, Franchella S, Hensen EF, Lauda L, Malpede S, Mandalà M, Rotteveel LJC, Simoncelli A, Stellato AC, Zanetti D, Benazzo M. Multi-Magnet Cochlear Implant Technology and Magnetic Resonance Imaging: The Safety Issue. Audiol Res 2024; 14:401-411. [PMID: 38804458 PMCID: PMC11130805 DOI: 10.3390/audiolres14030034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/07/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients.
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Affiliation(s)
- Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (P.C.); (S.M.); (A.C.S.); (M.B.)
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Elena Carlotto
- Department of Otolaryngology, S. Croce Hospital, 12100 Cuneo, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35127 Padova, Italy; (E.Z.)
| | - Johan H. M. Frijns
- Department of Otorhinolaryngology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (J.H.M.F.); (E.F.H.)
| | - Daniele Borsetto
- Department of ENT, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (D.B.); (N.C.)
| | - Antonio Caruso
- Department of Otology and Skull Base Surgery, Otologic Group, 29121 Piacenza, Italy; (A.C.); (L.L.)
| | - Luisa Chiapparini
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (L.C.); (S.C.); (A.S.)
| | - Andrea Ciorba
- ENT and Audiology Department, University Hospital of Ferrara, 44122 Ferrara, Italy;
| | - Giorgio Conte
- Neuroradiology Department Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy;
| | - Nathan Creber
- Department of ENT, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK; (D.B.); (N.C.)
| | - Stefania Criscuolo
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (L.C.); (S.C.); (A.S.)
| | - Filippo Di Lella
- Otolaryngology and Otoneurosurgery Unit, University of Parma, 43126 Parma, Italy;
| | - Sebastiano Franchella
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35127 Padova, Italy; (E.Z.)
| | - Erik F. Hensen
- Department of Otorhinolaryngology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (J.H.M.F.); (E.F.H.)
| | - Lorenzo Lauda
- Department of Otology and Skull Base Surgery, Otologic Group, 29121 Piacenza, Italy; (A.C.); (L.L.)
| | - Stefano Malpede
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (P.C.); (S.M.); (A.C.S.); (M.B.)
| | - Marco Mandalà
- Department of Otology and Skull Base Surgery, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy;
| | - Liselotte J. C. Rotteveel
- Department of Otorhinolaryngology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands; (J.H.M.F.); (E.F.H.)
| | - Anna Simoncelli
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (L.C.); (S.C.); (A.S.)
| | - Anna Chiara Stellato
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (P.C.); (S.M.); (A.C.S.); (M.B.)
| | - Diego Zanetti
- Audiology Unit, Department of Specialistic Surgical Sciences Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy;
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (P.C.); (S.M.); (A.C.S.); (M.B.)
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
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Canzi P, Carlotto E, Simoncelli A, Lafe E, Scribante A, Minervini D, Nardo M, Malpede S, Chiapparini L, Benazzo M. The usefulness of the O-MAR algorithm in MRI skull base assessment to manage cochlear implant-related artifacts. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:273-282. [PMID: 37488991 PMCID: PMC10366562 DOI: 10.14639/0392-100x-n2434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/02/2023] [Indexed: 07/26/2023]
Abstract
Objective To assess artifact size and MRI visibility when applying the "Orthopedic-Metal Artifact Reduction" (O-MAR) algorithm for cochlear implant (CI) scanning. Methods Two volunteers were submitted to 1.5 T MRI with an Ultra 3D CI receiver stimulator placed on their head. Four angular CI orientations were adopted: 90, 120, 135 and 160 degrees. Volunteers were scanned in each condition using T1w and T2w TSE sequences, as well as O-MAR sequences, in both axial and coronal planes. Quantitative comparisons were made of signal void and penumbra extent. Additionally, qualitative evaluations of global image quality, MRI readability with respect to 12 anatomical structures and visibility through the penumbra were undertaken. Results After application of the O-MAR protocol, the radius of the signal void reduced from 50.76 mm to 45.43 mm and from 49.22 mm to 40.15 mm on T1w and T2w TSE axial sequences, respectively (p < 0.05). Qualitatively, sequences acquired with O-MAR produced better outcomes in terms of image quality and anatomical depiction. Despite the area of the penumbra being increased for the O-MAR protocol, visibility through penumbra was improved. Conclusions Application of O-MAR may provide a complementary strategy to those already in use to obtain diagnostically useful MRI examinations in the presence of a CI, especially in case of skull base diseases requiring MRI monitoring.
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Affiliation(s)
- Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Carlotto
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Simoncelli
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elvis Lafe
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Scribante
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Domenico Minervini
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Nardo
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Malpede
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luisa Chiapparini
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Pfeiffer CJ, Gehl HB, Scholtz LU, Goon P, Sudhoff H, Todt I. Endolymphatic Hydrops Magnet Resonance Imaging in Ménière's Disease Patients after Cochlea Implantation. Brain Sci 2023; 13:853. [PMID: 37371333 DOI: 10.3390/brainsci13060853] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/13/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Cochlear implantation in patients with Ménière's disease (MD) is the treatment of choice in cases of functional deafness. Additional vertigo control is of central importance in this group of patients. Endolymphatic hydrops (ELH) is the pathophysiological correlate of MD and can be evaluated by magnet resonance imaging (MRI). Bilateral MD occurs in 10-33% and can be the reason for a postoperative persisting or newly occurring vertigo in this group. Recent developments in the field of implant magnets and experience in MRI sequences allow the diagnostic performance of MRI in cochlear implantees to be evaluated. The aim of the present study was to evaluate the possibility of MRI as a visual diagnostic tool for endolymphatic hydrops in cochlear implantees. MATERIAL AND METHODS This was a retrospective study including three cochlear implantees (age: 61-76 years, one female, two male) suffering from MD who, postoperatively, had a recurrence of vertigo with Ménière's-like symptoms. An MRI was performed for the evaluation of ELH (ELH-MRI). MRI observation was performed by a 4 h iv. delayed Gad 3 D Flair sequence. RESULTS In all cases, the ipsilateral implant magnet artifact covered the vestibulum, the semicircular canals and the cochlea. The contralateral vestibulum, the semicircular canal and the cochlea were fully observable, and a classification of the ELH-MRI could be performed. CONCLUSION ELH-MRI scanning allows for the detection of contralateral labyrinthine endolymphatic hydrops and is a tool for the postoperative evaluation of vertigo in cochlear implantees.
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Affiliation(s)
- Christoph J Pfeiffer
- Department of Otolaryngology, Head and Neck Surgery, Medical School OWL, Bielefeld University, Klinikum Bielefeld Mitte, Teutoburger Str. 50, 33604 Bielefeld, Germany
| | - Hans-Björn Gehl
- Department of Radiology, Medical School OWL, Bielefeld University, Klinikum Bielefeld Mitte, Teutoburger Str. 50, 33604 Bielefeld, Germany
| | - Lars-Uwe Scholtz
- Department of Otolaryngology, Head and Neck Surgery, Medical School OWL, Bielefeld University, Klinikum Bielefeld Mitte, Teutoburger Str. 50, 33604 Bielefeld, Germany
| | - Peter Goon
- Department of Medicine and Otolaryngology, National University of Singapore and National University Health System, Singapore 117549, Singapore
| | - Holger Sudhoff
- Department of Otolaryngology, Head and Neck Surgery, Medical School OWL, Bielefeld University, Klinikum Bielefeld Mitte, Teutoburger Str. 50, 33604 Bielefeld, Germany
| | - Ingo Todt
- Department of Otolaryngology, Head and Neck Surgery, Medical School OWL, Bielefeld University, Klinikum Bielefeld Mitte, Teutoburger Str. 50, 33604 Bielefeld, Germany
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SEMAC + VAT for Suppression of Artifacts Induced by Dental-Implant-Supported Restorations in Magnetic Resonance Imaging. J Clin Med 2023; 12:jcm12031117. [PMID: 36769765 PMCID: PMC9917855 DOI: 10.3390/jcm12031117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
The purpose of this study was to assess the feasibility of SEMAC + VAT to reduce artifacts induced by dental implant-supported restorations, such as its impact on the image quality. Dental-implant supported restorations were installed in a dry mandible. Magnetic resonance scans were acquired on a 3-Tesla MRI system. Artifact suppression (SEMAC + VAT) was applied with different intensity modes (weak, moderate, strong). Artifacts assessment was performed by measuring the mandible volume increase in MRI images prior (reference dataset) and after installation of dental implant-supported prosthesis. Image quality was assessed by two examiners using a five-point scale. Inter-examiner concordance and correlation analysis was performed with Cronbach's alpha and Spearman's test with a significance level at p = 0.05. Mandible volume increased by 60.23% when no artifact suppression method was used. By applying SEMAC + VAT, the volume increase ranged from 17.13% (strong mode) to 32.77% (weak mode). Visualization of mandibular bone was positively correlated with SEMAC intensity degree. SEMAC + VAT reduced MRI artifacts caused by dental-implant supported restorations. A stronger suppression mode improved visualization of mandibular bone in detriment of the scanning time.
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Complications of cochlear implants with MRI scans in different body regions: type, frequency and impact. Insights Imaging 2023; 14:9. [PMID: 36645551 PMCID: PMC9842833 DOI: 10.1186/s13244-022-01353-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/11/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The aim was to assess the type, frequency and impact of MRI-related complications in patients with cochlear implants (CI) and MRI indications in different body regions. METHODS For that purpose, the institutional radiology database of a single tertiary hospital was searched for patients with a CI who underwent MRI between 2001 and 2018. The number of MRI examinations and complications were retrieved from the patient record. Examinations were categorized into five distinct body regions or combinations thereof. Records of CI artifacts in the head also included basic information on diagnostic image quality. RESULTS Out of 1017 MRI database entries (examinations) of patients with a CI, 91 records were after implantation (71 patients) and 66 were attempted (no contraindications, 49 patients). In four cases (4/66, 6.1%), the magnet was dislocated and had to be replaced surgically. Three out of four severe complications occurred for examination regions outside the head. Thirteen MRI examinations were aborted due to pain (19.7%) and one because of artifacts-resulting in 48 scans (72.7%) completed successfully (36 patients). All cranial scans featured device artifacts in all sequences, but the majority of them did not affect proper imaging diagnostics in the respective region. CONCLUSION This retrospective, single-center analysis of patients with MRI-conditional cochlear implants shows that MRI-related complications were common, at least in models with a fixed magnet, despite appropriate precautions and compliance with the manufacturers' guidelines. MRI examinations of CI patients should therefore be indicated strictly until the exact causes have been clarified.
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D'Arco F, Mertiri L, de Graaf P, De Foer B, Popovič KS, Argyropoulou MI, Mankad K, Brisse HJ, Juliano A, Severino M, Van Cauter S, Ho ML, Robson CD, Siddiqui A, Connor S, Bisdas S. Guidelines for magnetic resonance imaging in pediatric head and neck pathologies: a multicentre international consensus paper. Neuroradiology 2022; 64:1081-1100. [PMID: 35460348 DOI: 10.1007/s00234-022-02950-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/05/2022] [Indexed: 12/19/2022]
Abstract
The use of standardized imaging protocols is paramount in order to facilitate comparable, reproducible images and, consequently, to optimize patient care. Standardized MR protocols are lacking when studying head and neck pathologies in the pediatric population. We propose an international, multicenter consensus paper focused on providing the best combination of acquisition time/technical requirements and image quality. Distinct protocols for different regions of the head and neck and, in some cases, for specific pathologies or clinical indications are recommended. This white paper is endorsed by several international scientific societies and it is the result of discussion, in consensus, among experts in pediatric head and neck imaging.
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Affiliation(s)
- Felice D'Arco
- Radiology Department, Great Ormond Street Hospital for Children, London, UK.,Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Livja Mertiri
- Radiology Department, Great Ormond Street Hospital for Children, London, UK. .,Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy.
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bert De Foer
- Radiology Department, GZA Hospitals, Antwerp, Belgium
| | - Katarina S Popovič
- Neuroradiology Department, Clinical Institute of Radiology, University Medical Center Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia
| | - Maria I Argyropoulou
- Department of Clinical Radiology and Imaging, Medical School, University of Ioannina, Ioannina, Greece
| | - Kshitij Mankad
- Radiology Department, Great Ormond Street Hospital for Children, London, UK
| | - Hervé J Brisse
- Imaging Department, Institut Curie, Paris, France.,Institut Curie, Paris Sciences Et Lettres (PSL) Research University, Paris, France
| | - Amy Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | | | - Sofie Van Cauter
- Department of Medical Imaging, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Mai-Lan Ho
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ata Siddiqui
- Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Steve Connor
- Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK.,School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College, London, UK
| | - Sotirios Bisdas
- Lysholm Department of Neuroradiology, The National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
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