A Green's function approach to local rf heating in interventional MRI

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.

Feasibility of Temperature Control by Electrical Impedance Tomography in Hyperthermia

We present a simulation study investigating the feasibility of electrical impedance tomography (EIT) as a low cost, noninvasive technique for hyperthermia (HT) treatment monitoring and adaptation. Temperature rise in tissues leads to perfusion and tissue conductivity changes that can be reconstructed in 3D by EIT to noninvasively map temperature and perfusion. In this study, we developed reconstruction methods and investigated the achievable accuracy of EIT by simulating HT treatmentlike scenarios, using detailed anatomical models with heterogeneous conductivity distributions. The impact of the size and location of the heated region, the voltage measurement signal-to-noise ratio, and the reference model personalization and accuracy were studied. Results showed that by introducing an iterative reconstruction approach, combined with adaptive prior regions and tissue-dependent penalties, planning-based reference models, measurement-based reweighting, and physics-based constraints, it is possible to map conductivity-changes throughout the heated domain, with an accuracy of around 5% and cm-scale spatial resolution. An initial exploration of the use of multifrequency EIT to separate temperature and perfusion effects yielded promising results, indicating that temperature reconstruction accuracy can be in the order of 1 ∘C. Our results suggest that EIT can provide valuable real-time HT monitoring capabilities. Experimental confirmation in real-world conditions is the next step.

Analysis of the effect of external heating in the human tissue: A finite element approach

Thermal therapy which involves either raising or lowering tissue temperature to treat malignant cells needs precise acknowledgment of thermal history inside the biological system to ensure effective treatment. For this purpose, this study presents a two-dimensional unsteady finite element model (FEM) of the bioheat transfer problem based on Pennes bio-heat equation to analyze the thermal response of tissue subject to external heating. Crank-Nikolson scheme was used for the unsteady solution. A finite element code was developed using C language to calculate results. The obtained numerical result was compared with the analytical and other numerical results available in the literature. A good agreement was found from the comparison. Temperature distribution inside the human body due to constant and sinusoidal spatial and surface heating were analyzed. Response to point heating was also investigated. Moreover, a sensitivity analysis was carried out to know the effect of various parameters, i.e. blood temperature, thermal conductivity, and blood perfusion rate on tissue temperature. The outcome of this study will be helpful for the researchers and physicians involved in the thermal treatment of human tissue.

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.

Discussion on Spatial and Time Averaging Restrictions Within the Electromagnetic Exposure Safety Framework in the Frequency Range Above 6 GHz for Pulsed and Localized Exposures

Both the current and newly proposed safety guidelines for local human exposure to millimeter-wave frequencies aim at restricting the maximum local temperature increase in the skin to prevent tissue damage. In this study, we show that the application of the current and proposed limits for pulsed fields can lead to a temperature increase of 10°C for short pulses and frequencies between 6 and 30 GHz. We also show that the proposed averaging area of 4 cm² , that is greatly reduced compared with the current limits, does not prevent high-temperature increases in the case of narrow beams. A realistic Gaussian beam profile with a 1 mm radius can result in a temperature increase about 10 times higher than the 0.4°C increase the same averaged power density would produce for a plane wave. In the case of pulsed narrow beams, the values for the time and spatial-averaged power density allowed by the proposed new guidelines could result in extreme temperature increases. Bioelectromagnetics. 2020;41:164-168. © 2019 Bioelectromagnetics Society.

Anatomical Model Uncertainty for RF Safety Evaluation of Metallic Implants Under MRI Exposure

The Virtual Population (ViP) phantoms have been used in many dosimetry studies, yet, to date, anatomical phantom uncertainty in radiofrequency (RF) research has largely been neglected. The objective of this study is to gain insight, for the first time, regarding the uncertainty in RF-induced fields during magnetic resonance imaging associated with tissue assignment and segmentation quality and consistency in anatomical phantoms by evaluating the differences between two generations of ViP phantoms, ViP1.x and ViP3.0. The RF-induced 10g-average electric (E-) fields, tangential E-fields distribution along active implantable medical devices (AIMD) routings, and estimated AIMD heating were compared for five phantoms that are part of both ViP1.x and ViP3.0. The results demonstrated that differences exceeded 3 dB (-29%, +41%) for local quantities and 1 dB (±12% for field, ±25% for power) for integrated and volume-averaged quantities (e.g., estimated AIMD-heating and 10 g-average E-fields), while the variation across different ViP phantoms of the same generation can exceed 10 dB (-68% and +217% for field, -90% and +900% for power). In conclusion, the anatomical phantom uncertainty associated with tissue assignment and segmentation quality/consistency is larger than previously assumed, i.e., 0.6 dB or ±15% (k = 1) for AIMD heating. Further, multiple phantoms based on different volunteers covering the target population are required for quantitative analysis of dosimetric endpoints, e.g., AIMD heating, which depend on patient anatomy. Phantoms with the highest fidelity in tissue assignment and segmentation should be used, as these ensure the lowest uncertainty and possible underestimation of exposure. To verify that the uncertainty decreases monotonically with improved phantom quality, the evaluation of differences between phantom generations should be repeated for any improvement in segmentation. Bioelectromagnetics. 2019;40:458-471. © 2019 Bioelectromagnetics Society.

Systematic Derivation of Safety Limits for Time-Varying 5G Radiofrequency Exposure Based on Analytical Models and Thermal Dose

Extreme broadband wireless devices operating above 10 GHz may transmit data in bursts of a few milliseconds to seconds. Even though the time- and area-averaged power density values remain within the acceptable safety limits for continuous exposure, these bursts may lead to short temperature spikes in the skin of exposed people. In this paper, a novel analytical approach to pulsed heating is developed and applied to assess the peak-to-average temperature ratio as a function of the pulse fraction α (relative to the averaging time [INCREMENT]T; it corresponds to the inverse of the peak-to-average ratio). This has been analyzed for two different perfusion-related thermal time constants (τ1 = 100 s and 500 s) corresponding to plane-wave and localized exposures. To allow for peak temperatures that considerably exceed the 1 K increase, the CEM43 tissue damage model, with an experimental-data-based damage threshold for human skin of 600 min, is used to allow large temperature oscillations that remain below the level at which tissue damage occurs. To stay consistent with the current safety guidelines, safety factors of 10 for occupational exposure and 50 for the general public were applied. The model assumptions and limitations (e.g., employed thermal and tissue damage models, homogeneous skin, consideration of localized exposure by a modified time constant) are discussed in detail. The results demonstrate that the maximum averaging time, based on the assumption of a thermal time constant of 100 s, is 240 s if the maximum local temperature increase for continuous-wave exposure is limited to 1 K and α ≥ 0.1. For a very low peak-to-average ratio of 100 (α ≥ 0.01), it decreases to only 30 s. The results also show that the peak-to-average ratio of 1,000 tolerated by the International Council on Non-Ionizing Radiation Protection guidelines may lead to permanent tissue damage after even short exposures, highlighting the importance of revisiting existing exposure guidelines.

Modeling Tissue Heating From Exposure to Radiofrequency Energy and Relevance of Tissue Heating to Exposure Limits: Heating Factor

This review/commentary addresses recent thermal and electromagnetic modeling studies that use image-based anthropomorphic human models to establish the local absorption of radiofrequency energy and the resulting increase in temperature in the body. The frequency range of present interest is from 100 MHz through the transition frequency (where the basic restrictions in exposure guidelines change from specific absorption rate to incident power density, which occurs at 3-10 GHz depending on the guideline). Several detailed thermal modeling studies are reviewed to compare a recently introduced dosimetric quantity, the heating factor, across different exposure conditions as related to the peak temperature rise in tissue that would be permitted by limits for local body exposure. The present review suggests that the heating factor is a robust quantity that is useful for normalizing exposures across different simulation models. Limitations include lack of information about the location in the body where peak absorption and peak temperature increases occur in each exposure scenario, which are needed for careful assessment of potential hazards. To the limited extent that comparisons are possible, the thermal model (which is based on Pennes' bioheat equation) agrees reasonably well with experimental data, notwithstanding the lack of theoretical rigor of the model and uncertainties in the model parameters. In particular, the blood flow parameter is both variable with physiological condition and largely determines the steady state temperature rise. We suggest an approach to define exposure limits above and below the transition frequency (the frequency at which the basic restriction changes from specific absorption rate to incident power density) to provide consistent levels of protection against thermal hazards. More research is needed to better validate the model and to improve thermal dosimetry in general. While modeling studies have considered the effects of variation in thickness of tissue layers, the effects of normal physiological variation in tissue blood flow have been relatively unexplored.

Realistic modeling of deep brain stimulation implants for electromagnetic MRI safety studies

We propose a framework for electromagnetic (EM) simulation of deep brain stimulation (DBS) patients in radiofrequency (RF) coils. We generated a model of a DBS patient using post-operative head and neck computed tomography (CT) images stitched together into a 'virtual CT' image covering the entire length of the implant. The body was modeled as homogeneous. The implant path extracted from the CT data contained self-intersections, which we corrected automatically using an optimization procedure. Using the CT-derived DBS path, we built a model of the implant including electrodes, helicoidal internal conductor wires, loops, extension cables, and the implanted pulse generator. We also built four simplified models with straight wires, no extension cables and no loops to assess the impact of these simplifications on safety predictions. We simulated EM fields induced by the RF birdcage body coil in the body model, including at the DBS lead tip at both 1.5 Tesla (64 MHz) and 3 Tesla (123 MHz). We also assessed the robustness of our simulation results by systematically varying the EM properties of the body model and the position and length of the DBS implant (sensitivity analysis). The topology correction algorithm corrected all self-intersection and curvature violations of the initial path while introducing minimal deformations (open-source code available at http://ptx.martinos.org/index.php/Main_Page). The unaveraged lead-tip peak SAR predicted by the five DBS models (0.1 mm resolution grid) ranged from 12.8 kW kg-1 (full model, helicoidal conductors) to 43.6 kW kg-1 (no loops, straight conductors) at 1.5 T (3.4-fold variation) and 18.6 kW kg-1 (full model, straight conductors) to 73.8 kW kg-1 (no loops, straight conductors) at 3 T (4.0-fold variation). At 1.5 T and 3 T, the variability of lead-tip peak SAR with respect to the conductivity ranged between 18% and 30%. Variability with respect to the position and length of the DBS implant ranged between 9.5% and 27.6%.

Toward in vivo quantification of induced RF currents on long thin conductors

PURPOSE

Most MR-guided catheter-based procedures, and imaging of patients with implanted medical devices, are currently contraindicated due to a significant risk of heating associated with induced RF currents. The induced RF current produces a corresponding artifact which can be used to remotely characterize current and safely predict RF heating. Application of this remote technique in vivo to safely quantify RF heating risk may allow for execution of many scans currently contraindicated. Sources of phase other than induced RF current may present difficulty in practical in vivo.

METHODS

A custom ultra-short echo time (UTE) sequence was developed to minimize unwanted phase contributions. A phantom experiment was performed to compare current characterization using a stock gradient-echo (GRE) sequence and the custom UTE sequence following calibration of the temperature measurement apparatus using a previously published heating prediction technique. Animal experiments were used to investigate the feasibility of using the UTE sequence to quantify RF heating.

RESULTS

Current characterization and heating prediction with a stock GRE sequence was equivalent to that with the custom UTE sequence. Heating measurements and image-based predictions in animal experiments agreed within error in all experiments.

CONCLUSION

Through comparison of measured heating and image-based prediction, feasibility of using a custom UTE sequence to quantify RF heating risk in vivo was demonstrated.

Thermal Response of Human Skin to Microwave Energy: A Critical Review

This is a review/modeling study of heating of tissue by microwave energy in the frequency range from 3 GHz through the millimeter frequency range (30-300 GHz). The literature was reviewed to identify studies that reported RF-induced increases in skin temperature. A simple thermal model, based on a simplified form of Pennes' bioheat equation (BHTE), was developed, using parameter values taken from the literature with no further adjustment. The predictions of the model were in excellent agreement with available data. A parametric analysis of the model shows that there are two heating regimes with different dominant mechanisms of heat transfer. For small irradiated areas (less than about 0.5-1 cm in radius) the temperature increase at the skin surface is chiefly limited by conduction of heat into deeper tissue layers, while for larger irradiated areas, the steady-state temperature increase is limited by convective cooling by blood perfusion. The results support the use of this simple thermal model to aid in the development and evaluation of RF safety limits at frequencies above 3 GHz and for millimeter waves, particularly when the irradiated area of skin is small. However, very limited thermal response data are available, particularly for exposures lasting more than a few minutes to areas of skin larger than 1-2 cm in diameter. The paper concludes with comments about possible uses and limitations of thermal modeling for setting exposure limits in the considered frequency range.

Modeling of electrodes and implantable pulse generator cases for the analysis of implant tip heating under MR imaging

PURPOSE

The authors' purpose is to model the case of an implantable pulse generator (IPG) and the electrode of an active implantable medical device using lumped circuit elements in order to analyze their effect on radio frequency induced tissue heating problem during a magnetic resonance imaging (MRI) examination.

METHODS

In this study, IPG case and electrode are modeled with a voltage source and impedance. Values of these parameters are found using the modified transmission line method (MoTLiM) and the method of moments (MoM) simulations. Once the parameter values of an electrode/IPG case model are determined, they can be connected to any lead, and tip heating can be analyzed. To validate these models, both MoM simulations and MR experiments were used. The induced currents on the leads with the IPG case or electrode connections were solved using the proposed models and the MoTLiM. These results were compared with the MoM simulations. In addition, an electrode was connected to a lead via an inductor. The dissipated power on the electrode was calculated using the MoTLiM by changing the inductance and the results were compared with the specific absorption rate results that were obtained using MoM. Then, MRI experiments were conducted to test the IPG case and the electrode models. To test the IPG case, a bare lead was connected to the case and placed inside a uniform phantom. During a MRI scan, the temperature rise at the lead was measured by changing the lead length. The power at the lead tip for the same scenario was also calculated using the IPG case model and MoTLiM. Then, an electrode was connected to a lead via an inductor and placed inside a uniform phantom. During a MRI scan, the temperature rise at the electrode was measured by changing the inductance and compared with the dissipated power on the electrode resistance.

RESULTS

The induced currents on leads with the IPG case or electrode connection were solved for using the combination of the MoTLiM and the proposed lumped circuit models. These results were compared with those from the MoM simulations. The mean square error was less than 9%. During the MRI experiments, when the IPG case was introduced, the resonance lengths were calculated to have an error less than 13%. Also the change in tip temperature rise at resonance lengths was predicted with less than 4% error. For the electrode experiments, the value of the matching impedance was predicted with an error less than 1%.

CONCLUSIONS

Electrical models for the IPG case and electrode are suggested, and the method is proposed to determine the parameter values. The concept of matching of the electrode to the lead is clarified using the defined electrode impedance and the lead Thevenin impedance. The effect of the IPG case and electrode on tip heating can be predicted using the proposed theory. With these models, understanding the tissue heating due to the implants becomes easier. Also, these models are beneficial for implant safety testers and designers. Using these models, worst case conditions can be determined and the corresponding implant test experiments can be planned.

Parallel transmit pulse design for patients with deep brain stimulation implants

PURPOSE

Specific absorption rate (SAR) amplification around active implantable medical devices during diagnostic MRI procedures poses a potential risk for patient safety. In this study, we present a parallel transmit (pTx) strategy that can be used to safely scan patients with deep brain stimulation (DBS) implants.

METHODS

We performed electromagnetic simulations at 3T using a uniform phantom and a multitissue realistic head model with a generic DBS implant. Our strategy is based on using implant-friendly modes, which are defined as the modes of an array that reduce the local SAR around the DBS lead tip. These modes are used in a spokes pulse design algorithm in order to produce highly uniform magnitude least-squares flip angle excitations.

RESULTS

Local SAR (1 g) at the lead tip is reduced below 0.1 W/kg compared with 31.2 W/kg, which is obtained by a simple quadrature birdcage excitation without any sort of SAR mitigation. For the multitissue realistic head model, peak 10 g local SAR and global SAR are obtained as 4.52 W/kg and 0.48 W/kg, respectively. A uniform axial flip angle is also obtained (NRMSE <3%).

CONCLUSION

Parallel transmit arrays can be used to generate implant-friendly modes and to reduce SAR around DBS implants while constraining peak local SAR and global SAR and maximizing flip angle homogeneity.

Using a low-amplitude RF pulse at echo time (LARFET) for device localization in MRI

We describe a new method for frequency down-conversion of MR signals acquired with the radio-frequency projections method for device localization. A low-amplitude, off-center RF pulse applied simultaneously with the echo signal is utilized as the reference for frequency down-conversion. Because of the low-amplitude and large offset from the Larmor frequency, the RF pulse minimally interfered with magnetic resonance of protons. We conducted an experiment with the coil placed at different positions to verify this concept. The down-converted signal was transformed into optical signal and transmitted via fiber-optic cable to a receiver unit placed outside the scanner room. The position of the coil could then be determined by the frequency analysis of this down-converted signal and superimposed on previously acquired MR images for comparison. Because of minimal positional errors (≤ 0.8 mm), this new device localization method may be adequate for most interventional MRI applications.

Thermal safety of vibro-acoustography using a confocal transducer

Vibro-acoustography (VA) is an imaging method that forms a two-dimensional (2-D) image by moving two cofocused ultrasound beams with slightly different frequencies over the object in a C-scan format and recording acoustic emission from the focal region at the difference frequency. This article studies tissue heating due to a VA scan using a concentric confocal transducer. The three-dimensional (3-D) ultrasound intensity field calculated by Field II is used with the bio-heat equation to estimate tissue heating due to ultrasound absorption. Results calculated with thermal conduction and with blood perfusion, with conduction and without perfusion and without conduction and without perfusion are compared. Maximum heating due to ultrasound absorption occurs in the transducer's near-field and maximum temperature rise in soft tissue during a single VA scan is below 0.05 degrees C for all three attenuation coefficients evaluated: 0.3, 0.5 and 0.7 dB/cm/MHz. Transducer self-heating during a single VA scan measured by a thermocouple is less than 0.27 degrees C.

MR imaging during endovascular procedures: an evaluation of the potential for catheter heating

MRI in catheterized patients is considered unsafe due to the potential for focal heating. This concern arises from the continuous metallic braid that is incorporated into catheters to provide their desired physical properties. The potential for catheter heating during MR scanning was assessed in an in vitro model simulating a patient undergoing a neurovascular procedure in which MR scans of the brain will be performed. Heating adjacent to endovascular devices was assessed with fluoroptic temperature probes in a polyacrylamide gel. The effect of variable immersion lengths, lateral and longitudinal offsets, position along the endovascular device, physical MR system, and specific absorption rate (SAR) level were studied to determine their effect on catheter heating. A rapid temperature rise was evident next to endovascular devices during MR scanning and varied moderately with immersed length, position within the bore, measurement point on the device, and MR system used. Peak heating rates were less than 1 degree C/min with maximal SAR exposure and anatomically realistic geometries. Heating scaled linearly with SAR and SAR values below 0.2 W/kg produced negligible heating near catheters. For the evaluated application, substantial SAR restrictions, coupled with limited imaging durations, are proposed as sufficient to permit MRI without concern for thermal injury.

The performance of interventional loopless MRI antennae at higher magnetic field strengths

Interventional, "loopless antenna" MRI detectors are currently limited to 1.5 T. This study investigates whether loopless antennae offer signal-to-noise ratio (SNR) and field-of-view (FOV) advantages at higher fields, and whether device heating can be controlled within safe limits. The absolute SNR performance of loopless antennae from 0.5 to 5 T is investigated both analytically, using electromagnetic (EM) dipole antenna theory, and numerically with the EM method of moments, and found to vary almost quadratically with field strength depending on the medium's electrical properties, the noise being dominated by direct sample conduction losses. The prediction is confirmed by measurements of the absolute SNR of low-loss loopless antennae fabricated for 1.5, 3, and 4.7 T, immersed in physiologically comparable saline. Gains of 3.8 +/- 0.2- and 9.7 +/- 0.3-fold in SNR, and approximately 10- and 50-fold gains in the useful FOV area are observed at 3 and 4.7 T, respectively, compared to 1.5 T. Heat testing of a 3 T biocompatible nitinol-antenna fabricated with a redesigned decoupling circuit shows maximum heating of approximately 1 degrees C for MRI operating at high MRI exposure levels. Experiments in the rabbit aorta confirm the SNR and FOV advantages of the 3 T antenna versus an equivalent commercial 1.5 T device in vivo. This work is the first to study the performance of experimental internal MRI detectors above 1.5 T. The large SNR and FOV gains realized present a major opportunity for high-resolution imaging of vascular pathology and MRI-guided intervention.

Safety evaluation of large external fixation clamps and frames in a magnetic resonance environment

Large orthopedic external fixation clamps and related components were evaluated for force, torque, and heating response when subjected to the strong electromagnetic fields of magnetic-resonance (MR) imaging devices. Forces induced by a 3-Tesla (T) MR scanner were compiled for newly designed nonmagnetic clamps and older clamps that contained ferromagnetic components. Heating trials were performed in a 1.5 and in a 3 T MR scanner with two assembled external fixation frames. Forces of the newly designed clamps were more than a factor 2 lower as the gravitational force on the device whereas, magnetic forces on the older devices showed over 10 times the force induced by earth acceleration of gravity. No torque effects could be found for the newly designed clamps. Temperature measurements at the tips of Schanz screws in the 1.5 T MR scanner showed a rise of 0.7 degrees C for a pelvic frame and of 2.1 degrees C for a diamond knee bridge frame when normalized to a specific absorption rate (SAR) of 2 W/kg. The normalized temperature increases in the 3 T MR scanner were 0.9 degrees C for the pelvic frame and 1.1 degrees C for the knee bridge frame. Large external fixation frames assembled with the newly designed clamps (390 Series Clamps), carbon fiber reinforced rods, and implant quality 316L stainless steel Schanz screws met prevailing force and torque limits when tested in a 3-T field, and demonstrated temperature increase that met IEC-60601 guidelines for extremities. The influence of frame-induced eddy currents on the risk of peripheral nerve stimulation was not investigated.

Thermal mechanisms of interaction of radiofrequency energy with biological systems with relevance to exposure guidelines

This article reviews thermal mechanisms of interaction between radiofrequency (RF) fields and biological systems, focusing on theoretical frameworks that are of potential use in setting guidelines for human exposure to RF energy. Several classes of thermal mechanisms are reviewed that depend on the temperature increase or rate of temperature increase and the relevant dosimetric considerations associated with these mechanisms. In addition, attention is drawn to possible molecular and physiological reactions that could be induced by temperature elevations below 0.1 degrees, which are normal physiological responses to heat, and to the so-called microwave auditory effect, which is a physiologically trivial effect resulting from thermally-induced acoustic stimuli. It is suggested that some reported "nonthermal" effects of RF energy may be thermal in nature; also that subtle thermal effects from RF energy exist but have no consequence to health or safety. It is proposed that future revisions of exposure guidelines make more explicit use of thermal models and empirical data on thermal effects in quantifying potential hazards of RF fields.

Coupled field analysis of heat flow in the near field of a microwave applicator for tumor ablation

Microwave tumor ablation (MTA) offers a new approach for the treatment of hepatic neoplastic disease. Reliable and accurate information regarding the heat distribution inside biological tissue subjected to microwave thermal ablation is important for the efficient design of microwave applicators and for optimizing experiments, which aim to assess the effects of therapeutic treatments. Currently there are a variety of computational methods based on different vascular structures in tissue, which aim to model heat distribution during ablation. This paper presents results obtained from two such computational models for temperature distributions produced by a clinical 2.45 GHz MTA applicator immersed in unperfused ex vivo bovine liver, and compares them with measured results from a corresponding ex vivo experiment. The computational methods used to model the temperature distribution in tissue caused by the insertion of a 5.6 mm diameter "wandlike" microwave applicator are the Green's function method and the finite element method (FEM), both of which provide solutions of the heat diffusion partial differential equation. The results obtained from the coupled field simulations are shown to be in good agreement with a simplified analysis based on the bio-heat equation and with ex vivo measurements of the heat distribution produced by the clinical MTA applicator.

In vivo heating of pacemaker leads during magnetic resonance imaging

AIMS

Magnetic resonance imaging (MRI) is well established as an important diagnostic tool in medicine. However, the presence of a cardiac pacemaker is usually regarded as a contraindication for MRI due to safety reasons. In this study, heating effects at the myocardium-pacemaker lead tip interface have been investigated in a chronic animal model during MRI at 1.5 Tesla.

METHODS AND RESULTS

Pacemaker leads with additional thermocouple wires as temperature sensors were implanted in nine animals. Temperature increases of up to 20 degrees C were measured during MRI of the heart. Significant impedance and minor stimulation threshold changes could be seen. However, pathology and histology could not clearly demonstrate heat-induced damage.

CONCLUSIONS

MRI may produce considerable heating at the lead tip. Changes of pacing parameters due to MRI could be seen in chronic experiments. Potential risk of tissue damage cannot be excluded even though no reproducible alterations at the histological level could be found.

RF-induced temperature elevation along metallic wires in clinical magnetic resonance imaging: Influence of diameter and length

With the development of interventional MRI, heating of biological tissues along the metallic wires in the MRI scanner has become an important issue. To assess thermal response to RF exposure during MRI, we studied the temperature elevation near nonmagnetic metallic wires. All tests were performed on a 1.5 T clinical scanner. Four experiments were conducted to investigate the effects of the wire diameter, the excitation flip angle, the temperature distribution along the wire, and the wire length. Electromagnetic simulations of the experimental setup were made with the use of commercial method of moments (MoM) software and numerical simulations of Hallen's equations. Comparisons between measured and calculated values of the electric field are presented. This study demonstrates that 1) temperature decreases with the diameter of the wire,2) temperature increases quadratically with the excitation flip angle, 3) heating occurs not only at the tip but also along the wire, and 4) the heating peaks are not obtained for the classical resonant length multiple of lambda/4 (where lambda is the RF field wavelength). In addition, significant and rapid heating increases were observed in the close vicinity of the wire.

Interventional and intraoperative MR: review and update of techniques and clinical experience

The concept of interventional magnetic resonance imaging (MRI) is based on the integration of diagnostic and therapeutic procedures, favored by the combination of the excellent morphological and functional imaging characteristics of MRI. The spectrum of MRI-assisted interventions ranges from biopsies and intraoperative guidance to thermal ablation modalities and vascular interventions. The most relevant recently published experimental and clinical results are discussed. In the future, interventional MRI is expected to play an important role in interventional radiology, minimal invasive therapy and guidance of surgical procedures. However, the associated high costs require a careful evaluation of its potentials in order to ensure cost-effective medical care.

Numerical evaluation of heating of the human head due to magnetic resonance imaging

In this paper, we present a numerical model for evaluating tissue heating during magnetic resonance imaging (MRI). Our method, which included a detailed anatomical model of a human head, calculated both the electromagnetic power deposition and the associated temperature elevations during an MRI head examination. Numerical studies were conducted using a realistic birdcage coil excited at frequencies ranging from 63 to 500 MHz. The model was validated both experimentally and analytically. The experimental validation was performed at the MR test facility located at the Food and Drug Administration's Center for Devices and Radiological Health.

Thermal modeling of lesion growth with radiofrequency ablation devices

BACKGROUND

Temperature is a frequently used parameter to describe the predicted size of lesions computed by computational models. In many cases, however, temperature correlates poorly with lesion size. Although many studies have been conducted to characterize the relationship between time-temperature exposure of tissue heating to cell damage, to date these relationships have not been employed in a finite element model.

METHODS

We present an axisymmetric two-dimensional finite element model that calculates cell damage in tissues and compare lesion sizes using common tissue damage and iso-temperature contour definitions. The model accounts for both temperature-dependent changes in the electrical conductivity of tissue as well as tissue damage-dependent changes in local tissue perfusion. The data is validated using excised porcine liver tissues.

RESULTS

The data demonstrate the size of thermal lesions is grossly overestimated when calculated using traditional temperature isocontours of 42 degrees C and 47 degrees C. The computational model results predicted lesion dimensions that were within 5% of the experimental measurements.

CONCLUSION

When modeling radiofrequency ablation problems, temperature isotherms may not be representative of actual tissue damage patterns.

Endovascular interventional magnetic resonance imaging

Minimally invasive interventional radiological procedures, such as balloon angioplasty, stent placement or coiling of aneurysms, play an increasingly important role in the treatment of patients suffering from vascular disease. The non-destructive nature of magnetic resonance imaging (MRI), its ability to combine the acquisition of high quality anatomical images and functional information, such as blood flow velocities, perfusion and diffusion, together with its inherent three dimensionality and tomographic imaging capacities, have been advocated as advantages of using the MRI technique for guidance of endovascular radiological interventions. Within this light, endovascular interventional MRI has emerged as an interesting and promising new branch of interventional radiology. In this review article, the authors will give an overview of the most important issues related to this field. In this context, we will focus on the prerequisites for endovascular interventional MRI to come to maturity. In particular, the various approaches for device tracking that were proposed will be discussed and categorized. Furthermore, dedicated MRI systems, safety and compatibility issues and promising applications that could become clinical practice in the future will be discussed.

RF heating due to conductive wires during MRI depends on the phase distribution of the transmit field

In many studies concerning wire heating during MR imaging, a "resonant wire length" that maximizes RF heating is determined. This may lead to the nonintuitive conclusion that adding more wire, so as to avoid this resonant length, will actually improve heating safety. Through a theoretical analysis using the method of moments, we show that this behavior depends on the phase distribution of the RF transmit field. If the RF transmit field has linear phase, with slope equal to the real part of the wavenumber in the tissue, long wires always heat more than short wires. In order to characterize the intrinsic safety of a device without reference to a specific body coil design, this maximum-tip heating phase distribution must be considered. Finally, adjusting the phase distribution of the electric field generated by an RF transmit coil may lead to an "implant-friendly" coil design.

RF safety of wires in interventional MRI: using a safety index

With the rapid growth of interventional MRI, radiofrequency (RF) heating at the tips of guidewires, catheters, and other wire-shaped devices has become an important safety issue. Previous studies have identified some of the variables that affect the relative magnitude of this heating but none could predict the absolute amount of heating to formulate safety margins. This study presents the first theoretical model of wire tip heating that can accurately predict its absolute value, assuming a straight wire, a homogeneous RF coil, and a wire that does not extend out of the tissue. The local specific absorption rate (SAR) amplification from induced currents on insulated and bare wires was calculated using the method of moments. This SAR gain was combined with a semianalytic solution to the bioheat transfer equation to generate a safety index. The safety index ( degrees C/(W/kg)) is a measure of the in vivo temperature change that can occur with the wire in place, normalized to the SAR of the pulse sequence. This index can be used to set limits on the spatial peak SAR of pulse sequences that are used with the interventional wire. For the case of a straight resonant wire in a tissue with very low perfusion, only about 100 mW/kg/ degrees C spatial peak SAR may be used at 1.5 T. But for < or =10-cm wires with an insulation thickness > or =30% of the wire radius that are placed in well-perfused tissues, normal operating conditions of 4 W/kg spatial peak SAR are possible at 1.5 T. Further model development to include the influence of inhomogeneous RF, curved wires, and wires that extend out of the sample are required to generate safety indices that are applicable to common clinical situations. We propose a simple way to ensure safety when using an interventional wire: set a limit on the SAR of allowable pulse sequences that is a factor of a safety index below the tolerable temperature increase.

Estimation of heat transfer and temperature rise in partial-body regions during MR procedures: an analytical approach with respect to safety considerations

In order to assess thermal response to RF exposure during MR procedures at the tissue level, simple analytical solutions to the non-stationary Pennes' bio-heat equation were obtained using the Green's function approach. Two thermal models appropriate for partial-body exposure were analyzed: In the first model, the temperature field at the periphery of an idealized volume RF resonator was modeled. The analytical solution reveals that tissue response to RF heating is characterized by an equilibration time and length. Both parameters are inversely related to tissue perfusion and vary for the soft-tissues considered between 0.27-25 min and 1.5-12 mm, respectively. None of the tissues investigated increase in temperature more than 0.5 degrees C for each W/kg of power dissipated. Secondly, a homogeneous tissue solution was derived that predicts the temperature-time course to an MR examination with time-varying specific absorption rates (SAR). Since SAR limits indicated in current MR safety standards relate to running SAR averages computed over an appropriate period of time, an expression was formulated that gives an upper limit for the temperature rise averaged over the same period of time, as a function of both the upper limit of running SAR averages and the duration of the MR examination. The analysis revealed that the partial-body SAR limits indicated in the IEC standard may not guarantee under all circumstances compliance with the basic restrictions concerning temperature rise.