Anastasia Papadaki1,2, David Carmichael3, Andrew McEvoy4,5, Anna Miserocchi4,5, Tarek Yousry1,2, Beate Diehl4,6, Louis Lemieux4, and John S Thornton1,2
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH, London, United Kingdom, 2Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom, 3Imaging and Biophysics Unit, UCL Institute of Child Health, London, United Kingdom, 4Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom, 5Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom, 6Department of Neurophysiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
Synopsis
In this study we assessed temperature changes (∆T) during MRI
in the vicinity of microwires EEG electrodes in a phantom. Measurements were
performed at 1.5T during a high SAR TSE sequence for two different depth
electrode arrangements with and without microwires. Although we observed a
small temperature rise due to the presence of microwires the maximum temperature change ∆T did not
exceed 1°C at 1.5T. PURPOSE:
Intracranial-electroencephalography (icEEG) is a
specific invasive EEG recording technique with the aim of precisely identifying
focal epileptogenic networks in patients with drug-resistant epilepsy. In
recent years, there has been an increased interest in monitoring single unit
activity during epileptic seizure using microwire electrodes protruding at the
end of intracranial depth electrodes. Performing high-resolution MRI post
implantation could significantly improve the accuracy of anatomical electrode
localisation, with the risk however of radiofrequency (RF) induced heating in
the vicinity of the electrodes. Although a number of studies have used this
approach without report of adverse incidents
1-7, systematic safety
assessment has been limited. Our purpose was therefore to assess temperature
changes (∆T) in the vicinity of microwire electrodes (AdTech, Racine, USA) with
reference to our established safety protocol for standard icEGG
8 on
our 1.5T MR system.
METHODS:
A torso phantom was filled with a gel
of poly-acrylic acid partial sodium salt, as described previously5. Temperature recordings were made using a
fibre optic temperature thermometer (Neoptix, Canada). Temperature probes were
attached to the tips of 2 depth electrodes positioned either parallel or
perpendicular to B
0. Additional probes were positioned 5 mm
from the distal end of the depth electrodes. The tails of both electrodes were
arranged such that they were parallel to B
0 and isolated from each
other. Measurements were performed at
1.5T (Avanto, Siemens, Erlangen, Germany) using a transmit-receive head coil,
and temperature increase (∆T) was calculated during a 6 min Turbo Spin Echo
sequence (scanner-estimated head SAR: 3 W/Kg, B1
RMS 4.3µT).
Microwire electrodes were then removed and measurements were repeated at the
same probe locations.
RESULTS:
Maximum ∆T was measured for
the macro/micro electrode parallel to B
0 and representative results
are shown in figure 1: Maximum ∆T rose to +0.5°C at 5 mm from the distal end of
the depth electrode, in the area where microwires are, however ∆T
remained below our experimental thermometry precision (≤0.1 °C) when the bundle
of microwires was removed. ∆T rose to 0.4°C at the tip of the depth electrode
parallel to B
0.
DISCUSSION /CONCLUSION:
We observed a
small increase of temperature of the gel due to the presence of microwires.
This contrasts with a report by Hefft et
al.
5, who with their arrangement did not measure any temperature
increase on a 1.5T scanner using a body-transmit/ 12 channel receive head
coil during a number of sequences (maximum 3.9W/Kg scanner reported SAR).
Heating did not exceeded 1°C
in any of our measurements with our specific set up, supporting the view that
under controlled conditions MRI with these electrodes in situ may be safe. However caution may still be warranted, as due
to the microwire size (40 μm diameter) our measurements of gel heating over a
relatively large volume in the vicinity of a bundle of microwires may not fully
reflect local heating over smaller volumes at the tip of the microwire itself.
Acknowledgements
The authors
would like to thank Mr Adam Zeller (Severn
Healthcare Technologies) for his help in this study. References
1. Howard M et al J Neurosurgery 84 (1996), 2. Fried I et al J
Neurosurg 91 (1999), 3. Bhattacharya J et al Chapter in Fractals in Biol and
Med (2005), 4. Keller CJ et al Brain 133; (2010), 5. Hefft S et al Neurosurgery
Vol 75(1) (2013),6. Kondylis E et al Frontiers in Neurology Vol 5 (2014), 7. Misra
et al J Neual Eng 11 (2014), 8. Carmichael et al Neuroimage 49(1) (2010)