Johannes B. Erhardt1,2, Jessica A. Martinez2, Tyler E Cork2, Isabel Gessner3, Sanjay Mathur3, Thomas Stieglitz1, and Daniel B. Ennis2
1University of Freiburg, Freiburg, Germany, 2UCLA, Los Angeles, CA, United States, 3University of Cologne, Cologne, Germany
Synopsis
IcEEG
electrodes for epilepsy and research applications impair fMRI and MR images with
compromising susceptibility artifacts. Thin-film implants feature 100x less
metal thickness and thus minimal artifacts. However, thin-film implants are
inconspicuous in MRI. Therefore we present means of localization using super
paramagnetic iron oxide nano particles to make thin-film implants ready for
future applications. We present feasible concentrations and proof of concept.
Introduction
Intercranial EEG (icEEG) electrodes are implanted
for pre-surgical assessment of cortical electrical activity in patients with
epilepsy. MRI helps to localize the implant with respect to the individual’s anatomy
and fMRI can improve understanding of the neuropathology. However, the magnetic
susceptibility artifacts caused by the metal components of commercially
available implants produce MRI artifacts that compromise the results especially
in the direct vicinity of the implants. Next generation “thin-film” implants which
feature 100x less metal thickness can mitigate these artifacts, but thin-film
implants produce inconspicuous MRI signal voids in many clinical MRI sequences.
Imperatively, physicians need to know the implant position and the value of EEG
increases with the precision of electrode localization. Therefore, we
investigated various concentrations of super paramagnetic iron oxide (SPIO)
nanoparticles (NP) to label thin-film implants for localization in MRI using a
range of sequences. In particular, we aim to create a marker that conspicuously
renders the implant, enables spatial localization of the individual electrodes,
and keeps disruptive imaging artifacts small.Materials and Methods
Eight
samples of silicone rubber doped with various SPIO-NP concentration were
fabricated. SPIO-NPs were synthesized using oleic acid as surface active ligand
to obtain SPIO-NPs which were soluble in n-heptane [1]. The SPIO-NPs were then added
to n-heptane and mixed with MED1000 silicone rubber (Nusil). The mixture was
spin coated on substrates to achieve homogenous layer thickness where the
thicknesses vary among samples. By weighing the samples with a precision scale,
dividing their weight by their length and multiplying by SPIO-NP concentration
in weight% we obtained a measure of the amount of NPs per cross-section in
arbitrary units termed “concentration” in the following (Table1).
A strip of each sample was arranged on a
polyimide sheet (Figure1), then embedded in 1% agarose gel to mimic MRI
contrast of gray matter [2,3].
The polyimide sheet was then placed in a 3T
scanner (Siemens Skyra) and imaged using a T2 TSE STIR sequence as commonly
used in clinical post-implantation practice [4] employing a body coil and the
vendor’s standard epilepsy protocol with a transmit/receive head coil. From the
acquired sagittal T2 TSE STIR sequence images, we extracted a signal intensity
profile as shown in Figure1.
A deviation of 30% from the background signal intensity (ASTM2119) was used to
define and calculate the artifact area of each sample (Figure2, Table1).
We then took two 128 channel thin-film icEEG implants
made of 300 nm thick platinum iridium sandwiched in a layer of 5µm
polyimide on either side (fabrication: [5]) using sample #7 as marker on one of
the implants (Figure3).
Then both implants were embedded in 1% agarose using the same MRI protocol as before
with the implants in the axial orientation as intended for use.
Results
Figure1
shows that sample #1, #2, #4, and #5 exhibit limited artifacts according to
ASTM2119. The artifact created by sample #8 exceeds the sample dimensions. Samples
#3, #6 and #7 show distinct image artifacts without exceeding their sample
dimensions excessively.
Figure2
suggests a correlation between the “concentration” of SPIO-NPs and the imaging
artifact size.
Figure3 illustrates the application of sample #7
as thin-film icEEG implant marker for localization in MRI. All MR images show
that the implants themselves appear with little to no contrast compared to the gel background. The SPIO-NP marker creates contrast that facilitates
localization of the implant and can be used as a reference to locate the
individual electrodes. Notably, the SWI image displays single electrodes.Discussion
The “concentration”
of samples #4 and #5 are close to the artifact threshold and therefore resemble minimum “concentration”. Sample #3, #6 and #7 show artifacts and the
artifact size remains close to the sample dimensions and therefore fulfills our
requirements of marking the implant while keeping the disruption of the image small.
Sample #8 shows 5x artifact size of #7 which results in excessive concealment which is counterproductive.
Figure3 shows
good results for identifying the thin-film implant location with SPIO-NPs in
the GRE sequence while the TSE sequences allow for unimpaired observation of
the surroundings. In the SWI sequence the SPIO-NP markers provide conspicuous
localization of the location of the implant. The illustration of single
electrode sites may be of great value for electrode registration in brain
function mapping. Further work is needed to evaluate the electrode conspicuity when
the electrode is surrounded by tissue and placed on a curvature such as the
brain. For a better correlation between the SPIO-NP concentration and the
resulting imaging artifact size a wider range of SPIO-NP “concentration” should
be investigated.Conclusion
We show examples
of SPIO-NP concentration that allow conspicuous localization of thin-film
icEEG implants in MRI and localization of single electrode sites while keeping
disruptive artifacts small.Acknowledgements
The icEEG implants were generously made available by
Christian Bentler. Partially funded within “BrainLinks-BrainTools” by the
German Research Foundation (DFG ExC1086).References
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