Peripheral Nerve Stimulation, Implants & Devices: Safe Use & Considerations for MRI
Mark Conroy1

1Medtronic,Inc., United States

Synopsis

This presentation will describe the MRI related risks to patients with active implantable devices with respect to unintended electrical tissue stimulation. The mechanisms due to RF rectification and gradient induced electrical potential will be described using simplified circuit models. Standard test methods for characterizing device performance in the MRI environment will be described. Finally, risk mitigation strategies and MR Conditional labeling strategies will be reviewed.

TARGET AUDIENCE

MRI Technologists, Clinical Medical Physicists, Radiologists

PURPOSE

To review the MRI related risks to patients with active implantable devices with respect to unintended electrical tissue stimulation, describe the mechanisms that may produce unintended stimulation, review test methods for characterizing implanted device performance in the MRI environment, and describe methods for mitigating these risks.

SUMMARY

The time varying radio-frequency (RF) and magnetic gradient fields associated with MRI can interact with active implanted medical devices and produce undesired electrical tissue stimulation. The mechanisms due to RF rectification and gradient induced electrical potential will be described in detail using simplified circuit models. The risks associated with unintended stimulation will be discussed in terms of typical cardiac rhythm and neurostimulation therapies. Finally, standard test methods described in TS10974[1] for evaluating device performance in the MRI environment will be described.



CONCLUSION

Implantable device engineering, rigorous testing and, and MR Conditional Labeling will expand safe access to MRI for patients with active implantable devices.

Acknowledgements

Medtronic Applied Physics Team: Riki Banerjee Ph.D., Arcan Etruk Ph.D., Yohan Kim Ph.D., Jiashu Li, Chanjoon Lee Ph.D., Lauren Tran Ph.D., Dave Kelly, Leonard Gramse, Tom Wyatt, Katlyn Johnson.

References

[1] ISO/TS 10974:2012, Assessment of the Safety of Magnetic Resonance Imaging for Patients with an Active Implantable Medical Device
Proc. Intl. Soc. Mag. Reson. Med. 26 (2018)