Jagjit S Sidhu1, Ken Sakaie1, Pallab K Bhattacharyya1, and Mark Lowe1
1Cleveland Clinic, Cleveland, OH, United States
Synopsis
Keywords: Safety, Safety
Implanted
electrodes can induce unsafe heating during MRI. Developing safe MRI protocols
can be a burdensome process, involving intensive simulations that are hard to
tailor to individual patients. To
increase the feasibility of safe imaging of patients with implanted electrodes,
we extend previous work, that nulled induced currents when the number of
transmitters exceeded the number of electrodes, to account for the case when
these are equal or the number of electrodes exceeds the number of transmitters.
In such cases, complete nulling (no measured temperature rise) is impossible in
all electrodes unless an acceptable induced temperature rise is allowed.
Introduction
Patients
with implanted electrodes are typically denied the potential benefit of HF
(>3T) or UHF MRI (>7T) due to safety concerns 1. Higher
field strengths provide increased signal-to-noise ratio (SNR) 2, which allows
for smaller structures to be more clearly visualized. To increase the
feasibility of safe imaging of patients with implanted electrodes, Eryaman et
al. 3 and Sadeghi-Tarakameh
et al. 4 demonstrated a method to
identify a safe operating point—an implant-friendly (IF) mode 5,6. The
results of 3,4 were extended to the case of bilateral electrodes 7.
Here, we extend the formalism presented by Sadeghi-Tarakameh et al. 7 to an arbitrary number of electrodes
and validate the formalism with a phantom experiment.Theory
The case of two electrodes and two transmitters is important because
bilateral electrodes are common for treating movement disorders 8, and two
transmitters are common among standard body transmit coils.
$$ A_1 I_{1,1} + A_2 I_{1,2} = J_1 $$
$$ \qquad \qquad \quad \qquad \qquad \quad \qquad \qquad \qquad A_1 I_{2,1} + A_2 I_{2,2} = J_2
\qquad \qquad \qquad \qquad \qquad \qquad \quad \qquad (1) $$
$$$ A_i $$$ is the
complex amplitude in transmitter
. $$$ I_{j,i} $$$ is the current induced in electrode $$$ j $$$ when
transmitter $$$ i $$$ is
switched on and includes contributions from the transmitter and the other
electrode. $$$ J_j $$$ is the net
current induced in electrode $$$ j $$$.
Various studies report a linear relationship between the
specific absorption rate (SAR) and measured temperature rise 9-12. SAR depends on the dissipated
power, which in turn depends quadratically 3 on the induced current in each
electrode:
$$ \qquad \qquad \qquad \qquad \qquad \qquad \qquad \qquad \qquad \Delta T_j \propto | I_j | ^2 \qquad \qquad \qquad \qquad \qquad \qquad \qquad \qquad \quad (2) $$
$$$ \Delta T_j $$$ is the
temperature rise in electrode j. $$$ | I_j | $$$ denotes the magnitude of the induced current in
electrode j. Writing the weights and induced currents as $$$ A_1 = \alpha_1 e^{i \phi_1} $$$, $$$ A_2 = \alpha_2 e^{i \phi_2} $$$, $$$ I_{j,1} = \beta_1 e^{i \theta_1} $$$ and $$$ I_{j,2} = \beta_2 e^{i \theta_2} $$$ we find
$$ \qquad \qquad \qquad \quad \quad \qquad \qquad \qquad \qquad \Delta T_j = C + D cos \Psi
\qquad \qquad \qquad \qquad \qquad \qquad \qquad \quad \quad (3) $$
where $$$ C = (\alpha_1 \beta_1)^2 + (\alpha_2 \beta_2)^2 $$$, $$$ D = 2 \alpha_1 \beta_1 \alpha_2 \beta_2 $$$, $$$ \Psi = \theta_1 - \theta_2 + \phi_{rel} $$$ and $$$ \phi_{rel} = \phi_1 - \phi_2 $$$ is the relative phase between the two
transmitters. Equation
(3) generalizes to any number of transmitters and electrodes.Methods
Imaging
was performed on a Siemens 3T Prisma system equipped with two independent 13 and fully integrated
whole-body transmit channels (Siemens Healthineers, Erlangen, Germany)
with a standard 20-channel head-neck receive-only array. A high SAR T2-TSE sequence with B1+ rms
value of 2.1μT and Time-averaged RF power of approximately 20W was acquired to
induce heating (axial, 240 mm x 240 mm FOV, 256 x 256 matrix, 32 slices,
4 mm thick, TE/TR=71/6470 msec, 212 Hz/Pixel bandwidth).
To
simulate bilaterally implanted
electrodes, two 0.8-mm diameter insulated copper wires with exposed tips
were secured to the bottom of a cuboid shaped container of approximately 50 cm
x 30 cm x 20 cm filled with gel prepared by following ASTM F2182-11a standard 14. Wire lengths of 85 cm were chosen to maximize heating 15. Wires were
chosen instead of electrodes to exaggerate heating, providing a worst-case scenario 16. Temperature changes were measured using fluoroptic temperature sensor
(model m3300, Luxtron (Lumasense Technologies), Santa Clara, CA, USA) by
securely tying probes to the exposed wire tips.
The amplitude of transmitter one was fixed at 0.8 and
that of transmitter 2 at 0.4. The
phase of transmitter 1 was fixed at 0. The
phase of transmitter 2 was varied from 0 to 360⁰ in increments of 30⁰.
Matlab 17 was used
to perform a fit of the maximum temperature rise as a function of phase for
each wire to equation 2.Results and Discussion
In Figure 1, we show the
temperature as a function of time across the full duration of the TSE. A
negligible temperature rise was measured in one wire but unacceptable
temperature rise ($$$ > 2°$$$) 18 was observed in the other. This demonstrates
that a safe operating point for one electrode is not necessarily safe for
multiple electrodes.
Figure 2 shows the maximum temperature as a function of relative
phase. The maximum temperature in each electrode follows the cosine relation
predicted by equation (3). A minimum temperature rise can be achieved by
appropriate manipulation of the relative phase (arrow, figure 2).Conclusion
We have
generalized the formalism of Eryaman et al. 3,4,7 to include any number of
transmitters and implanted electrodes and tested the formalism on a clinically
relevant configuration of two transmitters and two electrodes. As the formalism
is analytic, it may provide helpful constraints for finding safe operating
points in general, allowing patients to benefit from the higher signal-to-noise
ratio at higher field strengths. Acknowledgements
We
acknowledge support from the Imaging Institute of the Cleveland Clinic and from
Siemens Healthineers.References
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