08:46:42 From Frank G. Shellock, Ph.D., FACR, FISMRM, FACC / Panelist to Hosts and panelists: Test 08:59:52 From Moby to Everyone: Hi Everyone, welcome to MR Safety Study Group Virtual Meeting. Please take this time to change the chatbox to "EVERYONE" and let us know where you're viewing from today. 09:00:13 From Kim Cecil to Everyone: Hello from Cincinnati! 09:00:17 From Michael Hoff to Everyone: Oakland! 09:00:23 From Sayim Gokyar to Everyone: Hello from Los Angeles 09:00:24 From Pallab Bhattacharyya to Everyone: Cleveland. 09:00:28 From Nancy Beluk to Everyone: Hello all from Pittsburgh! 09:00:29 From Judd Storrs to Everyone: Hello from Columbus! 09:00:29 From Garfield Detzler to Everyone: Hello from Toronto! 09:00:30 From Stephen Mercedes to Hosts and panelists: Atlanta, GA! 09:00:31 From Heidi Edmonson to Everyone: Hello from Rochester, MN! 09:00:31 From Peter Truong to Hosts and panelists: Hello from Toronto 09:00:34 From Rosti Lemdiasov to Everyone: Boston 09:00:36 From silvia hidalgo to Hosts and panelists: Mexico City 09:00:36 From Ulrike Scholpp to Hosts and panelists: Hello from Toronto 09:00:38 From Stanley Fricke to Hosts and panelists: Maryland 09:00:38 From Jessica Martinez to Everyone: Hello! 09:00:39 From Yonggang Lu to Everyone: Milwaukee 09:00:46 From Hiroyuki Takashima to Everyone: Good evening Japan 09:00:47 From Ming-Jye Chen to Hosts and panelists: Taiwan 09:00:47 From Maggie Johnson to Everyone: Hi Maggie From Washington, DC 09:00:49 From Carollyn Hurst to Hosts and panelists: Bonjour from Montreal, Canada 09:00:51 From Ji Chen to Everyone: Houston 09:01:00 From John Trudeau to Everyone: Boston 09:01:08 From Stephanie Ohrel to Everyone: Hello from Gloucester, UK! 09:01:09 From Swachchhanda Songmen to Hosts and panelists: Boston 09:01:15 From Peter Hardy to Everyone: Peter Hardy, Lexington, KY, USA 09:01:21 From Finya Ketelsen to Hosts and panelists: Germany 09:01:21 From Rashid Ngalawango to Everyone: Rashid, Malawi. 09:01:35 From Frank G. Shellock, Ph.D., FACR, FISMRM, FACC / Panelist to Everyone: Welcome One and All! 09:01:42 From Julien Sein to Hosts and panelists: Hello from Marseille, France 09:01:45 From Simona Nikolova to Everyone: Hello from Phoenix, Arizona 09:01:53 From Michel Fuentes to Everyone: im I muted? 09:02:00 From Christine Harris RT (MR) MRSO / Speaker to Hosts and panelists: Welcome all, Maggie I see you 09:02:02 From Michel Fuentes to Everyone: just need to know 09:02:27 From Nancy Beluk to Everyone: Attendees can NOT speak and are muted Yes 09:02:42 From Sam-Luca Hansen to Everyone: Hello from Germany 09:02:52 From Stanley Fricke to Hosts and panelists: Congratulations Sunder 09:03:05 From Nancy Beluk to Everyone: @michael Fuentes If you have a question, you need to type it in 09:03:10 From Emre Kopanoglu to Hosts and panelists: Hi from Cardiff, UK 09:03:24 From Margaret Graves to Everyone: Hello from Washington, DC 09:03:34 From R. Jason Stafford to Hosts and panelists: Hola from Houston, TX 09:04:06 From R. Jason Stafford to Everyone: Hola from Houston, TX 09:04:49 From Kagayaki Kuroda to Hosts and panelists: Hello from Yokohama, Japan 09:04:52 From Louai Aldayeh to Everyone: Hi from, now sunny, recently rainy, LA! 09:05:41 From Shawn Etheridge to Hosts and panelists: Hello! 09:05:59 From Michel Fuentes to Everyone: Thank you! 09:06:15 From Marzieh Nezamzadeh to Hosts and panelists: Hello from Upstate, NY 09:07:58 From Stanley Fricke to Hosts and panelists: Sunder can you put a link to that document in the chat? 09:08:28 From Michel Fuentes to Everyone: is this presentation going to be available after either by link or PPP? 09:08:42 From Sunder Rajan, PhD / Moderator to Stanley Fricke and all panelists: hi, it should be up on ismrm website 09:19:51 From Frank G. Shellock, Ph.D., FACR, FISMRM, FACC / Panelist to Hosts and panelists: Great turnout! 09:24:06 From Sunder Rajan, PhD / Moderator to Hosts and panelists: y-axis scale on graph? 09:26:57 From Pallab Bhattacharyya to Everyone: Nice talk. How is "Small" body size defined? Would it be fair to categorize as body size instead of pediatric/adult? 09:27:08 From Ji Chen to Everyone: What is the heating level as compared to adult for these? Higher or Lower ? 09:28:30 From silvia hidalgo to Hosts and panelists: How many degrees Celsius are we talking ? 09:28:51 From Heidi Edmonson to Everyone: Are any epicardial leads labeled with MR conditional status for adult patients? 09:29:38 From Stanley Fricke to Everyone: Also it is true that the gradient strength is lowest at the center of the MRI but given the smaller size of the youngest Pediatric patients steeper gradients are used (higher resolution) is some cases... 09:30:37 From Shona Hares to Everyone: What's the difference between electrode 1 &2 ? Why is 2 so much higher? 09:31:06 From Stanley Fricke to Everyone: Jonathan, is there any work in the field that would allow an implanted device to report its temperature? 09:32:12 From Stephanie Holowka to Everyone: With RF being the greatest risk on a paediatric patient, could the heating be lessened or made safer by scanning brain in a T/R head cool? in paediatrics we are being asked about scanning a patient's brain when they have a non conditional or MR unsafe pacemaker with bipolar leads implanted in the abdomen 09:32:23 From Bhumi Bhusal to Everyone: Can you please give more detail on how do you employ the transfer function for bipolar epicardial leads? 09:33:36 From Sunder Rajan, PhD / Moderator to Stanley Fricke and all panelists: but remember the landmark can change depending on the scan 09:33:37 From Stanley Fricke to Hosts and panelists: Congratulations Christine! 09:33:47 From Vera Kimbrell to Hosts and panelists: Hey Christine! Great to see you here! 09:35:34 From Stephanie Ohrel to Everyone: Many thanks Jonathan. For epicardial leads, does the fact they are surrounded by tissue of about half the conductivity of blood imply than the SAR for an equivalent E field intensity will be lower than for intravenous leads? 09:38:34 From Jonathan Edmonson, PhD / Speaker to Stephanie Ohrel and all panelists: Stephanie - The SAR is not necessarily lower as the e-fields are scaling with the body diameter, so the e-fields in those tissues may be quite a bit higher than what would be seen for a transvenous lead in blood. 09:40:49 From Jonathan Edmonson, PhD / Speaker to Stephanie Holowka and all panelists: Stephanie Holowka - Using a head T/R coil will significantly reduce the electric fields around a cardiac implant and would be a good solution for reducing the potential risk. 09:41:56 From Laleh Golestani Rad, PhD / Speaker to Everyone: @Stephanie Holowka: We have done some in vitro experiments and our finding is that scanning even with the body coil when the patient is positioned for brain imaging produced much less heating. 09:43:05 From Jonathan Edmonson, PhD / Speaker to Shona Hares and all panelists: Shona Hares - the difference between electrode 1 and 2 is simply due to the design of the electrical conductor within the lead which can impact that transfer function and cause differences in heating between the two electrodes. 09:44:38 From Joanna Shechtel to Hosts and panelists: @Laleh Golestani: Can you send a link to that data/publication, please? I would love to read it! 09:45:11 From Stephanie Holowka to Everyone: Thanks. 09:45:44 From Rosti Lemdiasov to Everyone: Rotatable magnets can still experience strong pull from magnetic field, in the regions where the field is not uniform. 09:45:57 From Jonathan Edmonson, PhD / Speaker to Pallab Bhattacharyya and all panelists: Pallab Bhattacharyya - you are correct that it is fair to categorize as body size vs pediatric/adult, however very small adults will often still have vasculature that permits the use of typical transvenous endocardial leads. 09:46:58 From Joanna Shechtel to Everyone: @Laleh Golestani: Can you send a link to that data/publication, please? I would love to read it! 09:47:44 From Stephanie Holowka to Hosts and panelists: When pacemakers are labeled unsafe is it the totality of the three forces or specifically RF heating? The added consideration in our case is the need for anaesthesia as well 09:48:11 From Laleh Golestani Rad, PhD / Speaker to Everyone: @Joanna Shechtel and Stephanie: can you send me an email to laleh.rad1@northwestern.com? I'll send you the paper that is currently under review and a conference paper that is published on this 09:49:42 From Stephanie Holowka to Hosts and panelists: @Laleh, was it not you who gave the interesting presentation on the coiling of DBS leads ladt fall? it was very interesting. I will email you 09:50:26 From Laleh Golestani Rad, PhD / Speaker to Stephanie Holowka and all panelists: Yes ,we did that study p 09:50:59 From Pallab Bhattacharyya to Everyone: @Laleh Golestani Rad: What do you mean by "much less heating"? Thank you. 09:51:35 From John Trudeau to Everyone: what type of monitoring is done when scanning pediatric pacemakers? 09:52:41 From silvia hidalgo to Hosts and panelists: the technologist should only scan the patient for metals, not worrying whether a device is safe or not. The number of patients is enormous daily. When parents or guardians do not even know the brand of the device, and it is impossible to guess BUT the MRI study is urgent. What is clear to me is that if there is a consequence (electronic malfunction / harm to the patient), it is not necessarily immediate, but can occur days/hours after the MRI study. 09:53:49 From Stephanie Holowka to Hosts and panelists: @Laleh Golestani Rad: It was excellent. I mentioned it to our DBS neurosurgeon. I will send the email. 09:53:51 From Laleh Golestani Rad, PhD / Speaker to Everyone: My bad: send to Laleh.rad1@northwestern.edu 09:54:20 From Shawn Etheridge to Hosts and panelists: lol! 09:54:30 From Shawn Etheridge to Hosts and panelists: great meeting in any case 09:55:47 From Maggie Johnson to Everyone: Excellent presentation Chris, good representation for Technologists. 09:56:34 From Stephen Mercedes to Everyone: We have yet been able to scan a patient in both pediatric and adult setting with cochlear implant without expressing some sort of pain or discomfort. Is this simply the norm for individuals with cochlear implants or has it been a large enough study case of individuals that have not experienced pain or discomfort? 09:57:35 From ray schmitz to Everyone: in the old days, the techs would vet the devices based on avail documentation. Then came the time the Mnf embedded a clinician sign offs in the IFUs. We feel that since this document is now 'available' we are 'obligated' to follow this work flow. Our experience is that it generally slows the booking processes awaiting this sign-off document. Thoughts/recommendations? 10:08:35 From Shona Hares to Everyone: The trouble is those leads move with growth of child so won't stay where surgeon initially loops the lead 10:10:49 From Judd Storrs to Everyone: Are we able evaluate device malfunction with non-conditional or off label use? 10:11:00 From Marzieh Nezamzadeh to Hosts and panelists: Great, Thank you very much, 10:11:05 From Carollyn Hurst to Everyone: Thank you to everyone. Great presentations. 10:11:21 From Laleh Golestani Rad, PhD / Speaker to Everyone: Shona: great point! We are and should be looking at the effect of growth as well 10:12:01 From Marzieh Nezamzadeh to Everyone: Great talks, thank you very much 10:12:27 From Stephanie Holowka to Hosts and panelists: @Christine Harris: I enjoyed your lecture and perspective. 10:13:54 From Alex Goodall to Everyone: Excellent presentations, thank you 10:14:30 From Maggie Johnson to Everyone: Excellent presentations !! 10:16:33 From Shona Hares to Hosts and panelists: Would love to see your data. Email is Shona.hares@nhs.net. Thank you 10:16:49 From Edmund Kwok to Everyone: How about post-surgical temporary epicardial leads that have been partially removed? 10:17:12 From Margaret Graves to Everyone: Many thanks for excellent presentations! 10:18:18 From Stanley Fricke to Hosts and panelists: How about adding temperature sensing pulse sequences like the ones used for MR-guided-HIFU 10:18:49 From Philip Lledo to Hosts and panelists: Thanks everyone, excellent presentation. 10:19:56 From silvia hidalgo to Hosts and panelists: As a physicist I understand the constant and variable electromagnetic fields that we have. But they don't work separately. There is the overlap of electromagnetic fields, and although there are quite a few simulations with different scenarios. Each patient is unique, even the humidity of his skin plays an important role, here is the challenge as a medical physicist. 10:20:10 From Heidi Edmonson to Everyone: Depends on the condition. Annual MRI for neurofibromatosis patients that typically have cochlear implants... 10:20:12 From Shona Hares to Everyone: The tests we do on the device would indicate a problem with scar tissue induced by heating so we would be able to tell with the pre and post scan tests ? 10:20:39 From Heidi Edmonson to Everyone: Can you comment on patient risk of explantation of leads? 10:24:07 From Emma Einarsson to Hosts and panelists: Thanks for very interesting talks and discussion! Laleh, I am very interested in reading your paper. emma.einarsson@med.lu.se 10:25:06 From Shona Hares to Everyone: It's becoming more and more common that we have an MRI conditional device that can be programmed into an MRI mode but the leads are mixed manufacturer or older and not tested. We are finding we have to just risk assess on an individual basis in order to be able to try and provide best imaging modality 10:26:02 From Elizaveta Motovilova to Everyone: Thank you so much for excellent presentations and engaging discussion! 10:26:24 From Stanley Fricke to Everyone: Thank you! 10:26:34 From Gill MacNaught to Everyone: Thanks you for a really helpful webinar! 10:26:37 From Sunder Rajan, PhD / Moderator to Hosts and panelists: any chance to respond to questions off line? 10:26:39 From Bill Smith to Everyone: Really interesting presentations & discussions. Thanks all ! 10:26:39 From Emre Kopanoglu to Hosts and panelists: Thank you! 10:26:47 From Shona Hares to Everyone: Thanks 10:26:48 From Stephanie Ohrel to Everyone: Many thanks!