1 From the University Health Network, Toronto, Canada (A.B., C.T.C., K.N., G.J.B.E., C.N., J.G., A.L., W.K., A.M.L.); Joint Department of Medical Imaging, University of Toronto, Toronto, Canada (A.B., W.K.); Department of Neurosurgery, West Virginia University, Morgantown, WVa (M.R., A.R.R.); Department of Neurosurgery, Rockefeller Neuroscience Institute, Morgantown, WVa (M.R., A.R.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (A.J.M.); Department of Psychology, Concordia University, Montreal, Canada (C.J.S.); Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (C.J.S.); Center for Scientific Review, National Institutes of Health, Bethesda, Md (I.H.); and Division of Neurosurgery, Department of Surgery, Toronto Western Hospital and University of Toronto, 399 Bathurst St, WW 4-437, Toronto, ON, Canada M5T 2S8 (A.M.L.).

Improving Safety of MRI in Patients with Deep Brain Stimulation Devices.

Radiology. 2020 Jun 23;:192291

Authors: Boutet A, Chow CT, Narang K, Elias GJB, Neudorfer C, Germann J, Ranjan M, Loh A, Martin AJ, Kucharczyk W, Steele CJ, Hancu I, Rezai AR, Lozano AM

Abstract

MRI is a valuable clinical and research tool for patients undergoing deep brain stimulation (DBS). However, risks associated with imaging DBS devices have led to stringent regulations, limiting the clinical and research utility of MRI in these patients. The main risks in patients with DBS devices undergoing MRI are heating at the electrode tips, induced currents, implantable pulse generator dysfunction, and mechanical forces. Phantom model studies indicate that electrode tip heating remains the most serious risk for modern DBS devices. The absence of adverse events in patients imaged under DBS vendor guidelines for MRI demonstrates the general safety of MRI for patients with DBS devices. Moreover, recent work indicates that-given adequate safety data-patients may be imaged outside these guidelines. At present, investigators are primarily focused on improving DBS device and MRI safety through the development of tools, including safety simulation models. Existing guidelines provide a standardized framework for performing safe MRI in patients with DBS devices. It also highlights the possibility of expanding MRI as a tool for research and clinical care in these patients going forward.

PMID: 32573388 [PubMed - as supplied by publisher]