Three-Tesla Magnetic Resonance Imaging of Patients With Deep Brain Stimulators: Results From a Phantom Study and a Pilot Study in Patients

• Published in: Neurosurgery Vol. 88; no. 2; pp. 349 - 355
• Main Authors: Davidson, Benjamin, Tam, Fred, Yang, Benson, Meng, Ying, Hamani, Clement, Graham, Simon J, Lipsman, Nir
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.02.2021; Wolters Kluwer Health, Inc
• Subjects: Aged; Anthropomorphism; Brain; Brain - physiology; Brain research; Care and treatment; Cohort Studies; Deep brain stimulation; Deep Brain Stimulation - methods; Diagnostic imaging; Electrodes; Electrodes, Implanted; Female; Health sciences; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - adverse effects; Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Male; Medical equipment; Medical imaging equipment; Middle Aged; Nervous system diseases; Neural circuitry; Neurosurgery; Phantoms, Imaging; Pilot Projects; Printing, Three-Dimensional; Research centers; Research—Human—Clinical Studies; Temperature; Canada; Phantom; Radiofrequency heating; Magnetic resonance imaging; Deep brain stimulation; Psychiatric surgery
• ISSN: 0148-396X; 1524-4040; 1081-1281; 1524-4040
• DOI: 10.1093/neuros/nyaa439

Abstract BACKGROUND Deep brain stimulation (DBS) is a standard of care treatment for multiple neurologic disorders. Although 3-tesla (3T) magnetic resonance imaging (MRI) has become the gold-standard modality for structural and functional imaging, most centers refrain from 3T imaging in patients with DBS devices in place because of safety concerns. 3T MRI could be used not only for structural imaging, but also for functional MRI to study the effects of DBS on neurocircuitry and optimize programming. OBJECTIVE To use an anthropomorphic phantom design to perform temperature and voltage safety testing on an activated DBS device during 3T imaging. METHODS An anthropomorphic 3D-printed human phantom was constructed and used to perform temperature and voltage testing on a DBS device during 3T MRI. Based on the phantom assessment, a cohort study was conducted in which 6 human patients underwent MRI with their DBS device in an activated (ON) state. RESULTS During the phantom study, temperature rises were under 2°C during all sequences, with the DBS in both the deactivated and activated states. Radiofrequency pulses from the MRI appeared to modulate the electrical discharge from the DBS, resulting in slight fluctuations of voltage amplitude. Six human subjects underwent MRI with their DBS in an activated state without any serious adverse events. One patient experienced stimulation-related side effects during T1-MPRAGE scanning with the DBS in an ON state because of radiofrequency-induced modulation of voltage amplitude. CONCLUSION Following careful phantom-based safety testing, 3T structural and functional MRI can be safely performed in subjects with activated deep brain stimulators.