Cause and Amelioration of MRI-Induced Heating Through Medical Implant Lead Wires

The RF fields present in magnetic resonance imaging (MRI) scanners can induce hazardous heating in patients wearing medical implants. The inherent design and locale of deep brain stimulators (DBS) and spinal cord stimulators (SCS) make them particularly susceptible. We apply antenna concepts and use electromagnetic (EM) simulation to explain the phenomenon and anticipate its sensitivity to lead wire length. We anticipate that a DC resistance of less than 50 Ω/m and an RF impedance of more than 1:23kΩ/m would be required for a safe electrode for SCS use. We investigate the possibility of manipulating wire conductivity and diameter in order to use the skin depth effect to achieve a safe electrode. The effect of the thickness and permittivity of insulation surrounding the wires is explored

Quantitative imaging:systematic review of perfusion/flow phantoms

Background: We aimed at reviewing design and realisation of perfusion/flow phantoms for validating quantitative perfusion imaging (PI) applications to encourage best practices. Methods: A systematic search was performed on the Scopus database for “perfusion”, “flow”, and “phantom”, limited to articles written in English published between January 1999 and December 2018. Information on phantom design, used PI and phantom applications was extracted. Results: Of 463 retrieved articles, 397 were rejected after abstract screening and 32 after full-text reading. The 37 accepted articles resulted to address PI simulation in brain (n = 11), myocardial (n = 8), liver (n = 2), tumour (n = 1), finger (n = 1), and non-specific tissue (n = 14), with diverse modalities: ultrasound (n = 11), computed tomography (n = 11), magnetic resonance imaging (n = 17), and positron emission tomography (n = 2). Three phantom designs were described: basic (n = 6), aligned capillary (n = 22), and tissue-filled (n = 12). Microvasculature and tissue perfusion were combined in one compartment (n = 23) or in two separated compartments (n = 17). With the only exception of one study, inter-compartmental fluid exchange could not be controlled. Nine studies compared phantom results with human or animal perfusion data. Only one commercially available perfusion phantom was identified. Conclusion: We provided insights into contemporary phantom approaches to PI, which can be used for ground truth evaluation of quantitative PI applications. Investigators are recommended to verify and validate whether assumptions underlying PI phantom modelling are justified for their intended phantom application

Characterization and Compensation of Hysteretic Cardiac Respiratory Motion in Myocardial Perfusion Studies Through MRI Investigations

Respiratory motion causes artifacts and blurring of cardiac structures in reconstructed images of SPECT and PET cardiac studies. Hysteresis in respiratory motion causes the organs to move in distinct paths during inspiration and expiration. Current respiratory motion correction methods use a signal generated by tracking the motion of the abdomen during respiration to bin list- mode data as a function of the magnitude of this respiratory signal. They thereby fail to account for hysteretic motion. The goal of this research was to demonstrate the effects of hysteretic respiratory motion and the importance of its correction for different medical imaging techniques particularly SPECT and PET. This study describes a novel approach for detecting and correcting hysteresis in clinical SPECT and PET studies. From the combined use of MRI and a synchronized Visual Tracking System (VTS) in volunteers we developed hysteretic modeling using the Bouc-Wen model with inputs from measurements of both chest and abdomen respiratory motion. With the MRI determined heart motion as the truth in the volunteer studies we determined the Bouc Wen model could match the behavior over a range of hysteretic cycles. The proposed approach was validated through phantom simulations and applied to clinical SPECT studies

A Multimodality Myocardial Perfusion Phantom:Initial Quantitative Imaging Results

This proof-of-concept study explores the multimodal application of a dedicated cardiac flow phantom for ground truth contrast measurements in dynamic myocardial perfusion imaging with CT, PET/CT, and MRI. A 3D-printed cardiac flow phantom and flow circuit mimics the shape of the left ventricular cavity (LVC) and three myocardial regions. The regions are filled with tissue-mimicking materials and the flow circuit regulates and measures contrast flow through LVC and myocardial regions. Normal tissue perfusion and perfusion deficits were simulated. Phantom measurements in PET/CT, CT, and MRI were evaluated with clinically used hardware and software. The reference arterial input flow was 4.0 L/min and myocardial flow 80 mL/min, corresponding to myocardial blood flow (MBF) of 1.6 mL/g/min. The phantom demonstrated successful completion of all processes involved in quantitative, multimodal myocardial perfusion imaging (MPI) applications. Contrast kinetics in time intensity curves were in line with expectations for a mimicked perfusion deficit (38 s vs. 32 s in normal tissue). Derived MBF in PET/CT and CT led to under- and overestimation of reference flow of 0.9 mL/g/min and 4.5 mL/g/min, respectively. Simulated perfusion deficit (0.8 mL/g/min) in CT resulted in MBF of 2.8 mL/g/min. We successfully performed initial, quantitative perfusion measurements with a dedicated phantom setup utilizing clinical hardware and software. These results showcase the multimodal phantom’s potential.</p

In silico evaluation of the thermal stress induced by MRI switched gradient fields in patients with metallic hip implant

This work focuses on the in silico evaluation of the energy deposed by MRI switched gradient fields in bulk metallic implants and the consequent temperature increase in the surrounding tissues. An original computational strategy, based on the subdivision of the gradient coil switching sequences into sub-signals and on the time-harmonic electromagnetic field solution, allows to realistically simulate the evolution of the phenomena produced by the gradient coils fed according to any MRI sequence. Then, Pennes' bioheat equation is solved through a Douglas-Gunn time split scheme to compute the time-dependent temperature increase. The procedure is validated by comparison with laboratory results, using a component of a realistic hip implant embedded within a phantom, obtaining an agreement on the temperature increase better than 5%, lower than the overall measurement uncertainty. The heating generated inside the body of a patient with a unilateral hip implant when undergoing an Echo-Planar Imaging (EPI) MRI sequence is evaluated and the role of the parameters affecting the thermal results (body position, coil performing the frequency encoding, effects of thermoregulation) is discussed. The results show that the gradient coils can generate local increases of temperature up to some kelvin when acting without radiofrequency excitation. Hence, their contribution in general should not be disregarded when evaluating patients' safety

Doctor of Philosophy

dissertationDynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is a powerful tool to detect cardiac diseases and tumors, and both spatial resolution and temporal resolution are important for disease detection. Sampling less in each time frame and applying sophisticated reconstruction methods to overcome image degradations is a common strategy in the literature. In this thesis, temporal TV constrained reconstruction that was successfully applied to DCE myocardial perfusion imaging by our group was extended to three-dimensional (3D) DCE breast and 3D myocardial perfusion imaging, and the extension includes different forms of constraint terms and various sampling patterns. We also explored some other popular reconstruction algorithms from a theoretical level and showed that they can be included in a unified framework. Current 3D Cartesian DCE breast tumor imaging is limited in spatiotemporal resolution as high temporal resolution is desired to track the contrast enhancement curves, and high spatial resolution is desired to discern tumor morphology. Here temporal TV constrained reconstruction was extended and different forms of temporal TV constraints were compared on 3D Cartesian DCE breast tumor data with simulated undersampling. Kinetic parameters analysis was used to validate the methods

A Multimodality Myocardial Perfusion Phantom:Initial Quantitative Imaging Results

This proof-of-concept study explores the multimodal application of a dedicated cardiac flow phantom for ground truth contrast measurements in dynamic myocardial perfusion imaging with CT, PET/CT, and MRI. A 3D-printed cardiac flow phantom and flow circuit mimics the shape of the left ventricular cavity (LVC) and three myocardial regions. The regions are filled with tissue-mimicking materials and the flow circuit regulates and measures contrast flow through LVC and myocardial regions. Normal tissue perfusion and perfusion deficits were simulated. Phantom measurements in PET/CT, CT, and MRI were evaluated with clinically used hardware and software. The reference arterial input flow was 4.0 L/min and myocardial flow 80 mL/min, corresponding to myocardial blood flow (MBF) of 1.6 mL/g/min. The phantom demonstrated successful completion of all processes involved in quantitative, multimodal myocardial perfusion imaging (MPI) applications. Contrast kinetics in time intensity curves were in line with expectations for a mimicked perfusion deficit (38 s vs. 32 s in normal tissue). Derived MBF in PET/CT and CT led to under- and overestimation of reference flow of 0.9 mL/g/min and 4.5 mL/g/min, respectively. Simulated perfusion deficit (0.8 mL/g/min) in CT resulted in MBF of 2.8 mL/g/min. We successfully performed initial, quantitative perfusion measurements with a dedicated phantom setup utilizing clinical hardware and software. These results showcase the multimodal phantom’s potential

Partial volume correction incorporating Rb-82 positron range for quantitative myocardial perfusion PET based on systolic-diastolic activity ratios and phantom measurements.

BACKGROUND: Quantitative myocardial PET perfusion imaging requires partial volume corrections. METHODS: Patients underwent ECG-gated, rest-dipyridamole, myocardial perfusion PET using Rb-82 decay corrected in Bq/cc for diastolic, systolic, and combined whole cycle ungated images. Diastolic partial volume correction relative to systole was determined from the systolic/diastolic activity ratio, systolic partial volume correction from phantom dimensions comparable to systolic LV wall thicknesses and whole heart cycle partial volume correction for ungated images from fractional systolic-diastolic duration for systolic and diastolic partial volume corrections. RESULTS: For 264 PET perfusion images from 159 patients (105 rest-stress image pairs, 54 individual rest or stress images), average resting diastolic partial volume correction relative to systole was 1.14 ± 0.04, independent of heart rate and within ±1.8% of stress images (1.16 ± 0.04). Diastolic partial volume corrections combined with those for phantom dimensions comparable to systolic LV wall thickness gave an average whole heart cycle partial volume correction for ungated images of 1.23 for Rb-82 compared to 1.14 if positron range were negligible as for F-18. CONCLUSION: Quantitative myocardial PET perfusion imaging requires partial volume correction, herein demonstrated clinically from systolic/diastolic absolute activity ratios combined with phantom data accounting for Rb-82 positron range