Modeling of radio-frequency induced currents on lead wires during MR imaging using a modified transmission line method

Cataloged from PDF version of article.Purpose: Metallic implants may cause serious tissue heating during magnetic resonance (MR) imaging. This heating occurs due to the induced currents caused by the radio-frequency (RF) field. Much work has been done to date to understand the relationship between the RF field and the induced currents. Most of these studies, however, were based purely on experimental or numerical methods. This study has three main purposes: (1) to define the RF heating properties of an implant lead using two parameters; (2) to develop an analytical formulation that directly explains the relationship between RF fields and induced currents; and (3) to form a basis for analysis of complex cases. Methods: In this study, a lumped element model of the transmission line was modified to model leads of implants inside the body. Using this model, leads are defined using two parameters: impedance per unit length, Z, and effective wavenumber along the lead, k t. These two parameters were obtained by using methods that are similar to the transmission line theory. As long as these parameters are known for a lead, currents induced in the lead can be obtained no matter how complex the lead geometry is. The currents induced in bare wire, lossy wire, and insulated wire were calculated using this new method which is called the modified transmission line method or MoTLiM. First, the calculated induced currents under uniform electric field distribution were solved and compared with method-of-moments (MoM) calculations. In addition, MoTLiM results were compared with those of phantom experiments. For experimental verification, the flip angle distortion due to the induced currents was used. The flip angle distribution around a wire was both measured by using flip angle imaging methods and calculated using current distribution obtained from the MoTLiM. Finally, these results were compared and an error analysis was carried out. Results: Bare perfect electric, bare lossy, and insulated perfect electric conductor wires under uniform and linearly varying electric field exposure were solved, both for 1.5 T and 3 T scanners, using both the MoTLiM and MoM. The results are in agreement within 10 mean-square error. The flip angle distribution that was obtained from experiments was compared along the azimuthal paths with different distances from the wire. The highest mean-square error was 20 among compared cases. Conclusions: A novel method was developed to define the RF heating properties of implant leads with two parameters and analyze the induced currents on implant leads that are exposed to electromagnetic fields in a lossy medium during a magnetic resonance imaging (MRI) scan. Some simple cases are examined to explain the MoTLiM and a basis is formed for the analysis of complex cases. The method presented shows the direct relationship between the incident RF field and the induced currents. In addition, the MoTLiM reveals the RF heating properties of the implant leads in terms of the physical features of the lead and electrical properties of the medium. © 2011 American Association of Physicists in Medicine

Intravascular magnetic resonance imaging (MRI)

This chapter discusses the advantages of using MRI in intravascular operations. Beginning with a brief explanation of some sample intravascular MR operations, the chapter goes on to outline the visualization problem of catheters under MRI. Some of the fundamental catheter coil designs are shown and a range of imaging techniques for catheter tracking are discussed. Finally, safety issues related both specifically to these catheter coil designs and to MRI more generally are explored. © 2014 Woodhead Publishing Limited All rights reserved

Modeling of radio-frequency induced currents on lead wires during MR imaging using a modified transmission line method

Purpose: Metallic implants may cause serious tissue heating during magnetic resonance (MR) imaging. This heating occurs due to the induced currents caused by the radio-frequency (RF) field. Much work has been done to date to understand the relationship between the RF field and the induced currents. Most of these studies, however, were based purely on experimental or numerical methods. This study has three main purposes: (1) to define the RF heating properties of an implant lead using two parameters; (2) to develop an analytical formulation that directly explains the relationship between RF fields and induced currents; and (3) to form a basis for analysis of complex cases. Methods: In this study, a lumped element model of the transmission line was modified to model leads of implants inside the body. Using this model, leads are defined using two parameters: impedance per unit length, Z, and effective wavenumber along the lead, k t. These two parameters were obtained by using methods that are similar to the transmission line theory. As long as these parameters are known for a lead, currents induced in the lead can be obtained no matter how complex the lead geometry is. The currents induced in bare wire, lossy wire, and insulated wire were calculated using this new method which is called the modified transmission line method or MoTLiM. First, the calculated induced currents under uniform electric field distribution were solved and compared with method-of-moments (MoM) calculations. In addition, MoTLiM results were compared with those of phantom experiments. For experimental verification, the flip angle distortion due to the induced currents was used. The flip angle distribution around a wire was both measured by using flip angle imaging methods and calculated using current distribution obtained from the MoTLiM. Finally, these results were compared and an error analysis was carried out. Results: Bare perfect electric, bare lossy, and insulated perfect electric conductor wires under uniform and linearly varying electric field exposure were solved, both for 1.5 T and 3 T scanners, using both the MoTLiM and MoM. The results are in agreement within 10 mean-square error. The flip angle distribution that was obtained from experiments was compared along the azimuthal paths with different distances from the wire. The highest mean-square error was 20 among compared cases. Conclusions: A novel method was developed to define the RF heating properties of implant leads with two parameters and analyze the induced currents on implant leads that are exposed to electromagnetic fields in a lossy medium during a magnetic resonance imaging (MRI) scan. Some simple cases are examined to explain the MoTLiM and a basis is formed for the analysis of complex cases. The method presented shows the direct relationship between the incident RF field and the induced currents. In addition, the MoTLiM reveals the RF heating properties of the implant leads in terms of the physical features of the lead and electrical properties of the medium. © 2011 American Association of Physicists in Medicine

Modeling of electrodes and implantable pulse generator cases for the analysis of implant tip heating under MR imaging

Purpose: The authors purpose is to model the case of an implantable pulse generator (IPG) and the electrode of an active implantable medical device using lumped circuit elements in order to analyze their effect on radio frequency induced tissue heating problem during a magnetic resonance imaging (MRI) examination. Methods: In this study, IPG case and electrode are modeled with a voltage source and impedance. Values of these parameters are found using the modified transmission line method (MoTLiM) and the method of moments (MoM) simulations. Once the parameter values of an electrode/IPG case model are determined, they can be connected to any lead, and tip heating can be analyzed. To validate these models, both MoM simulations and MR experiments were used. The induced currents on the leads with the IPG case or electrode connections were solved using the proposed models and the MoTLiM. These results were compared with the MoM simulations. In addition, an electrode was connected to a lead via an inductor. The dissipated power on the electrode was calculated using the MoTLiM by changing the inductance and the results were compared with the specific absorption rate results that were obtained using MoM. Then, MRI experiments were conducted to test the IPG case and the electrode models. To test the IPG case, a bare lead was connected to the case and placed inside a uniform phantom. During a MRI scan, the temperature rise at the lead was measured by changing the lead length. The power at the lead tip for the same scenario was also calculated using the IPG case model and MoTLiM. Then, an electrode was connected to a lead via an inductor and placed inside a uniform phantom. During a MRI scan, the temperature rise at the electrode was measured by changing the inductance and compared with the dissipated power on the electrode resistance. Results: The induced currents on leads with the IPG case or electrode connection were solved for using the combination of the MoTLiM and the proposed lumped circuit models. These results were compared with those from the MoM simulations. The mean square error was less than 9%. During the MRI experiments, when the IPG case was introduced, the resonance lengths were calculated to have an error less than 13%. Also the change in tip temperature rise at resonance lengths was predicted with less than 4% error. For the electrode experiments, the value of the matching impedance was predicted with an error less than 1%. Conclusions: Electrical models for the IPG case and electrode are suggested, and the method is proposed to determine the parameter values. The concept of matching of the electrode to the lead is clarified using the defined electrode impedance and the lead Thevenin impedance. The effect of the IPG case and electrode on tip heating can be predicted using the proposed theory. With these models, understanding the tissue heating due to the implants becomes easier. Also, these models are beneficial for implant safety testers and designers. Using these models, worst case conditions can be determined and the corresponding implant test experiments can be planned. © 2015 American Association of Physicists in Medicine

Frequency of Agenesis Palmaris Longus through Clinical Examination - An East African Study

INTRODUCTION: The Palmaris longus, one of the most variable muscles in the body both flexes the wrist and tenses the palmar fascia. It is used by surgeons as a source of tendon graft and racial differences in its variation have been documented. We sought to determine the frequency of the absence of the Palmaris longus in an East African population. METHODS: A prospective study was conducted using ten common clinical tests among patients and students in a large teaching hospital in East Africa to determine the presence of a Palmaris longus. RESULTS: The overall rate of absence was 4.4% with unilateral absence at 3.3% and bilateral absence at 1.1%. The overall difference between males and females was not statistically significant (p = 0.605). Participants were more likely to have absence in their non dominant hand. DISCUSSION: Our findings though in contrast to many studies worldwide, it concurs with most studies done in the African setting. These differences may be due to the higher levels of manual labour and the more use of the right hand in these activities. The frequency of the absence of Palmaris longus in East Africa has been determined. Surgeons should acquaint themselves with prevalence in their areas of practice

Pharmacologic prophylaxis for atrial fibrillation following cardiac surgery: a systematic review

Atrial Fibrillation (AF) is the most common arrhythmia occurring after cardiac surgery. Its incidence varies depending on type of surgery. Postoperative AF may cause hemodynamic deterioration, predispose to stroke and increase mortality. Effective treatment for prophylaxis of postoperative AF is vital as reduces hospitalization and overall morbidity. Beta - blockers, have been proved to prevent effectively atrial fibrillation following cardiac surgery and should be routinely used if there are no contraindications. Sotalol may be more effective than standard b-blockers for the prevention of AF without causing an excess of side effects. Amiodarone is useful when beta-blocker therapy is not possible or as additional prophylaxis in high risk patients. Other agents such as magnesium, calcium channels blocker or non-antiarrhythmic drugs as glycose-insulin - potassium, non-steroidal anti-inflammatory drugs, corticosteroids, N-acetylcysteine and statins have been studied as alternative treatment for postoperative AF prophylaxis

Machine learning for genetic prediction of psychiatric disorders: a systematic review

Machine learning methods have been employed to make predictions in psychiatry from genotypes, with the potential to bring improved prediction of outcomes in psychiatric genetics; however, their current performance is unclear. We aim to systematically review machine learning methods for predicting psychiatric disorders from genetics alone and evaluate their discrimination, bias and implementation. Medline, PsycInfo, Web of Science and Scopus were searched for terms relating to genetics, psychiatric disorders and machine learning, including neural networks, random forests, support vector machines and boosting, on 10 September 2019. Following PRISMA guidelines, articles were screened for inclusion independently by two authors, extracted, and assessed for risk of bias. Overall, 63 full texts were assessed from a pool of 652 abstracts. Data were extracted for 77 models of schizophrenia, bipolar, autism or anorexia across 13 studies. Performance of machine learning methods was highly varied (0.48–0.95 AUC) and differed between schizophrenia (0.54–0.95 AUC), bipolar (0.48–0.65 AUC), autism (0.52–0.81 AUC) and anorexia (0.62–0.69 AUC). This is likely due to the high risk of bias identified in the study designs and analysis for reported results. Choices for predictor selection, hyperparameter search and validation methodology, and viewing of the test set during training were common causes of high risk of bias in analysis. Key steps in model development and validation were frequently not performed or unreported. Comparison of discrimination across studies was constrained by heterogeneity of predictors, outcome and measurement, in addition to sample overlap within and across studies. Given widespread high risk of bias and the small number of studies identified, it is important to ensure established analysis methods are adopted. We emphasise best practices in methodology and reporting for improving future studies

Salivary infectious agents and periodontal disease status

WOS: 000287702700012PubMed ID: 21261620Background and Objectives: The potential of salivary microorganisms to diagnose periodontal disease and to guide periodontal treatment is a research topic of current interest. This study aimed to determine whether the salivary counts of periodontopathic microbes correlated with the periodontal pocket counts of the same infectious agents, and whether the salivary counts of the test infectious agents could distinguish among individuals with periodontal health and various types of periodontal disease. Material and Methods: The study included 150 systemically healthy adults, of whom 37 were periodontally healthy, 31 had gingivitis, 46 had chronic periodontitis and 36 had aggressive periodontitis. Each study subject contributed microbial samples from the two deepest periodontal pockets of the dentition and from whole saliva. Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Epstein-Barr virus were identified using the TaqMan real-time PCR methodology. Statistical analysis was performed using the Mann-Whitney U-test and the receiver operating characteristic statistics. Results: C. rectus, F. nucleatum, P. gingivalis, P. intermedia and T. forsythia occurred with significantly higher copy-counts in salivary samples from patients with gingivitis, chronic periodontitis and aggressive periodontitis than from periodontally healthy individuals. A. actinomycetemcomitans only showed higher salivary copy-counts in subjects with aggressive periodontitis compared with subjects with healthy periodontium, and the salivary copy-counts of Epstein-Barr virus did not reveal any significant difference among the four subject groups studied. The diagnostic sensitivity for periodontitis was 89.19 for P. gingivalis and for T. forsythia and 86.49 for P. intermedia, with specificities ranging from 83.78 to 94.59. The optimal copy-counts per mL saliva for identifying periodontitis were 40,000 for P. gingivalis, 700,000 for T. forsythia and 910,000 for P. intermedia. Conclusion: Salivary copy-counts of P. gingivalis, T. forsythia and P. intermedia appear to have the potential to identify the presence of periodontitis, whereas the salivary level of the other test infectious agents may possess little or no diagnostic utility. Longitudinal studies are warranted to determine the ability of salivary copy-counts of major periodontopathic bacteria to predict future periodontal breakdown