Leonardo M. Angelone

Specific absorption rate studies of the parallel transmission of inner‐volume excitations at 7T

To investigate the behavior of whole‐head and local specific absorption rate (SAR) as a function of trajectory acceleration factor and target excitation pattern due to the parallel transmission (pTX) of spatially tailored excitations at 7T.

MIDA: A Multimodal Imaging-Based Detailed Anatomical Model of the Human Head and Neck

Computational modeling and simulations are increasingly being used to complement experimental testing for analysis of safety and efficacy of medical devices. Multiple voxel- and surface-based whole- and partial-body models have been proposed in the literature, typically with spatial resolution in the range of 1–2 mm and with 10–50 different tissue types resolved. We have developed a multimodal imaging-based detailed anatomical model of the human head and neck, named “MIDA”. The model was obtained by integrating three different magnetic resonance imaging (MRI) modalities, the parameters of which were tailored to enhance the signals of specific tissues: i) structural T1- and T2-weighted MRIs; a specific heavily T2-weighted MRI slab with high nerve contrast optimized to enhance the structures of the ear and eye; ii) magnetic resonance angiography (MRA) data to image the vasculature, and iii) diffusion tensor imaging (DTI) to obtain information on anisotropy and fiber orientation. The unique multimodal high-resolution approach allowed resolving 153 structures, including several distinct muscles, bones and skull layers, arteries and veins, nerves, as well as salivary glands. The model offers also a detailed characterization of eyes, ears, and deep brain structures. A special automatic atlas-based segmentation procedure was adopted to include a detailed map of the nuclei of the thalamus and midbrain into the head model. The suitability of the model to simulations involving different numerical methods, discretization approaches, as well as DTI-based tensorial electrical conductivity, was examined in a case-study, in which the electric field was generated by transcranial alternating current stimulation. The voxel- and the surface-based versions of the models are freely available to the scientific community.

Analysis of the Role of Lead Resistivity in Specific Absorption Rate for Deep Brain Stimulator Leads at 3T MRI

Magnetic resonance imaging (MRI) on patients with implanted deep brain stimulators (DBSs) can be hazardous because of the antenna-effect of leads exposed to the incident radio-frequency field. This study evaluated electromagnetic field and specific absorption rate (SAR) changes as a function of lead resistivity on an anatomically precise head model in a 3T system. The anatomical accuracy of our head model allowed for detailed modeling of the path of DBS leads between epidermis and the outer table. Our electromagnetic finite difference time domain (FDTD) analysis showed significant changes of 1 g and 10 g averaged SAR for the range of lead resistivity modeled, including highly conductive leads up to highly resistive leads. Antenna performance and whole-head SAR were sensitive to the presence of the DBS leads only within 10%, while changes of over one order of magnitude were observed for the peak 10 g averaged SAR, suggesting that local SAR values should be considered in DBS guidelines. With ¿lead = ¿copper , and the MRI coil driven to produce a whole-head SAR without leads of 3.2 W/kg, the 1 g averaged SAR was 1080 W/kg and the 10 g averaged SAR 120 W/kg at the tip of the DBS lead. Conversely, in the control case without leads, the 1 g and 10 g averaged SAR were 0.5 W/kg and 0.6 W/kg, respectively, in the same location. The SAR at the tip of lead was similar with electrically homogeneous and electrically heterogeneous models. Our results show that computational models can support the development of novel lead technology, properly balancing the requirements of SAR deposition at the tip of the lead and power dissipation of the system battery.

A Novel Brain Stimulation Technology Provides Compatibility with MRI

Clinical electrical stimulation systems — such as pacemakers and deep brain stimulators (DBS) — are an increasingly common therapeutic option to treat a large range of medical conditions. Despite their remarkable success, one of the significant limitations of these medical devices is the limited compatibility with magnetic resonance imaging (MRI), a standard diagnostic tool in medicine. During an MRI exam, the leads used with these devices, implanted in the body of the patient, act as an electric antenna potentially causing a large amount of energy to be absorbed in the tissue, which can lead to serious heat-related injury. This study presents a novel lead design that reduces the antenna effect and allows for decreased tissue heating during MRI. The optimal parameters of the wire design were determined by a combination of computational modeling and experimental measurements. The results of these simulations were used to build a prototype, which was tested in a gel phantom during an MRI scan. Measurement results showed a three-fold decrease in heating when compared to a commercially available DBS lead. Accordingly, the proposed design may allow a significantly increased number of patients with medical implants to have safe access to the diagnostic benefits of MRI.

Feasibility of using linearly polarized rotating birdcage transmitters and close-fitting receive arrays in MRI to reduce SAR in the vicinity of deep brain simulation implants

MRI of patients with deep brain stimulation (DBS) implants is strictly limited due to safety concerns, including high levels of local specific absorption rate (SAR) of radiofrequency (RF) fields near the implant and related RF‐induced heating. This study demonstrates the feasibility of using a rotating linearly polarized birdcage transmitter and a 32‐channel close‐fit receive array to significantly reduce local SAR in MRI of DBS patients.

Assessing the Electromagnetic Fields Generated By a Radiofrequency MRI Body Coil at 64 MHz: Defeaturing Versus Accuracy

Goal: This study aims at a systematic assessment of five computational models of a birdcage coil for magnetic resonance imaging (MRI) with respect to accuracy and computational cost. Methods: The models were implemented using the same geometrical model and numerical algorithm, but different driving methods (i.e., coil “defeaturing”). The defeatured models were labeled as: specific (S2), generic (G32, G16), and hybrid (H16, H16fr-forced). The accuracy of the models was evaluated using the “symmetric mean absolute percentage error” (“SMAPE”), by comparison with measurements in terms of frequency response, as well as electric (||E⃗||) and magnetic (||B⃗||) field magnitude. Results: All the models computed the ||B⃗|| within 35% of the measurements, only the S2, G32, and H16 were able to accurately model the ||E⃗|| inside the phantom with a maximum SMAPE of 16%. Outside the phantom, only the S2 showed a SMAPE lower than 11%. Conclusions: Results showed that assessing the accuracy of ||B⃗|| based only on comparison along the central longitudinal line of the coil can be misleading. Generic or hybrid coils - when properly modeling the currents along the rings/rungs - were sufficient to accurately reproduce the fields inside a phantom while a specific model was needed to accurately model ||E⃗|| in the space between coil and phantom. Significance: Computational modeling of birdcage body coils is extensively used in the evaluation of radiofrequency-induced heating during MRI. Experimental validation of numerical models is needed to determine if a model is an accurate representation of a physical coil.

Construction and modeling of a reconfigurable MRI coil for lowering SAR in patients with deep brain stimulation implants

ABSTRACT Post‐operative MRI of patients with deep brain simulation (DBS) implants is useful to assess complications and diagnose comorbidities, however more than one third of medical centers do not perform MRIs on this patient population due to stringent safety restrictions and liability risks. A new system of reconfigurable magnetic resonance imaging head coil composed of a rotatable linearly‐polarized birdcage transmitter and a close‐fitting 32‐channel receive array is presented for low‐SAR imaging of patients with DBS implants. The novel system works by generating a region with low electric field magnitude and steering it to coincide with the DBS lead trajectory. We demonstrate that the new coil system substantially reduces the SAR amplification around DBS electrodes compared to commercially available circularly polarized coils in a cohort of 9 patient‐derived realistic DBS lead trajectories. We also show that the optimal coil configuration can be reliably identified from the image artifact on B1+ field maps. Our preliminary results suggest that such a system may provide a viable solution for high‐resolution imaging of DBS patients in the future. More data is needed to quantify safety limits and recommend imaging protocols before the novel coil system can be used on patients with DBS implants.

Local SAR near deep brain stimulation (DBS) electrodes at 64 and 127 MHz: A simulation study of the effect of extracranial loops

MRI may cause brain tissue around deep brain stimulation (DBS) electrodes to become excessively hot, causing lesions. The presence of extracranial loops in the DBS lead trajectory has been shown to affect the specific absorption rate (SAR) of the radiofrequency energy at the electrode tip, but experimental studies have reported controversial results. The goal of this study was to perform a systematic numerical study to provide a better understanding of the effects of extracranial loops in DBS leads on the local SAR during MRI at 64 and 127 MHz.

MRI-Based Multiscale Model for Electromagnetic Analysis in the Human Head with Implanted DBS

Deep brain stimulation (DBS) is an established procedure for the treatment of movement and affective disorders. Patients with DBS may benefit from magnetic resonance imaging (MRI) to evaluate injuries or comorbidities. However, the MRI radio-frequency (RF) energy may cause excessive tissue heating particularly near the electrode. This paper studies how the accuracy of numerical modeling of the RF field inside a DBS patient varies with spatial resolution and corresponding anatomical detail of the volume surrounding the electrodes. A multiscale model (MS) was created by an atlas-based segmentation using a 1 mm3 head model (mRes) refined in the basal ganglia by a 200 μm2 ex-vivo dataset. Four DBS electrodes targeting the left globus pallidus internus were modeled. Electromagnetic simulations at 128 MHz showed that the peak of the electric field of the MS doubled (18.7 kV/m versus 9.33 kV/m) and shifted 6.4 mm compared to the mRes model. Additionally, the MS had a sixfold increase over the mRes model in peak-specific absorption rate (SAR of 43.9 kW/kg versus 7 kW/kg). The results suggest that submillimetric resolution and improved anatomical detail in the model may increase the accuracy of computed electric field and local SAR around the tip of the implant.

Investigation of assumptions underlying current safety guidelines on EM-induced nerve stimulation

An intricate network of a variety of nerves is embedded within the complex anatomy of the human body. Although nerves are shielded from unwanted excitation, they can still be stimulated by external electromagnetic sources that induce strongly non-uniform field distributions. Current exposure safety standards designed to limit unwanted nerve stimulation are based on a series of explicit and implicit assumptions and simplifications. This paper demonstrates the applicability of functionalized anatomical phantoms with integrated coupled electromagnetic and neuronal dynamics solvers for investigating the impact of magnetic resonance exposure on nerve excitation within the full complexity of the human anatomy. The impact of neuronal dynamics models, temperature and local hot-spots, nerve trajectory and potential smoothing, anatomical inhomogeneity, and pulse duration on nerve stimulation was evaluated. As a result, multiple assumptions underlying current safety standards are questioned. It is demonstrated that coupled EM-neuronal dynamics modeling involving realistic anatomies is valuable to establish conservative safety criteria.