Modifying the trajectory of epicardial leads can substantially reduce MRI-induced RF heating in pediatric patients with a cardiac implantable electronic device at 1.5T
© 2023 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine..
PURPOSE: After epicardial cardiac implantable electronic devices are implanted in pediatric patients, they become ineligible to receive MRI exams due to an elevated risk of RF heating. We investigated whether simple modifications in the trajectories of epicardial leads could substantially and reliably reduce RF heating during MRI at 1.5 T, with benefits extending to abandoned leads.
METHODS: Electromagnetic simulations were performed to assess RF heating of two common 35-cm epicardial lead trajectories exhibiting different degrees of coupling with MRI incident electric fields. Experiments in anthropomorphic phantoms implanted with commercial cardiac implantable electronic devices confirmed the findings. Both electromagnetic simulations and experimental measurements were performed using head-first and feet-first positioning and various landmarks. Transfer function approach was used to assess the performance of suggested modifications in realistic body models.
RESULTS: Simulations (head-first, chest landmark) of a 35-cm epicardial lead with a trajectory where the excess length of the lead was looped and placed on the inferior surface of the heart showed an 87-fold reduction in the 0.1 g-averaged specific absorption rate compared with the lead where the excess length was looped on the anterior surface. Repeated experiments with a commercial epicardial device confirmed this. For fully implanted systems following low-specific absorption rate trajectories, there was a 16-fold reduction in the average temperature rise and a 28-fold reduction for abandoned leads. The transfer function method predicted a 7-fold reduction in the RF heating in 336 realistic scenarios.
CONCLUSION: Surgical modification of epicardial lead trajectory can substantially reduce RF heating at 1.5 T, with benefits extending to abandoned leads.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:90 |
|---|---|
| Enthalten in: |
Magnetic resonance in medicine - 90(2023), 6 vom: 01. Dez., Seite 2510-2523 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Jiang, Fuchang [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cardiovascular implantable electronic devices |
|---|
| Anmerkungen: |
Date Completed 02.10.2023 Date Revised 16.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/mrm.29776 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM360259464 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM360259464 | ||
| 003 | DE-627 | ||
| 005 | 20240216232608.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/mrm.29776 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1295.xml |
| 035 | |a (DE-627)NLM360259464 | ||
| 035 | |a (NLM)37526134 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Jiang, Fuchang |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Modifying the trajectory of epicardial leads can substantially reduce MRI-induced RF heating in pediatric patients with a cardiac implantable electronic device at 1.5T |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.10.2023 | ||
| 500 | |a Date Revised 16.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine. | ||
| 520 | |a PURPOSE: After epicardial cardiac implantable electronic devices are implanted in pediatric patients, they become ineligible to receive MRI exams due to an elevated risk of RF heating. We investigated whether simple modifications in the trajectories of epicardial leads could substantially and reliably reduce RF heating during MRI at 1.5 T, with benefits extending to abandoned leads | ||
| 520 | |a METHODS: Electromagnetic simulations were performed to assess RF heating of two common 35-cm epicardial lead trajectories exhibiting different degrees of coupling with MRI incident electric fields. Experiments in anthropomorphic phantoms implanted with commercial cardiac implantable electronic devices confirmed the findings. Both electromagnetic simulations and experimental measurements were performed using head-first and feet-first positioning and various landmarks. Transfer function approach was used to assess the performance of suggested modifications in realistic body models | ||
| 520 | |a RESULTS: Simulations (head-first, chest landmark) of a 35-cm epicardial lead with a trajectory where the excess length of the lead was looped and placed on the inferior surface of the heart showed an 87-fold reduction in the 0.1 g-averaged specific absorption rate compared with the lead where the excess length was looped on the anterior surface. Repeated experiments with a commercial epicardial device confirmed this. For fully implanted systems following low-specific absorption rate trajectories, there was a 16-fold reduction in the average temperature rise and a 28-fold reduction for abandoned leads. The transfer function method predicted a 7-fold reduction in the RF heating in 336 realistic scenarios | ||
| 520 | |a CONCLUSION: Surgical modification of epicardial lead trajectory can substantially reduce RF heating at 1.5 T, with benefits extending to abandoned leads | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a RF heating | |
| 650 | 4 | |a cardiovascular implantable electronic devices | |
| 650 | 4 | |a epicardial leads | |
| 650 | 4 | |a safety | |
| 700 | 1 | |a Bhusal, Bhumi |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Bach |e verfasserin |4 aut | |
| 700 | 1 | |a Monge, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Webster, Gregory |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Bonmassar, Giorgio |e verfasserin |4 aut | |
| 700 | 1 | |a Popsecu, Andrada R |e verfasserin |4 aut | |
| 700 | 1 | |a Golestanirad, Laleh |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Magnetic resonance in medicine |d 1993 |g 90(2023), 6 vom: 01. Dez., Seite 2510-2523 |w (DE-627)NLM01259413X |x 1522-2594 |7 nnns |
| 773 | 1 | 8 | |g volume:90 |g year:2023 |g number:6 |g day:01 |g month:12 |g pages:2510-2523 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/mrm.29776 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 90 |j 2023 |e 6 |b 01 |c 12 |h 2510-2523 | ||