RF-induced heating of capped and uncapped abandoned epicardial leads during MRI at 1.5 T and 3 T.

There is a paucity of data regarding the safety of magnetic resonance imaging (MRI) in patients with abandoned epicardial leads. Few studies have reported temperature rises up to 76 °C during MRI at 1.5 T in gel phantoms implanted with epicardial leads; however, lead trajectories used in these experiments were not clinically relevant. This work reports patient-specific RF heating of both capped and uncapped abandoned epicardial lead configurations during MRI at both 1.5 T and 3 T field strengths. We found that leads routed along realistic, patient-derived trajectories generated substantially lower RF heating than the previously reported worst-case phantom experiments. We also found that MRI at the head imaging landmark leads to substantially lower RF heating compared to MRI at the chest or abdomen landmarks at both 1.5 T and 3 T. Our results suggest that patients with abandoned epicardial leads may safely undergo MRI for head imaging, but caution is warranted during chest and abdominal imaging.Clinical Relevance- Patients with abandoned epicardial leads may safely undergo MRI for head imaging, but caution is warranted during chest and abdominal imaging.

Numerical Simulation and Experimental Studies of a Ribbon Coil for Trans Spinal Magnetic Stimulation (TSMS) in Rats.

We propose a non-invasive Trans Spinal Magnetic Stimulation (TSMS) coil allowing for focal stimulation. The device is based on a new figure-8 ribbon design, ensuring low R0, and low heating. The two coils were designed and studied using the finite element method (FEM) coupled with NEURON and tested for efficacy on rats. The numerical simulations confirmed the generation of the observed action potentials when the coil was driven with 2.8kA.Clinical Relevance- Chronic neuropathic back and leg pain is one of the main indications for spinal cord stimulation in the United States. Chronic low back pain is one of the most common reasons patients seek medical care, and in 2013 resulted in 87.6 billion dollars in healthcare costs in the USA. Patients would most likely prefer a low-risk, non-invasive procedure, such as TSMS, to surgery with a significant rate of complications.

Multi-Segment Leads To Reduce RF Heating in MRI: A Computational Evaluation at 1.5T and 3T.

Implanted neurostimulators are currently in widespread use and allow patients to receive therapeutic nerve stimulation for a variety of conditions. Such devices often make use of long leads extending from the device to the relevant nerve to deliver their stimulation. These leads carry a significant radiofrequency (RF) safety concern for patients who also receive magnetic resonance imaging (MRI) scans. The incident RF energy from the MRI body coil can couple with the lead and produce dangerous levels of heating at the tip of the lead during a scan. Recent studies have shown one useful approach to mitigate this heating is to vary the conductivity of the wire along its length to decrease the coupling of the incoming RF energy from the MRI coil with the long lead. In this study, we adopt a similar approach and extend it by segmenting a long cylindrical lead model into two sections of differing conductivities and assessing the maximum 1g specific absorption rate (SAR) at the lead tip at both 64 MHz and 127 MHz. We also evaluated the effect of insulation thickness as well as conductivity of the phantom on the maximum 1g SAR. An 11-fold reduction in the SAR was achieved when using high conductivity ratios between the two wire segments for the 127 MHz coil and a 2-fold reduction was seen for the 64 MHz coil.Clinical relevance- Design of an implantable segmented lead has potential to mitigate RF heating concerns and open a wider patient population to both 1.5T and 3T MRI scans.

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.

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.

The MotoNet: A 3 Tesla MRI-Conditional EEG Net with Embedded Motion Sensors.

We introduce a new electroencephalogram (EEG) net, which will allow clinicians to monitor EEG while tracking head motion. Motion during MRI limits patient scans, especially of children with epilepsy. EEG is also severely affected by motion-induced noise, predominantly ballistocardiogram (BCG) noise due to the heartbeat. METHODS: The MotoNet was built using polymer thick film (PTF) EEG leads and motion sensors on opposite sides in the same flex circuit. EEG/motion measurements were made with a standard commercial EEG acquisition system in a 3 Tesla (T) MRI. A Kalman filtering-based BCG correction tool was used to clean the EEG in healthy volunteers. RESULTS: MRI safety studies in 3 T confirmed the maximum heating below 1 °C. Using an MRI sequence with spatial localization gradients only, the position of the head was linearly correlated with the average motion sensor output. Kalman filtering was shown to reduce the BCG noise and recover artifact-clean EEG. CONCLUSIONS: The MotoNet is an innovative EEG net design that co-locates 32 EEG electrodes with 32 motion sensors to improve both EEG and MRI signal quality. In combination with custom gradients, the position of the net can, in principle, be determined. In addition, the motion sensors can help reduce BCG noise.

Aluminum Thin Film Nanostructure Traces in Pediatric EEG Net for MRI and CT Artifact Reduction.

Magnetic resonance imaging (MRI) and continuous electroencephalogram (EEG) monitoring are essential in the clinical management of neonatal seizures. EEG electrodes, however, can significantly degrade the image quality of both MRI and CT due to substantial metallic artifacts and distortions. Thus, we developed a novel thin film trace EEG net ("NeoNet") for improved MRI and CT image quality without compromising the EEG signal quality. The aluminum thin film traces were fabricated with an ultra-high-aspect ratio (up to 17,000:1, with dimensions 30 nm × 50.8 cm × 100 µm), resulting in a low density for reducing CT artifacts and a low conductivity for reducing MRI artifacts. We also used numerical simulation to investigate the effects of EEG nets on the B1 transmit field distortion in 3 T MRI. Specifically, the simulations predicted a 65% and 138% B1 transmit field distortion higher for the commercially available copper-based EEG net ("CuNet", with and without current limiting resistors, respectively) than with NeoNet. Additionally, two board-certified neuroradiologists, blinded to the presence or absence of NeoNet, compared the image quality of MRI images obtained in an adult and two children with and without the NeoNet device and found no significant difference in the degree of artifact or image distortion. Additionally, the use of NeoNet did not cause either: (i) CT scan artifacts or (ii) impact the quality of EEG recording. Finally, MRI safety testing confirmed a maximum temperature rise associated with the NeoNet device in a child head-phantom to be 0.84 °C after 30 min of high-power scanning, which is within the acceptance criteria for the temperature for 1 h of normal operating mode scanning as per the FDA guidelines. Therefore, the proposed NeoNet device has the potential to allow for concurrent EEG acquisition and MRI or CT scanning without significant image artifacts, facilitating clinical care and EEG/fMRI pediatric research.

A high-resolution pediatric female whole-body numerical model with comparison to a male model.

Objective. Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.Approach. We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.Main results. We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7 T MRI.Significance. This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.

A study of flex miniaturized coils for focal nerve magnetic stimulation.

BACKGROUND: Peripheral magnetic stimulation (PMS) is emerging as a complement to standard electrical stimulation (ES) of the peripheral nervous system (PNS). PMS may stimulate sensory and motor nerve fibers without the discomfort associated with the ES used for standard nerve conduction studies. The PMS coils are the same ones used in transcranial magnetic stimulation (TMS) and lack focality and selectiveness in the stimulation. PURPOSE: This study presents a novel coil for PMS, developed using Flexible technologies, and characterized by reduced dimensions for a precise and controlled targeting of peripheral nerves. METHODS: We performed hybrid electromagnetic (EM) and electrophysiological simulations to study the EM exposure induced by a novel miniaturized coil (or mcoil) in and around the radial nerve of the neuro-functionalized virtual human body model Yoon-Sun, and to estimate the current threshold to induce magnetic stimulation (MS) of the radial nerve. Eleven healthy subjects were studied with the mcoil, which consisted of two 15 mm diameter coils in a figure-of-eight configuration, each with a hundred turns of a 25 µm copper-clad four-layer foil. Sensory nerve action potentials (SNAPs) were measured in each subject using two electrodes and compared with those obtained from standard ES. The SNAPs conduction velocities were estimated as a performance metric. RESULTS: The induced electric field was estimated numerically to peak at a maximum intensity of 39 V/m underneath the mcoil fed by 70 A currents. In such conditions, the electrophysiological simulations suggested that the mcoil elicits SNAPs originating at 7 mm from the center of the mcoil. Furthermore, the numerically estimated latencies and waveforms agreed with those obtained during the PMS experiments on healthy subjects, confirming the ability of the mcoil to stimulate the radial nerve sensory fibers. CONCLUSION: Hybrid EM-electrophysiological simulations assisted the development of a miniaturized coil with a small diameter and a high number of turns using flexible electronics. The numerical dosimetric analysis predicted the threshold current amplitudes required for a suprathreshold peripheral nerve sensory stimulation, which was experimentally confirmed. The developed and now validated computational pipeline will be used to improve the performances (e.g., focality and minimal currents) of new generations of mcoil designs.

Short-pulsed micro-magnetic stimulation of the vagus nerve.

Vagus nerve stimulation (VNS) is commonly used to treat drug-resistant epilepsy and depression. The therapeutic effect of VNS depends on stimulating the afferent vagal fibers. However, the vagus is a mixed nerve containing afferent and efferent fibers, and the stimulation of cardiac efferent fibers during VNS may produce a rare but severe risk of bradyarrhythmia. This side effect is challenging to mitigate since VNS, via electrical stimulation technology used in clinical practice, requires unique electrode design and pulse optimization for selective stimulation of only the afferent fibers. Here we describe a method of VNS using micro-magnetic stimulation (µMS), which may be an alternative technique to induce a focal stimulation, enabling a selective fiber stimulation. Micro-coils were implanted into the cervical vagus nerve in adult male Wistar rats. For comparison, the physiological responses were recorded continuously before, during, and after stimulation with arterial blood pressure (ABP), respiration rate (RR), and heart rate (HR). The electrical VNS caused a decrease in ABP, RR, and HR, whereas µM-VNS only caused a transient reduction in RR. The absence of an HR modulation indicated that µM-VNS might provide an alternative technology to VNS with fewer heart-related side effects, such as bradyarrhythmia. Numerical electromagnetic simulations helped estimate the optimal coil orientation with respect to the nerve to provide information on the electric field's spatial distribution and strength. Furthermore, a transmission emission microscope provided very high-resolution images of the cervical vagus nerve in rats, which identified two different populations of nerve fibers categorized as large and small myelinated fibers.

A comparative study of MRI-induced RF heating in pediatric and adult populations with epicardial and endocardial implantable electronic devices.

Patients with congenital heart defects, inherited arrhythmia syndromes, and congenital disorders of cardiac conduction often receive a cardiac implantable electronic device (CIED). At least 75% of patients with CIEDs will need magnetic resonance imaging (MRI) during their lifetime. In 2011, the US Food and Drug Administration approved the first MR-conditional CIEDs for patients with endocardial systems, in which leads are passed through the vein and affixed to the endocardium. The majority of children, however, receive an epicardial CIED, where leads are directly sewn to the epicardium. Unfortunately, an epicardial CIED is a relative contraindication to MRI due to the unknown risk of RF heating. In this work, we performed anthropomorphic phantom experiments to investigate differences in RF heating between endocardial and epicardial leads in both pediatric and adult-sized phantoms, where adult endocardial CIED was the control. Clinical Relevance-This work provides a quantitative comparison of MRI RF heating of epicardial and endocardial leads in pediatric and adult populations.

The Position and Orientation of the Pulse Generator Affects MRI RF Heating of Epicardial Leads in Children.

Infants and children with congenital heart defects often receive a cardiac implantable electronic device (CIED). Because transvenous access to the heart is difficult in patients with small veins, the majority of young children receive epicardial CIEDs. Unfortunately, however, once an epicardial CIED is placed, patients are no longer eligible to receive magnetic resonance imaging (MRI) exams due to the unknown risk of MRI-induced radiofrequency (RF) heating of the device. Although many studies have assessed the role of device configuration in RF heating of endocardial CIEDs in adults, such case for epicardial devices in pediatric patients is relatively unexplored. In this study, we evaluated the variation in RF heating of an epicardial lead due to changes in the lateral position and orientation of the implantable pulse generator (IPG). We found that changing the orientation and position of the IPG resulted in a five-fold variation in the RF heating at the lead's tip. Maximum heating was observed when the IPG was moved to a left lateral abdominal position of patient, and minimum heating was observed when the IPG was positioned directly under the heart. Clinical Relevance- This study examines the role of device configuration on MRI-induced RF heating of an epicardial CIED in a pediatric phantom. Results could help pediatric cardiac surgeons to modify device implantation to reduce future risks of MRI in patients.

A temporal sequence of thalamic activity unfolds at transitions in behavioral arousal state.

Awakening from sleep reflects a profound transformation in neural activity and behavior. The thalamus is a key controller of arousal state, but whether its diverse nuclei exhibit coordinated or distinct activity at transitions in behavioral arousal state is unknown. Using fast fMRI at ultra-high field (7 Tesla), we measured sub-second activity across thalamocortical networks and within nine thalamic nuclei to delineate these dynamics during spontaneous transitions in behavioral arousal state. We discovered a stereotyped sequence of activity across thalamic nuclei and cingulate cortex that preceded behavioral arousal after a period of inactivity, followed by widespread deactivation. These thalamic dynamics were linked to whether participants subsequently fell back into unresponsiveness, with unified thalamic activation reflecting maintenance of behavior. These results provide an outline of the complex interactions across thalamocortical circuits that orchestrate behavioral arousal state transitions, and additionally, demonstrate that fast fMRI can resolve sub-second subcortical dynamics in the human brain.

A New Phased-Array Magnetic Resonance Imaging Receive-Only Coil for HBO2 Studies.

The paper describes a new magnetic resonance imaging (MRI) phased-array receive-only (Rx) coil for studying decompression sickness and disorders of hyperbaricity, including nitrogen narcosis. Functional magnetic resonance imaging (fMRI) is noninvasive, is considered safe, and may allow studying the brain under hyperbaric conditions. All of the risks associated with simultaneous MRI and HBO2 therapy are described in detail, along with all of the mitigation strategies and regulatory testing. One of the most significant risks for this type of study is a fire in the hyperbaric chamber caused by the sparking of the MRI coils as a result of high-voltage RF arcs. RF pulses at 128 MHz elicit signals from human tissues, and RF sparking occurs commonly and is considered safe in normobaric conditions. We describe how we built a coil for HBO2-MRI studies by modifying an eight-channel phased-array MRI coil with all of the mitigation strategies discussed. The coil was fabricated and tested with a unique testing platform that simulated the worst-case RF field of a three-Tesla MRI in a Hyperlite hyperbaric chamber at 3 atm pressure. The coil was also tested in normobaric conditions for image quality in a 3 T scanner in volunteers and SNR measurement in phantoms. Further studies are necessary to characterize the coil safety in HBO2/MRI.

Numerical estimation of the B1 transmit field distortion in a copper EEG trace comparison with the thin-film based resistive trace "NeoNet".

This study investigates the effects of EEG traces in B1 transmit field distortion in a 3T MRI. EEG is a non-invasive method to monitor brain activities. Although EEG monitors brain activities with a high temporal resolution, it has trouble localizing the signal source. The EEG-fMRI is the multimodal imaging method, but care is needed to use EEG while in MRI as EEG traces create the signal distortion to the MRI. To tackle this problem, resistive traces are developed using thin-film technology to reduce the signal distortion during MRI. Numerical simulation was used to estimate the amount of B1 transmit field distortion of NeoNet and copper-based EEG nets (CuNet - with and without current limiting resistors) compared with the case without EEG net (NoNet). The reduced B1 transmit field distortion is estimated in the case of NeoNet compared to the CuNets. NeoNet is an MR-compatible high-density EEG net designed for pediatric subjects. The proposed NeoNet traces will facilitate/enable such EEG/fMRI pediatric studies with mitigated artifacts, which in turn will help to move the pediatric EEG/fMRI field forward.Clinical Relevance-This study estimates the benefit of the thin-film based EEG net with reduced B1 transmit artifact for the multimodal study of EEG-fMRI. The results are compared with commercial EEG trace made with copper metal with current limiting resistors. It is reported that about 470,000 children are suffering from Epilepsy. The MR-compatible resistive EEG traces se EEG-fMRI has potential to be a valuable tool to help understand pediatric Epilepsy and move the pediatric EEG-fMRI field forward.

Planar figure-8 coils for ultra-focal and directional micromagnetic brain stimulation.

Recently, white-matter fiber tract pathways carrying neural signals through the brain were shown to follow curved, orthogonal grids. This study focuses on how these white-matter fibers may be selectively excited using micromagnetic stimulation (µMS), a new type of neuronal stimulation, which generates microscopic eddy currents capable of directionally activating neurons. One of the most remarkable properties of this novel type of stimulation is that the µMS fields provide unique directional activation of neuronal elements not seen with traditional electrical stimulation. An initial prototype built with SU-8 based photolithography technology shows that the structure can be fabricated. The coil design was optimized through electrical resistance calculations and electric field simulations to elicit the brain's maximal focal and directional neural responses.

Numerical simulation of the radiofrequency safety of 128-channel hd-EEG nets on a 29-month-old whole-body model in a 3 Tesla MRI.

This study investigates the radiofrequency (RF) induced heating in a pediatric whole-body voxel model with a high-density electroencephalogram (hd-EEG) net during magnetic resonance imaging (MRI) at 3 Tesla. A total of three cases were studied: no net (NoNet), a resistive hd-EEG (NeoNet), and a copper (CuNet) net. The maximum values of specific absorption rate averaged over 10g-mass (10gSAR) in the head were calculated with the NeoNet was 12.51 W/kg and in the case of the NoNet was 12.40 W/kg. In contrast, the CuNet case was 17.04 W/Kg. Temperature simulations were conducted to determine the RF-induced heating without and with hd-EEG nets (NeoNet and CuNet) during an MRI scan using an age-corrected and thermoregulated perfusion for the child model. The results showed that the maximum temperature estimated in the child's head was 38.38 °C for the NoNet, 38.43 °C for the NeoNet, and 43.05 °C for the CuNet. In the case of NeoNet, the maximum temperature estimated in the child's head remained compliant with IEC 60601 for the MRI RF safety limit. However, the case of CuNet estimated to exceed the RF safety limit, which may require an appropriate cooling period or a hardware design to suppress the RF-induced heating.

Development, validation, and pilot MRI safety study of a high-resolution, open source, whole body pediatric numerical simulation model.

Numerical body models of children are used for designing medical devices, including but not limited to optical imaging, ultrasound, CT, EEG/MEG, and MRI. These models are used in many clinical and neuroscience research applications, such as radiation safety dosimetric studies and source localization. Although several such adult models have been reported, there are few reports of full-body pediatric models, and those described have several limitations. Some, for example, are either morphed from older children or do not have detailed segmentations. Here, we introduce a 29-month-old male whole-body native numerical model, "MARTIN", that includes 28 head and 86 body tissue compartments, segmented directly from the high spatial resolution MRI and CT images. An advanced auto-segmentation tool was used for the deep-brain structures, whereas 3D Slicer was used to segment the non-brain structures and to refine the segmentation for all of the tissue compartments. Our MARTIN model was developed and validated using three separate approaches, through an iterative process, as follows. First, the calculated volumes, weights, and dimensions of selected structures were adjusted and confirmed to be within 6% of the literature values for the 2-3-year-old age-range. Second, all structural segmentations were adjusted and confirmed by two experienced, sub-specialty certified neuro-radiologists, also through an interactive process. Third, an additional validation was performed with a Bloch simulator to create synthetic MR image from our MARTIN model and compare the image contrast of the resulting synthetic image with that of the original MRI data; this resulted in a "structural resemblance" index of 0.97. Finally, we used our model to perform pilot MRI safety simulations of an Active Implantable Medical Device (AIMD) using a commercially available software platform (Sim4Life), incorporating the latest International Standards Organization guidelines. This model will be made available on the Athinoula A. Martinos Center for Biomedical Imaging website.

MRI-Induced Heating of Coils for Microscopic Magnetic Stimulation at 1.5 Tesla: An Initial Study.

PURPOSE: Deep brain stimulation (DBS) has proved to be effective in the treatment of movement disorders. However, the direct contact between the metal contacts of the DBS electrode and the brain can cause RF heating in magnetic resonance imaging (MRI) scanning, due to an increase of local specific absorption rate (SAR). Recently, micro coils (µMS) have demonstrated excitation of neuronal tissue through the electromagnetic induction both in vitro and in vivo experiments. In contrast to electrical stimulation, in µMS, there is no direct contact between the metal and the biological tissue. METHODS: We compared the heating of a µMS coil with a control case of a metal wire. The heating was induced by RF fields in a 1.5 T MRI head birdcage coil (often used for imaging patients with implants) at 64 MHz, and normalized results to 3.2 W/kg whole head average SAR. RESULTS: The µMS coil or wire implants were placed inside an anatomically accurate head saline-gel filled phantom inserted in the RF coil, and we observed approximately 1°C initial temperature rise at the µMS coil, while the wire exhibited a 10°C temperature rise in the proximity of the exposed end. The numerical simulations showed a 32-times increase of local SAR induced at the tips of the metal wire compared to the µMS. CONCLUSION: In this work, we show with measurements and electromagnetic numerical simulations that the RF-induced increase in local SAR and induced heating during MRI scanning can be greatly reduced by using magnetic stimulation with the proposed µMS technology.

Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep.

Sleep is essential for both cognition and maintenance of healthy brain function. Slow waves in neural activity contribute to memory consolidation, whereas cerebrospinal fluid (CSF) clears metabolic waste products from the brain. Whether these two processes are related is not known. We used accelerated neuroimaging to measure physiological and neural dynamics in the human brain. We discovered a coherent pattern of oscillating electrophysiological, hemodynamic, and CSF dynamics that appears during non-rapid eye movement sleep. Neural slow waves are followed by hemodynamic oscillations, which in turn are coupled to CSF flow. These results demonstrate that the sleeping brain exhibits waves of CSF flow on a macroscopic scale, and these CSF dynamics are interlinked with neural and hemodynamic rhythms.

Reducing RF-induced Heating near Implanted Leads through High-Dielectric Capacitive Bleeding of Current (CBLOC).

Patients with implanted medical devices such as deep brain stimulation or spinal cord stimulation are often unable to receive magnetic resonance imaging (MRI). This is because once the device is within the radiofrequency (RF) field of the MRI scanner, electrically conductive leads act as antenna, amplifying the RF energy deposition in the tissue and causing possible excessive tissue heating. Here we propose a novel concept in lead design in which 40cm lead wires are coated with a ~1.2mm layer of high dielectric constant material (155 < ε r < 250) embedded in a weakly conductive insulation (σ = 20S/m). The technique called High-Dielectric Capacitive Bleeding of Current, or CBLOC, works by forming a distributed capacitance along the lengths of the lead, efficiently dissipating RF energy before it reaches the exposed tip. Measurements during RF exposure at 64 MHz and 123 MHz demonstrated that CBLOC leads generated 20-fold less heating at 1.5 T, and 40-fold less heating at 3 T compared to control leads. Numerical simulations of RF exposure at 297 MHz (7T) predicted a 15-fold reduction in specific absorption rate (SAR) of RF energy around the tip of CBLOC leads compared to control leads.