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Golestani Rad, L.

Publications and source records attributed to Golestani Rad, L..

6 recordsLinked to original sources

Cumulative Transfer Function for Assessment of MRI-Induced RF Heating Risk in Pediatric Patients Implanted with Bifurcated Leads

PurposeRF-induced heating remains a major barrier to MRI access for patients with epicardial cardiac implantable electronic devices (CIEDs). Although ISO/TS 10974 Tier-3 transfer function (TF) methods are established for unbranched leads, no analogous framework exists for bifurcated leads, in which branch asymmetry and inter-branch coupling may substantially alter heating. We developed and validated a cumulative transfer function (cTF) framework to address this gap. MethodsFollowing ISO/TS 10974 Tier-3 formalism, we measured, calibrated, and validated cTFs for a commercial 35 cm bipolar epicardial lead at 1.5 T. The framework explicitly accounts for branch-specific response and cross-branch coupling. Validation was performed with 24 canonical lead configurations in a homogeneous phantom and, without recalibration, in a heterogeneous anthropomorphic pediatric phantom with clinically derived trajectories. A single-branch TF approximation served as a comparator. The validated cTF was applied to predict RF heating across adult and pediatric human models at multiple imaging landmarks. ResultsCompared with the single-branch TF approximation, the cTF reduced prediction error by nearly 70% in the primary validation dataset. In secondary validation, the cTF maintained low error across clinically relevant trajectories and imaging landmarks. In human models, the framework revealed marked anatomy- and landmark-dependent variation in predicted heating for the tested 35 cm lead, with low predicted heating in pediatric models and substantially higher heating in selected adult chest and upper abdominal imaging scenarios. ConclusionThe cTF provides a validated framework for RF-heating assessment of bifurcated leads and substantially improves prediction accuracy over single-branch TF approximations that neglect branch coupling.

bioengineering↗

RF Heating of Bipolar Epicardial Implants during MRI at 0.55 T and 1.5T: Effect of Device Length and Termination Conditions

Pediatric patients with epicardial cardiac implantable electronic devices (CIEDs) are frequently excluded from the Magnetic Resonance Imaging (MRI) primarily due to RF heating safety concerns. In this study we evaluate RF heating of two bipolar epicardial leads during MRI at 0.55 T and 1.5 T under different termination conditions. Our findings showed that the mean RF heating was significantly reduced at 0.55 T MRI compared to that at 1.5 T. Similarly, the RF heating at 0.55 T MRI was highest for full system whereas, during MRI at 1.5 T, the RF heating was highest for the capped abandoned lead, showing dependence of RF heating pattern on MRI field strength. While RF heating at both fields surpassed the safety limit, the capped abandoned leads at 1.5 T MRI showed significantly higher RF heating with temperature rise surpassing 50{degrees}C in some of the cases. These results highlight the difference in RF heating of bipolar epicardial leads compared to the previously reported findings for monopolar epicardial lead which showed smallest heating for capped abandoned lead at both field strengths. These findings emphasize the necessity of device-specific evaluations at each field-strength to inform clinical decision-making and expand MRI access for this vulnerable population.

biophysics↗

Experimental Validation of Finite Element Models for Directional DBS: The Critical Role of Boundary Conditions on VTA Accuracy

ObjectiveComputational models and visualization toolboxes for Deep Brain Stimulation (DBS) increasingly rely on pre-computed electric field libraries to estimate the Volume of Tissue Activated (VTA). However, the boundary conditions (BCs) and source models used to generate these fields vary widely across studies, and there is currently no experimental consensus regarding which parameters most accurately reflect the physical device output. The objective of this study was to experimentally validate the electric potential distribution of directional DBS leads in order to determine the optimal Finite Element Method (FEM) configuration. ApproachThe voltage distribution surrounding a Boston Scientific Vercise Gevia directional lead was mapped in a saline phantom using a custom high-precision robotic scanning system. Experimental measurements were compared against six FEM configurations that varied in source formulation (Dirichlet vs. Neumann boundary conditions) and ground definitions. For each configuration, the resulting VTA volume was computed to assess the clinical impact of modeling assumptions. ResultsThe FEM configuration implementing a Dirichlet (voltage) boundary condition on the active contact with a grounded implantable pulse generator (IPG) surface demonstrated the highest accuracy, achieving a Symmetric Mean Absolute Percent Error (SMAPE) of less than 9% across all contact levels. In contrast, conventional current-controlled simulations employing Neumann boundary conditions with disparate ground definitions substantially overestimated electric field spread. Suboptimal boundary condition selection resulted in an approximate 67% overestimation of VTA volume (137 mm3 vs. 82 mm3) relative to the experimentally validated model. SignificanceAlthough clinical DBS systems operate as current sources, standard Neumann (current density) boundary conditions do not adequately represent the equipotential behavior of the electrode-tissue interface, resulting in nearly a two-fold error in predicted VTA volume. To improve the validity of predictive clinical models, we recommend the use of Dirichlet boundary conditions derived from the device operating impedance (V = Itarget x Zmeasured) rather than conventional current density specifications.

bioengineering↗

Application of Surgical Lead Management and Reconfigurable Coil Technology to Reduce RF Heating of DBS Implants during MRI at 3T Under Variant Body Compositions

Patients with active implants such as deep brain stimulation (DBS) devices, have limited access to magnetic resonance imaging (MRI) due to risks of RF heating. With an aging population, the prevalence of neurodegenerative and vascular disease increases; and so does the indication for MRI exams in patients with such implants. In response to this growing need for MRI, many groups have investigated strategies to mitigate the RF heating of the implants. These efforts, however, have relied either on simulations with homogenous body models or simplified phantom experiments (box shaped phantom with single tissue). It is well established, however, that the shape and heterogeneity of human body affects the distribution of MRI electric fields, which by proxy, alters the RF heating of an implant inside the body. In this contribution, we applied numerical simulations and phantom experiments to examine the effectiveness of RF heating mitigation strategies under variant patient body compositions, focusing on two recently proposed techniques: (a) surgical modification of DBS lead trajectories inside the body, and (b) use of a patient-adjustable reconfigurable MRI coil, both aiming to reduce the coupling of implanted leads and MRI electric fields. Our results demonstrated that both techniques perform well under variant body compositions.Competing Interest StatementThe authors have declared no competing interest.View Full Text

bioengineering↗

The effect of device configuration and patient body composition on image artifact and RF heating of deep brain stimulation devices during MRI at 1.5T and 3T

BACKGROUNDPatients with deep brain stimulation (DBS) implants have limited access to MRI due to safety concerns associated with RF-induced heating. Currently, MRI in these patients is allowed only in 1.5T horizontal scanners and with pulse sequences with reduced power. Nevertheless, off-label use of MRI at 3T is increasingly reported based on limited safety assessments. Here we present results of systematic RF heating measurements for two commercially available DBS systems during MRI at 1.5T and 3T. PURPOSETo assess the effect of imaging landmark, DBS lead configuration, and patient body composition on RF heating of DBS leads during MRI at 1.5 T and 3T. STUDY TYPEPhantom study. POPULATION/SUBJECTS/PHANTOM/SPECIMEN/ANIMAL MODELGel phantoms and cadaver brain. FIELD STRENGTH/SEQUENCE1.5T and 3T, T1-weighted turbo spin echo. ASSESSMENTRF heating was measured at tips of DBS leads implanted in brain-mimicking gel. STATISTICAL TESTSNone. RESULTSWe observed substantial fluctuation in RF heating mainly affected by phantom composition and DBS lead configuration, ranging from 0.14{degrees}C to 23.73{degrees}C at 1.5 T, and from 0.10{degrees}C to 7.39{degrees}C at 3T. The presence of subcutaneous fat substantially altered RF heating at electrode tips (-3.06{degrees}C < {Delta}T < 19.05{degrees}C). Introducing concentric loops in the extracranial portion of the lead at the surgical burr hole reduced RF heating by up to 89% at 1.5T and up to 98% at 3T compared to worst case heating scenarios. DATA CONCLUSIONDevice configuration and patient body composition significantly altered the RF heating of DBS leads during MRI at 1.5T and 3T. Interestingly, certain lead trajectories consistently reduced RF heating and image artifact over different imaging landmarks, RF frequencies, and phantom compositions. Such trajectories could be implemented in patients with minimal disruption to the surgical workflow.

bioengineering↗

RF heating of deep brain stimulation implants in open-bore vertical MRI systems

PurposePatients with deep brain stimulation (DBS) implants highly benefit from MRI, however access to MRI is restricted for these patients due to safety hazards associated with RF heating of the implant. To date, all MRI studies on RF heating of medical implants have been performed in horizontal closed-bore systems. Vertical MRI scanners have a fundamentally different distribution of electric and magnetic fields and are now available at 1.2T, capable of high-resolution structural and functional MRI. This work presents the first simulation study of RF heating of DBS implants in high-field vertical scanners.\n\nMethodsWe performed finite element electromagnetic simulations to calculate SAR at tips of DBS leads during MRI in a commercially available 1.2 T vertical coil compared to a 1.5 T horizontal scanner. Both isolated leads and fully implanted systems were included.\n\nResultsWe found 10-30-fold reduction in SAR implication at tips of isolated DBS leads, and up to 19-fold SAR reduction at tips of leads in fully implanted systems in vertical coils compared to horizontal birdcage coils.\n\nConclusionsIf confirmed in larger patient cohorts and verified experimentally, this result can open the door to plethora of structural and functional MRI applications to guide, interpret, and advance DBS therapy.

biophysics↗