Optimized, Minimal Specific Absorption Rate MRI for High-Resolution Imaging in Patients with Implanted Deep Brain...

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Deep brain stimulator (DBS) implantation presents challenges for high-resolution brain MRI due to safety concerns.
• Previous concerns have limited MRI use in patients with implanted DBS devices.

Purpose of the Study:

• To present a practical clinical protocol for obtaining high-resolution brain MRI in patients with existing DBS implants.
• To demonstrate the feasibility of achieving presurgical quality imaging for staged DBS insertion.

Main Methods:

• Optimized a 1.5T MRI protocol to minimize specific absorption rate (SAR) while maintaining image quality for surgical planning.
• Reviewed 29 patients with DBS implants who underwent MRI between 2012 and 2015.
• Assessed image quality and artifacts qualitatively by a neuroradiologist and functional neurosurgeon.

Main Results:

• Twenty-nine patients (Parkinson disease, dystonia, essential tremor) with DBS implants were successfully imaged.
• No adverse events occurred during or after MRI scans.
• Mild susceptibility artifacts were present but did not compromise overall image quality; all preoperative studies were adequate for guiding second DBS electrode placement.

Conclusions:

• An optimized, low-SAR MR imaging protocol can safely acquire high-quality brain images in patients with DBS.
• These images are sufficient for guiding subsequent deep brain stimulator placement.
• This protocol addresses a significant challenge in neuroimaging for patients with neuromodulation devices.