Wireless control of induced radiofrequency currents in active implantable medical devices during MRI.

PURPOSE: To introduce a prototype active implantable medical device (AIMD) for which the induced radiofrequency currents can be controlled wirelessly. METHODS: The modified transmission line method is used to formulate how the lead-case impedance of an AIMD affects the temperature rise around the electrode. A prototype AIMD is designed with the aim of controlling the unwanted temperature rise around its electrode during an MRI examination by altering the impedance between the lead and the case of the implant. MRI experiments were conducted with this prototype implant, which also has a built-in temperature sensor at its electrode. During the experiment, the implant's lead-case impedance was controlled using Bluetooth communication with a remote computer, and the lead tip temperature was recorded. RESULTS: Ten different lead-case impedance values and their corresponding tip temperature rises were examined during MRI experiments. The experimental results confirmed that the tip temperature rise can be controlled by varying the lead-case impedance wirelessly. CONCLUSION: The feedback from the temperature at the AIMD tip, together with variable lead-case impedance, enables control of the safety profile of the AIMD during an MRI examination.

A temperature sensor implant for active implantable medical devices for in vivo subacute heating tests under MRI.

PURPOSE: To introduce a temperature sensor implant (TSI) that mimics an active implantable medical device (AIMD) for animal testing of MRI heating. Computer simulations and phantom experiments poorly represent potential temperature increases. Animal experiments could be a better model, but heating experiments conducted immediately after the surgery suffer from alterations of the thermoregulatory and tissue properties during acute testing conditions. Therefore, the aim of this study was to introduce a temperature sensor implant that mimics an AIMD and capable of measuring the electrode temperature after implantation of the device without any further intervention at any time after the surgery in an animal model. METHODS: A battery-operated TSI, which resembled an AIMD, was used to measure the lead temperature and impedance and the case temperature. The measured values were transmitted to an external computer via a low-power Bluetooth communication protocol. In addition to validation experiments on the phantom, a sheep experiment was conducted to test the feasibility of the system in subacute conditions. RESULTS: The measurements had a maximum of 0.5°C difference compared to fiber-optic temperature probes. In vivo animal experiments demonstrated feasibility of the system. CONCLUSION: An active implant, which can measure its own temperature, was proposed to investigate implant heating during MRI examinations. Magn Reson Med 79:2824-2832, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Modeling of electrodes and implantable pulse generator cases for the analysis of implant tip heating under MR imaging.

PURPOSE: The authors' purpose is to model the case of an implantable pulse generator (IPG) and the electrode of an active implantable medical device using lumped circuit elements in order to analyze their effect on radio frequency induced tissue heating problem during a magnetic resonance imaging (MRI) examination. METHODS: In this study, IPG case and electrode are modeled with a voltage source and impedance. Values of these parameters are found using the modified transmission line method (MoTLiM) and the method of moments (MoM) simulations. Once the parameter values of an electrode/IPG case model are determined, they can be connected to any lead, and tip heating can be analyzed. To validate these models, both MoM simulations and MR experiments were used. The induced currents on the leads with the IPG case or electrode connections were solved using the proposed models and the MoTLiM. These results were compared with the MoM simulations. In addition, an electrode was connected to a lead via an inductor. The dissipated power on the electrode was calculated using the MoTLiM by changing the inductance and the results were compared with the specific absorption rate results that were obtained using MoM. Then, MRI experiments were conducted to test the IPG case and the electrode models. To test the IPG case, a bare lead was connected to the case and placed inside a uniform phantom. During a MRI scan, the temperature rise at the lead was measured by changing the lead length. The power at the lead tip for the same scenario was also calculated using the IPG case model and MoTLiM. Then, an electrode was connected to a lead via an inductor and placed inside a uniform phantom. During a MRI scan, the temperature rise at the electrode was measured by changing the inductance and compared with the dissipated power on the electrode resistance. RESULTS: The induced currents on leads with the IPG case or electrode connection were solved for using the combination of the MoTLiM and the proposed lumped circuit models. These results were compared with those from the MoM simulations. The mean square error was less than 9%. During the MRI experiments, when the IPG case was introduced, the resonance lengths were calculated to have an error less than 13%. Also the change in tip temperature rise at resonance lengths was predicted with less than 4% error. For the electrode experiments, the value of the matching impedance was predicted with an error less than 1%. CONCLUSIONS: Electrical models for the IPG case and electrode are suggested, and the method is proposed to determine the parameter values. The concept of matching of the electrode to the lead is clarified using the defined electrode impedance and the lead Thevenin impedance. The effect of the IPG case and electrode on tip heating can be predicted using the proposed theory. With these models, understanding the tissue heating due to the implants becomes easier. Also, these models are beneficial for implant safety testers and designers. Using these models, worst case conditions can be determined and the corresponding implant test experiments can be planned.

Modeling of radio-frequency induced currents on lead wires during MR imaging using a modified transmission line method.

PURPOSE: Metallic implants may cause serious tissue heating during magnetic resonance (MR) imaging. This heating occurs due to the induced currents caused by the radio-frequency (RF) field. Much work has been done to date to understand the relationship between the RF field and the induced currents. Most of these studies, however, were based purely on experimental or numerical methods. This study has three main purposes: (1) to define the RF heating properties of an implant lead using two parameters; (2) to develop an analytical formulation that directly explains the relationship between RF fields and induced currents; and (3) to form a basis for analysis of complex cases. METHODS: In this study, a lumped element model of the transmission line was modified to model leads of implants inside the body. Using this model, leads are defined using two parameters: impedance per unit length, Z, and effective wavenumber along the lead, k(t). These two parameters were obtained by using methods that are similar to the transmission line theory. As long as these parameters are known for a lead, currents induced in the lead can be obtained no matter how complex the lead geometry is. The currents induced in bare wire, lossy wire, and insulated wire were calculated using this new method which is called the modified transmission line method or MoTLiM. First, the calculated induced currents under uniform electric field distribution were solved and compared with method-of-moments (MoM) calculations. In addition, MoTLiM results were compared with those of phantom experiments. For experimental verification, the flip angle distortion due to the induced currents was used. The flip angle distribution around a wire was both measured by using flip angle imaging methods and calculated using current distribution obtained from the MoTLiM. Finally, these results were compared and an error analysis was carried out. RESULTS: Bare perfect electric, bare lossy, and insulated perfect electric conductor wires under uniform and linearly varying electric field exposure were solved, both for 1.5 T and 3 T scanners, using both the MoTLiM and MoM. The results are in agreement within 10% mean-square error. The flip angle distribution that was obtained from experiments was compared along the azimuthal paths with different distances from the wire. The highest mean-square error was 20% among compared cases. CONCLUSIONS: A novel method was developed to define the RF heating properties of implant leads with two parameters and analyze the induced currents on implant leads that are exposed to electromagnetic fields in a lossy medium during a magnetic resonance imaging (MRI) scan. Some simple cases are examined to explain the MoTLiM and a basis is formed for the analysis of complex cases. The method presented shows the direct relationship between the incident RF field and the induced currents. In addition, the MoTLiM reveals the RF heating properties of the implant leads in terms of the physical features of the lead and electrical properties of the medium.