Changes in the specific absorption rate (SAR) of radiofrequency energy in patients with retained cardiac leads during MRI at 1.5T and 3T

Magn Reson Med. 2019 Jan;81(1):653-669. doi: 10.1002/mrm.27350. Epub 2018 Jun 12.

Abstract

Purpose: To evaluate the local specific absorption rate (SAR) and heating around retained cardiac leads during MRI at 64 MHz (1.5T) and 127 MHz (3T) as a function of RF coil type and imaging landmark.

Methods: Numerical models of retained cardiac leads were built from CT and X-ray images of 6 patients with retained cardiac leads. Electromagnetic simulations and bio-heat modeling were performed with MRI RF body and head coils tuned to 64 MHz and 127 MHz and positioned at 9 different imaging landmarks covering an area from the head to the lower limbs.

Results: For all patients and at both 1.5T and 3T, local transmit head coils produced negligible temperature rise ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi> <mml:mo><</mml:mo> <mml:mn>0.1</mml:mn> <mml:mo>°</mml:mo> <mml:mi>C</mml:mi></mml:mrow> </mml:math> ) for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>3</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . For body imaging with quadrature-driven coils at 1.5T, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> during a 10-min scan remained < 3°C at all imaging landmarks for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>3</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> and <6°C for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>4</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . For body imaging at 3T, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> during a 10-min scan remained < 6°C at all imaging landmarks for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>2</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . For shorter pulse sequences up to 2 min, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> remained < 6°C for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>3</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> .

Conclusion: For the models based on 6 patients studied, simulations suggest that MRI could be performed safely using a local head coil at both 1.5T and 3T, and with a body coil at 1.5T with pulses that produced <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>4</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . MRI at 3T could be performed safely in these patients using pulses with <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>2</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> .

Keywords: RF heating; SAR; abandoned lead; anatomical models; cardiac implanted electronic device; computational modeling; defibrillator; finite element method; pacemaker; retained lead; safety.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Algorithms
  • Computer Simulation
  • Defibrillators, Implantable / adverse effects*
  • Device Removal*
  • Female
  • Finite Element Analysis
  • Foreign Bodies*
  • Heart / diagnostic imaging*
  • Heart Failure / surgery*
  • Heart Rate
  • Heart Transplantation
  • Hot Temperature
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Leg / diagnostic imaging
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Pacemaker, Artificial / adverse effects
  • Patient Safety
  • Postoperative Complications / surgery
  • Prostheses and Implants
  • Radio Waves*
  • Reproducibility of Results
  • Retrospective Studies
  • Young Adult