Implants In Magnetic Resonance Imaging Research Articles

Low-field MRI's Spark on Implant Safety: A Closer Look at Radiofrequency Heating.

Advances in low-field magnetic resonance imaging (MRI) are making imaging more accessible without significant losses in image quality. In addition to being more cost-effective and easier to place without as much needed infrastructure, it has been publicized that the lower field strengths make MRI safer for patients with implants. To test this claim, we conducted a total of 368 simulations with wires of various lengths and geometries in a gel phantom during radiofrequency (RF) exposure at 23 MHz and 63.6 MHz (corresponding to MRI at 0.55 T and 1.5 T). Our results showed that heating in the gel around wire tips could be higher in certain cases at 0.55 T. To examine the impact on real patients, we simulated two models of patients with deep brain stimulation (DBS) implants of different lengths. These simulations provide quantitative evidence that low-field MRI is not always safer, and this paper serves to illustrate some of the basic principles involved in RF heating of elongated implants in MRI environments.Clinical Relevance- This paper illustrates the physical concepts of resonance and inductive coupling in RF heating during MRI scanning with implants through systematic simulations and discusses the impact of these principles in practice.

Susceptibility artifacts induced by crowns of different materials with prepared teeth and titanium implants in magnetic resonance imaging

This study aimed to investigate the artifacts induced by crowns composed of different materials with prepared teeth and titanium implants. Resin, metal-ceramic, ceramic and zirconia crowns were fabricated and placed onto the prepared teeth on a human cadaver head or titanium implants with prosthesis abutments on a dry human mandible. The samples were scanned on a 1.5 T MRI apparatus, and artifact areas were defined as the signal intensity and signal loss adjacent to the prosthesis and measured by a threshold tool with ImageJ2x. Data were analyzed using SPSS 22.0. Resin, ceramic, zirconia, and precious metal-ceramic crowns barely produced artifacts on the cadaver skull (p > 0.999). By contrast, pure Ti and nonprecious metal-ceramic crowns created significant artifacts (p < 0.001). The average artifacts reduction of double Au-Pt and Ag-Pd metal-ceramic crowns combined with titanium implants and abutments was 79.49 mm2 (p < 0.001) and 74.17 mm2 (p < 0.001) respectively, while artifact areas were increased in double Co-Cr and Ni–Cr metal-ceramic crowns by 150.10 mm2 (p < 0.001) and 175.50 mm2 (p < 0.001) respectively. Zirconia, ceramic and precious metal-ceramic crowns induce less MRI artifacts after tooth preparation while precious metal-ceramic crowns alleviate artifacts in combination with titanium implants.

Evaluating metallic artefact of biodegradable magnesium-based implants in magnetic resonance imaging

Magnesium (Mg) implants have shown to cause image artefacts or distortions in magnetic resonance imaging (MRI). Yet, there is a lack of information on how the degradation of Mg-based implants influences the image quality of MRI examinations. In this study, Mg-based implants are analysed in vitro, ex vivo, and in the clinical setting for various magnetic field strengths with the aim to quantify metallic artefact behaviour. In vitro corroded Mg-based screws and a titanium (Ti) equivalent were imaged according to the ASTM F2119. Mg-based and Ti pins were also implanted into rat femurs for different time points and scanned to provide insights on the influence of soft and hard tissue on metallic artefact. Additionally, MRI data of patients with scaphoid fractures treated with CE-approved Mg-based compression screws (MAGNEZIX®) were analysed at various time points post-surgery. The artefact production of the Mg-based material decreased as implant material degraded in all settings. The worst-case imaging scenario was determined to be when the imaging plane was selected to be perpendicular to the implant axis. Moreover, the Mg-based implant outperformed the Ti equivalent in all experiments by producing lower metallic artefact (p < 0.05). This investigation demonstrates that Mg-based implants generate significantly lower metallic distortion in MRI when compared to Ti. Our positive findings suggest and support further research into the application of Mg-based implants including post-operative care facilitated by MRI monitoring of degradation kinetics and bone/tissue healing processes.

Gradient coil and radiofrequency induced heating of orthopaedic implants in MRI: influencing factors

Patients with implanted orthopaedic devices represent a growing number of subjects undergoing magnetic resonance imaging (MRI) scans each year. MRI safety labelling is required for all implants under the EU Medical Device Regulations to ensure regulatory compliance, with each device assessed through standardised testing procedures. In this paper, we employ parametric studies to assess a range of clinically relevant factors that cause tissue heating, performing simulations with both radiofrequency (RF) and gradient coil (GC) switching fields, the latter of which is often overlooked in the literature. A series of ‘worst-case’ scenarios for both types of excitation field is discussed. In the case of GC fields, large volume implants and large plate areas with the field orientated perpendicular to the plane cause the highest heating levels, along with sequences with high rates of field switching. Implant heating from RF fields is driven primarily from the ‘antenna effect’, with thin, linear implants of resonant length resulting in the highest temperature rises. In this work, we show that simplifications may be made to the field sequence and in some cases the device geometry without significantly compromising the accuracy of the simulation results, enabling the possibility for generic estimates of the implant heating for orthopaedic device manufacturers and opportunities to simplify the safety compliance process.

Metallic Implants in MRI – Hazards and Imaging Artifacts

Background Magnetic resonance imaging (MRI) is an examination method for noninvasive soft tissue imaging without the use of ionizing radiation. Metallic implants, however, may pose a risk for the patient and often result in imaging artifacts. Due to the increasing number of implants, reducing these artifacts has become an important goal. In this review, we describe the risks associated with implants and provide the background on how metal-induced artifacts are formed. We review the literature on methods on how to reduce artifacts and summarize our findings. Method The literature was searched using PubMed and the keywords “MRI metal artifact reduction”, “metallic implants” and “MRI artefacts/artifacts”. Results and Conclusion The MRI compatibility of implants has to be evaluated individually. To reduce artifacts, two general approaches were found: a) parameter optimization in standard sequences (echo time, slice thickness, bandwidth) and b) specialized sequences, such as VAT, OMAR, WARP, SEMAC and MAVRIC. These methods reduced artifacts and improved image quality, albeit at the cost of a (sometimes significantly) prolonged scan time. New developments in accelerated imaging will likely shorten the scan time of these methods significantly, such that routine use may become feasible. Key Points: Citation Format

Dimensions of artefacts caused by cochlear and auditory brainstem implants in magnetic resonance imaging

Background: The aim of the study was to investigate the extent of MRI artefacts due to the magnet of selected auditory implants.Study design: Artefacts of the Synchrony cochlear implant at 1.5 T as well as at 3 T MRI devices were examined in cadavers and compared to the artefacts in MRI scans at 1.5 T of 17 patients implanted with CI (n = 12) and auditory brainstem implants (ABI) (n = 5).Results: None of the scanned implants showed any failure after MRI. After removal of the magnet, only a portion of the images in the direct neighbourhood of the implant, especially in the temporal and parietal lobe, contained artefacts. More anatomical substructures were visible without artefacts using the MedEl Synchrony device.Conclusion: Artefacts can be markedly reduced by rotating, self-aligning magnet. Removal of the magnet also results in reduction of artefacts.

EVALUATION OF ARTIFACTS GENERATED BY TITANIUM, ZIRCONIUM, AND TITANIUM-ZIRCONIUM ALLOY DENTAL IMPLANTS IN MRI, CT, AND CBCT IMAGES: AN IN VITRO STUDY

<h3>Background</h3> Magnetic resonance imaging (MRI) or computed tomography/cone beam computed tomography (CT/CBCT) should be performed in implant therapy when the conventional image is not adequate or when more information is needed to improve the patient's treatment. Therefore, 3-D imaging may be required even when the implants are present in the field of view (FOV). Thus, determining the most suitable imaging technique and setting for each type of implant material will facilitate the radiologists ability to give the best care to the patient. <h3>Objective(s)</h3> The aim of this study was to assess the amount and structure of artifacts caused by titanium grade 4 and 5, zirconium, and titanium–zirconium alloy implants in MRI, CT, and CBCT with several acquisition protocols and to correlate the findings to the radiation dose given by 2 different CT machines and different CBCT exposure settings. <h3>Study Design</h3> Three phantoms were built by embedding titanium, zirconium, and titanium–zirconium alloy implants in ultrasound gel. MRI, CT, and CBCT images were acquired using multiple sequences and settings. For MRI, the artifact was described as the length of signal void beyond the limits of the implant. For CT and CBCT, the artifact was calculated by subtracting the gray level of the darkest pixel from the one of the lightest pixel. <h3>Results</h3> Titanium and titanium–zirconium alloy implants created extensive artifacts in MRI as a result of high susceptibility, whereas zirconium implants could be correctly depicted with only minor distortion artifacts. However, in CT and CBCT, titanium and titanium–zirconium alloy implants generated less severe artifacts than zirconium. <h3>Discussion/Conclusions</h3> MRI images were less affected by the artifacts from zirconium implants, whereas CT and CBCT images showed fewer artifacts from titanium and titanium–zirconium alloy implants. CBCT, especially at low dose settings, produced the least amount of radiation compared with high-resolution settings and 2 CT machines.

Artifact Properties of Dental Ceramic and Titanium Implants in MRI.

Assessment of the visualization of titanium and ceramic dental implants using various isotropic three-dimensional magnetic resonance imaging (MRI) methods. 21 dental implants (7 ceramic, 14 titanium) were scanned in vitro with a spatially isotropically resolved three-dimensional gradient echo (FFE), a turbo spin echo (SE) and an ultra-short-echo time (UTE) imaging technique. The resulting absolute volumes of the implants were quantified and the relative error to the theoretical volume was calculated. Ceramic implants and their periphery could be displayed well in all cases. The observed mean relative error results were 5.4 ± 2.3 % (UTE) to 6.5 ± 4.3 % (FFE). No significant difference was observed between the investigated MRI methods. The transition between implant and surrounding agarose could be shown in all cases without artifacts. Titanium implants resulted in mean relative errors between 1314 ± 350 % (FFE) and 2157 ± 810 % (SE). Here, significant differences were observed between the FFE and the SE and between the UTE and the SE sequence. The periphery of the implants could not be displayed in any case. Use of the MRI technique for the diagnosis of peri-implantitis, the assessment of anatomical structures and planning of dental implantation is currently very limited but could be used more frequently, provided there are no disturbing or imaging-disturbing materials in the region of interest. MRI technology is not suitable in case of titanium implants. When using ceramic implants, MRI technology is an option. · MRI allows the artifact-free depiction of dental ceramic implants.. · Titanium implants cause the greatest relative errors in SE techniques.. · The UTE technique shows no significant improvements with respect to artifact behavior over the FFE technique.. · Geibel M, Gelißen B, Bracher A et al. Artefakt-Verhalten von dentalen Keramik- und Titanimplantaten im MRT. Fortschr Röntgenstr 2019; 191: 433 - 441.

Assessment of magnetic field interactions and radiofrequency-radiation-induced heating of metallic spinal implants in 7 T field.

ABSTRACTThe safety of metallic spinal implants in magnetic resonance imaging (MRI) performed using ultrahigh fields has not been established. Hence, we examined whether the displacement forces caused by a static magnetic field and the heating induced by radiofrequency radiation are substantial for spinal implants in a 7 T field. We investigated spinal rods of various lengths and materials, a screw, and a cross‐linking bridge in accordance with the American Society for Testing and Materials guidelines. The displacement forces of the metallic implants in static 7 T and 3 T static magnetic fields were measured and compared. The temperature changes of the implants during 15‐min‐long fast spin‐echo and balanced gradient‐echo image acquisition sequences were measured in the 7 T field. The deflection angles of the metallic spinal materials in the 7 T field were 5.0–21.0° [median: 6.7°], significantly larger than those in the 3 T field (1.0–6.3° [2.2°]). Among the metallic rods, the cobalt–chrome rods had significantly larger deflection angles (17.8–21.0° [19.8°]) than the pure titanium and titanium alloy rods (5.0–7.7° [6.2°]). The temperature changes of the implants, including the cross‐linked rods, were 0.7–1.0°C [0.8°C] and 0.6–1.0°C [0.7°C] during the fast spin‐echo and balanced gradient‐echo sequences, respectively; these changes were slightly larger than those of the controls (0.4–1.1°C [0.5°C] and 0.3–0.9°C [0.6°C], respectively). All of the metallic spinal implants exhibited small displacement forces and minimal heating, indicating that MRI examinations using 7 T fields may be performed safely on patients with these implants. © 2016 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 35:1831–1837, 2017.

Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging

Abstract Metallic implants in magnetic resonance imaging (MRI) are a potential safety risk since the energy absorption may increase temperature of the surrounding tissue. The temperature rise is highly dependent on implant size. Numerical examinations can be used to calculate the energy absorption in terms of the specific absorption rate (SAR) induced by MRI on orthopaedic implants. This research presents the impact of titanium osteosynthesis spine implants, called spondylodesis, deduced by numerical examinations of energy absorption in simplified spondylodesis models placed in 1.5 T and 3.0 T MRI body coils. The implants are modelled along with a spine model consisting of vertebrae and disci intervertebrales thus extending previous investigations [1], [2]. Increased SAR values are observed at the ends of long implants, while at the center SAR is significantly lower. Sufficiently short implants show increased SAR along the complete length of the implant. A careful data analysis reveals that the particular anatomy, i.e. vertebrae and disci intervertebrales, has a significant effect on SAR. On top of SAR profile due to the implant length, considerable SAR variations at small scale are observed, e.g. SAR values at vertebra are higher than at disc positions.

TH-AB-207-04: Active Implants in MRI: The MR Technologist's Perspective

TH-AB-207-04: Active Implants in MRI: The MR Technologist's Perspective

Function and Performance of Nitinol Vascular Implants

Nitinol, an intermetallic compound of Titanium and Nickel has found widespread use as material for vascular implants. Its unusual stress hysteresis and superelasticity makes these devices biomechanically compatible with the body's structures. Nitinol also exhibits excellent corrosion resistance, biocompatibility and MR compatibility. The paper focuses on the material specific properties of self expanding stents to treat peripheral vascular disease, like biased and temperature dependent stiffness, kink resistance, stent durability and fatigue, and describes the design aspects of different Nitinol stents. The function and performance of other Nitinol implants is also explained, like vena cava filters, cardiac septal re- pair devices, and self-expanding heart valve prosthesis. A separate section describes the performance of endovascular Nit- inol implants in Magnetic Resonance Imaging, MRI.

Artifacts from dental implants in magnetic resonance imaging in the head and neck region

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Safety of orthopedic implants in magnetic resonance imaging: An experimental verification

Magnetic resonance imaging (MRI) is an indispensable tool for musculoskeletal imaging. The presence of metal, however, raises concerns. The potential risks are loosening and migration of the implant, heating of the metal with surrounding tissue, causing thermal damage, and artifactual distortion which compromise the diagnostic value of the procedure. The aim of this study was to test experimentally the nature and extent of the first two of these effects in orthopedic implants. The degree of ferromagnetism was evaluated by deflection studies at the portals of a 0.25 Tesla permanent magnet and 1.0 Tesla clinical MRI scanner. None of the orthopedic implants exhibited any attraction. External fixator clamps, however, showed significant ferromagnetism. The heating of implants by "worst-case" scenario imaging sequences was insignificant. Many contemporary nonferromagnetic orthopedic implants can be imaged safely. It is prudent, however, to perform ex vivo deflection studies on a duplicate implant to confirm MR compatibility. With external fixator devices exhibiting strong ferromagnetism, MRI should be avoided. With expanding indications for MRI, orthopedic implants are unlikely to limit the potential of this powerful tool.

Improving geometric accuracy in the presence of susceptibility difference artifacts produced by metallic implants in magnetic resonance imaging

Geometric and intensity distortions due to the presence of metallic implants in magnetic resonance imaging impede the full exploitation of this advanced imaging modality. The aim of this study is to provide a method for (a) quantifying and (b) reducing the implant distortions in patient images. Initially, a set of reference images (without distortion) was obtained by imaging a custom-designed three-dimensional grid phantom. Corresponding test images (containing the distortion) were acquired with the same imaging parameters, after positioning a specific metallic implant in the grid phantom. After determining: 1) the nonrecoverable; 2) the distorted, but recoverable; and 3) the unaffected areas, a point-based thin-plate spline image registration algorithm was employed to align the reference and test images. The calculated transformation functions utilized to align the image pairs described the implant distortions and could therefore be used to correct any other images containing the same distortions. The results demonstrate successful correction of grid phantom images with a metallic implant. Furthermore, the calculated correction was applied to porcine thigh images bearing the same metallic implant, simulating a patient environment. Qualitative and quantitative assessments of the proposed correction method are included.

Safety of metallic implants in magnetic resonance imaging

Magnetic resonance (MR) imaging has become a commonly accepted medical procedure. Manufacturers of medical implant devices are submitting claims that their devices are safe and effective in a MR environment. This paper concentrates on the issue of heating of patients due to the interaction of metallic implants with the strong radiofrequency (RF) magnetic field produced by the MR scanner. The commercially available program XFDTD was used to calculate the specific absorption rate (SAR) distribution in a realistic model of the human body. The body contained a metallic implant and was exposed to RF magnetic fields at 64 MHz from a model of a MR birdcage body coil. The results of the calculation showed that the magnitude of the increased heating of tissues due to the presence of the metallic implant depended on the dimensions, orientation, shape, and location of the metallic implant in the patient. This increased heating of surrounding tissues primarily concentrates in a small volume near the tip of the metallic wire. When the whole-body SAR was normalized to 1 W/kg, a calculated value of 41 W/kg was obtained at this location if the absorption was averaged over 1 g of tissue. However, a maximum value of 310 W/kg was calculated when the absorption was averaged over 1/8 g of tissue.

Volterra series modelling and compensation of non-linear distortions caused by susceptibility difference artefacts related to the presence of ferromagnetic implants in magnetic resonance imaging

Magnetic resonance imaging is popular in medical settings due to its unique technical characteristics. However, its full potential has been limited by imaging artefacts caused by various phenomena. Previously, a methodology was proposed to characterize and reduce artefacts caused specifically by magnetic susceptibility differences. In the present work, the Volterra series approach is suggested as an alternative method for describing non-linear distortions induced by susceptibility artefacts. A second-order Volterra series is utilized for characterizing the image non-linearities using a block-by-block processing approach. Subsequently, a corresponding second-order inverse Volterra series is applied to compensate for the quantified distortions. In addition, a technique for automatic demarcation of recoverable and non-recoverable regions in magnetic resonance images is proposed to ameliorate the developed methodology. Experimental results indicate that this approach offers improved accuracy and flexibility in reducing non-linear distortions caused by magnetic susceptibility artefacts.