A research team from the University of Twente and Radboudumc has taken an important step toward the safe use of 3T MRI scans in patients with Deep Brain Stimulation (DBS). With an adapted scanning protocol, it appears possible to accurately and safely visualize electrodes after implantation, potentially improving the treatment process.
In the Netherlands, around 1,700 new cases of Parkinson's disease are diagnosed each year. Although the disease cannot be cured, DBS can relieve symptoms in some patients. In this treatment, electrodes are placed dep in the brain to electrically stimulate specific regions. Because these target areas are often only a few millimeters in size, extremely precise placement is essential.
Current treatment
Currently, an MRI-scan is performed before surgery to visualize the target brain areas. After implantation, a CT-scan is usually used to check the position of the electrodes. By combining these images, doctors determine whether the electrodes are correctly placed. Both techniques have limitations: CT clearly shows the electrodes but provides little detail of surrounding brain tissue, while MRI offers detailed images of tissue but generally cannot be safely used after implantation.
'With our adapted 3T protocol, that does become possible,' the researchteam states. This could allow clinicians to use MRI immediately after surgery to verify electrode placement and adjust stimulation accordingly.
Why isn’t 3T MRI used yet?
The challenge lies in safety. MRI-scanners emit strong radiofrequency signals that can accumulate around metal implants, potentially causing unwanted heating of surrounding tissue. This effect is stronger in 3T MRI-scanners, which are otherwise attractive due to their higher resolution.
Previous research has shown that heating around a single electrode can be prevented by adjusting scanner settings. 'However, in Parkinson's disease, two electrodes are often implanten,' says Camille van Speybroeck, a resident in clinical physics at Radboudumc. It was not yet known whether both electrodes could be scanned safely at the same time.
Impact
The team has now demonstrated that this is possible. With specific settings, heating around both electrodes can be limited while also reducing image distortion. This could potentially enable patients with two electrodes to be safely scanned using a 3T MRI in the future. 'This allows doctors to better verify electrode placement immediately after surgery,' says Wyger Brink, assistent professor at the University of Twente. 'It speeds up follow-up care and enables higher-quality follow-up scans.'
An important advantage is that this method works on standard 3T MRI-scanners already available in many hospitals. No specialized hardware is required, increasing the potential for broad implementation.
HealthTech Nexus
The research was conducted within HealthTech Nexus, the collaboration between the University of Twente (TechMed Centre) and Radboudumc. Within this partnership, technological and clinical expertise are combined to develop solutions for urgent healthcare challenges.
Read more
For the full background story and a deeper look into the technology, see the complete article.
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