Exposure Optimization Trial for Patients With Medical Implants During MRI Exposure: Balance Between the Completeness and Efficiency

Elongated conductors, such as pacemaker leads, can couple to the MRI radio-frequency (RF) field during MRI scan and cause dangerous tissue heating. By selecting proper RF exposure conditions, the RF-induced power deposition can be suppressed. As the RF-induced power deposition is a complex function of multiple clinical factors, the problem remains how to perform the exposure selection in a comprehensive and efficient way. The purpose of this work is to demonstrate an exposure optimization trail that allows a comprehensive optimization in an efficient and traceable manner. The proposed workflow is demonstrated with a generic 40 cm long cardio pacemaker, major components of the clinical factors are decoupled from the redundant data set using principle component analysis, the optimized exposure condition can not only reduce the in vivo power deposition but also maintain good image quality.

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 are discussed. In the case of GC fields large volume implants and large plate areas with the field oriented 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 device geometry without significantly comprising the accuracy of the simulation results, opening up the possibility for generic estimates of the implant heating for orthopaedic device manufacturers and opportunities to simplify the safety compliance process.

Towards temperature controlled retinal laser treatment with a single laser at 10 kHz repetition rate

Laser photocoagulation is one of the most frequently used treatment approaches in ophthalmology for a variety of retinal diseases. Depending on indication, treatment intensity varies from application of specific micro injuries down to gentle temperature increases without inducing cell damage. Especially for the latter, proper energy dosing is still a challenging issue, which mostly relies on the physician’s experience. Pulsed laser photoacoustic temperature measurement has already proven its ability for automated irradiation control during laser treatment but suffers from a comparatively high instrumental effort due to combination with a conventional continuous wave treatment laser. In this paper, a simplified setup with a single pulsed laser at 10 kHz repetition rate is presented. The setup combines the instrumentation for treatment as well as temperature measurement and control in a single device. In order to compare the solely pulsed heating with continuous wave (cw) tissue heating, pulse energies of 4 µJ were applied with a repetition rate of 1 kHz to probe the temperature rise, respectively. With the same average laser power of 60 mW an almost identical temporal temperature course was retrieved in both irradiation modes as expected. The ability to reach and maintain a chosen aim temperature of 41 °C is demonstrated by means of model predictive control (MPC) and extended Kalman filtering at a the measurement rate of 250 Hz with an accuracy of less than ±0.1 °C. A major advantage of optimization-based control techniques like MPC is their capability of rigorously ensuring constraints, e.g., temperature limits, and thus, realizing a more reliable and secure temperature control during retinal laser irradiation.

Next-Gen Network: Microwave Perspective: Impact, Challenges and Opportunity

Our need for higher performance and improved efficiency has led to the invention of 4G from 1G. This tendency to never settle has now brought us to a new generation of mobile communication - 5G. It is expected to provide more than just a faster network. Reduced latency, enormous netwrok capacity, greater reliability and overall improved user experience. This has come into focus with the possibility that the unused spectrum - (300 MHz to 30 GHz) can also be brought into use in the telecommunication inductry. As we know, everything comes with its own demerits and in this review paper, we shall discuss the health effects that microwave radiation has on living organisms with the antennas and connected devices being in close proximity to users and other organisms. Thereafter, we shall discuss the challenges and opportunities of the same. Keywords: next generation network, millimeter waves, health impact, tissue heating, radiation

5G New Radio Requires the Best Possible Risk Assessment Studies: Perspective and Recommended Guidelines

The development and establishment of mobile communication technologies has necessitated assessments of possible risks to human health from exposures to radio-frequency electromagnetic fields (RF EMF). A number of expert committees have concluded that there is no evidence for such risks as long as exposures are at or below levels that do not allow tissue heating. These assessments have been based primarily on studies investigating frequencies up to 6 GHz including frequencies similar to those used by two of three major bands of fifth generation (more accurately 5G New Radio or 5G NR) of mobile communication. Bioeffects studies in so-called high-band at 25–39 GHz are particularly sparse. Future assessments relevant for these frequencies will need to rely on still unperformed studies. Due to few available studies at 5G NR “high band” frequencies, and questions raised by some existing studies, a recent review recommended a wide range of RF biostudies be done at 5G NR “high band” frequencies. It is of importance that such studies be done using the best possible science. Here we suggest factors to consider when performing future studies in this area. The present focus is on laboratory studies to clarify biological effects of radiofrequency (RF) energy at 5G “high band” frequencies and, more generally at millimeter wave (mm-wave) frequencies (30-300 GHz) which will be increasingly used by communications technologies in the future. Similar comments would apply to epidemiology and exposure assessment studies, but those are not the focus of the present Perspective.

Evaluation of potential tissue heating during percutaneous drill-assisted bone sampling in an in vivo porcine study

Background Minimally invasive, battery-powered drilling systems have become the preferred tool for obtaining representative samples from bone lesions. However, the heat generated during battery-powered bone drilling for bone biopsies has not yet been sufficiently investigated. Thermal necrosis can occur if the bone temperature exceeds a critical threshold for a certain period of time. Purpose To investigate heat production as a function of femur temperature during and after battery-powered percutaneous bone drilling in a porcine in vivo model. Methods We performed 16 femur drillings in 13 domestic pigs with an average age of 22 weeks and an average body temperature of 39.7 °C, using a battery-powered drilling system and an intraosseous temperature monitoring device. The standardized duration of the drilling procedure was 20 s. The bone core specimens obtained were embedded in 4% formalin, stained with haematoxylin and eosin (H&E) and sent for pathological analysis of tissue quality and signs of thermal damage. Results No significant changes in the pigs’ local temperature were observed after bone drilling with a battery-powered drill device. Across all measurements, the median change in temperature between the initial measurement and the temperature measured after drilling (at 20 s) was 0.1 °C. Histological examination of the bone core specimens revealed no signs of mechanical or thermal damage. Conclusion Overall, this preliminary study shows that battery-powered, drill-assisted harvesting of bone core specimens does not appear to cause mechanical or thermal damage.

Comparing the Safety and Effectiveness of Dedicated Radiofrequency Transseptal Wires to Electrified Metal Guidewires

Application of electrocautery to a metal guidewire can be used to perform transseptal puncture (TSP). Dedicated radiofrequency guidewires (RF) may represent a better alternative. This study compares safety and effectiveness of electrified guidewires to a dedicated RF wire. TSP was performed on porcine hearts using an electrified 0.014” or 0.032” guidewire under various power settings compared to TSP using a dedicated RF wire with 5W power. The primary endpoint was the number of attempts required to achieve TSP. Secondary endpoints included the rate of TSP failure, TSP consistency, effect of the distance between tip of the guidewire and the tip of the dilator, and effect of RF power output level. Qualitative secondary endpoints included tissue puncture defect appearance, thermal damage to the TSP guidewire or dilator, and tissue temperature using thermal imaging. The RF wire required 1.10 ± 0.47 attempts to cross the septum. The 0.014” electrified guidewire required 2.17 ± 2.36 attempts (2.0x higher than the RF wire; p<0.01), and the 0.032” electrified guidewire required 3.90 ± 2.93 attempts (3.5x higher than the RF wire; p<0.01). Electrified guidewires had a higher rate of TSP failure, larger defects, more tissue charring, higher temperatures, and greater tissue heating. Fewer RF applications were required to achieve TSP using a dedicated RF wire compared to an electrified guidewire. Smaller defects and lower tissue temperatures were also observed using the RF wire. Electrified guidewires required greater energy delivery and were associated with equipment damage and tissue charring.