Orthopedic implants affect the electric field induced by switching gradients in MRI
Luca Zilberti, Alessandro Arduino, Riccardo Torchio, Umberto Zanovello, Fabio Baruffaldi, Hector Sanchez-Lopez, Paolo Bettini, Piergiorgio Alotto, Mario Chiampi, Oriano Bottauscio
Abstract
Purpose
To investigate whether the risk of peripheral nerve stimulation increases in the presence of bulky metallic prostheses implanted in a patient’s body.
Methods
A computational tool was used to calculate the electric field (E-field) induced in a realistic human model due to the action of gradient fields. The calculations were performed both on the original version of the anatomical model and on a version modified through “virtual surgery” to incorporate knee, hip, and shoulder prostheses. Five exam positions within a body gradient coil and one position using a head gradient coil were simulated, subjecting the human model to the readout gradient from an EPI sequence. The induced E-field in models with and without prostheses was compared, focusing on the nerves and all other tissues (both including and excluding the bones from the analysis).
Results
In the nerves, the most pronounced increase in the E-field (+24%) was observed around the knee implant during an abdominal MRI (Y axis readout). When extending the analysis to encompass all tissues (excluding bones), the greatest amplification (+360%) occurred around the knee implant during pelvic MRI (Z axis readout). Notable increases in E-field peaks were also identified around the shoulder and hip implants in multiple scenarios.
Conclusion
Based on the presented results, further investigations aimed at quantifying the threshold of nerve stimulation in the presence of bulky implants are desirable.