PMID- 32076667
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220412
IS  - 2638-6135 (Electronic)
IS  - 2638-6135 (Linking)
VI  - 1
IP  - 3
DP  - 2019 Aug 29
TI  - Patient Orientation Affects Lead-Tip Heating of Cardiac Active Implantable 
      Medical Devices during MRI.
PG  - e190006
LID - 10.1148/ryct.2019190006 [doi]
LID - e190006
AB  - PURPOSE: To evaluate changes in patient orientation to mitigate 
      radiofrequency-induced lead-tip heating (LTH) during MRI. MATERIALS AND METHODS: 
      LTH was evaluated for device type, lead path, and distance to the isocenter of a 
      1.5-T MRI system. LTH for 378 conditions in both head-first (HF) and feet-first 
      (FF) orientations was measured for nine MRI-unsafe cardiac active implantable 
      medical devices (AIMDs) placed along three (two anatomic, one planar) left-sided 
      lead paths at nine landmark locations. The devices were exposed to 5 minutes of 
      continuous radiofrequency energy at 4 W/kg whole-body specific absorption rate. 
      RESULTS: LTH was greater in HF than in FF orientation for the planar and one 
      anatomic lead path (P < .05). LTH was significantly affected by lead path, 
      distance to isocenter, and patient orientation (all P < .05), but not by cardiac 
      AIMD device type. Maximum LTH was observed in an HF orientation for the planar 
      lead path when the lead tip was at isocenter (right ventricular [RV] lead: 32.0 
       degrees C +/- 16.3 [standard deviation], right atrial [RA] lead: 16.1 degrees C +/- 9.3). In the FF 
      orientation, LTH was significantly reduced (RV lead: 1.6 degrees C +/- 1.4; mean RA lead: 
      0.5 degrees C +/- 1.0; P = .008). CONCLUSION: LTH for supine FF patient orientations among 
      patients with anterior left-sided cardiac AIMDs can be significantly lower than 
      LTH for supine HF orientations. There was no scenario in which LTH was 
      significantly worse in the FF position. Changing patient orientation is a simple 
      method to reduce radiofrequency-induced LTH.(c) RSNA, 2019See also the commentary 
      by Litt in this issue.
CI  - 2019 by the Radiological Society of North America, Inc.
FAU - Martinez, Jessica A
AU  - Martinez JA
AUID- ORCID: 0000-0002-3274-566X
AD  - Form the Departments of Radiological Sciences and Bioengineering, University of 
      California, Los Angeles, Calif (J.A.M.); ANSYS, Canonsburg, Pa (P.S.); and 
      Department of Radiological Sciences, Stanford University, 1201 Welch Rd, 
      Stanford, CA 94305 (J.A.M., D.B.E.).
FAU - Serano, Peter
AU  - Serano P
AUID- ORCID: 0000-0002-6777-6810
AD  - Form the Departments of Radiological Sciences and Bioengineering, University of 
      California, Los Angeles, Calif (J.A.M.); ANSYS, Canonsburg, Pa (P.S.); and 
      Department of Radiological Sciences, Stanford University, 1201 Welch Rd, 
      Stanford, CA 94305 (J.A.M., D.B.E.).
FAU - Ennis, Daniel B
AU  - Ennis DB
AD  - Form the Departments of Radiological Sciences and Bioengineering, University of 
      California, Los Angeles, Calif (J.A.M.); ANSYS, Canonsburg, Pa (P.S.); and 
      Department of Radiological Sciences, Stanford University, 1201 Welch Rd, 
      Stanford, CA 94305 (J.A.M., D.B.E.).
LA  - eng
GR  - R21 HL127433/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20190829
PL  - United States
TA  - Radiol Cardiothorac Imaging
JT  - Radiology. Cardiothoracic imaging
JID - 101748663
CIN - Radiol Cardiothorac Imaging. 2019 Aug 29;1(3):e190151. PMID: 33778514
PMC - PMC6735361
COIS- Disclosures of Conflicts of Interest: J.A.M. disclosed no relevant relationships. 
      P.S. disclosed no relevant relationships. D.B.E. Activities related to the 
      present article: project supported in part by NIH grant. Activities not related 
      to the present article: institution has two NIH R01 awards unrelated to this 
      article; institution received money from Abbott and Siemens for unrelated work. 
      Other relationships: disclosed no relevant relationships.
EDAT- 2020/02/23 06:00
MHDA- 2020/02/23 06:01
PMCR- 2019/08/29
CRDT- 2020/02/21 06:00
PHST- 2019/01/08 00:00 [received]
PHST- 2019/05/15 00:00 [revised]
PHST- 2019/05/23 00:00 [accepted]
PHST- 2020/02/21 06:00 [entrez]
PHST- 2020/02/23 06:00 [pubmed]
PHST- 2020/02/23 06:01 [medline]
PHST- 2019/08/29 00:00 [pmc-release]
AID - 10.1148/ryct.2019190006 [doi]
PST - epublish
SO  - Radiol Cardiothorac Imaging. 2019 Aug 29;1(3):e190006. doi: 
      10.1148/ryct.2019190006.