Charakterisierung der hochfrequenz-induzierten Erwärmung passiver Implantate während MRT-Untersuchungen bei 7 Tesla am Beispiel von intrakraniellen Aneurysma-Clips
In conclusion, the retrospective study on the safety of implants at 7 T at our institute shows that an overly conservative exclusion of all subjects with implants and/or tattoos from 7 T examinations is not warranted. Nevertheless, imaging should only be performed in carefully selected subjects after acquiring substantial information to enable a proper risk assessment. Furthermore, a new comprehensive test procedure for the safety assessment of implants at 7 T, taking into account the more complex coupling of electromagnetic field with the implant and the human body as well as polarization effects, was presented in the second part of the thesis. This new method was extensively applied to test one of the most common implants in neurosurgery: aneurysm clips. This study on potential RF heating of an aneurysm clip at 7 T indicates that safe scanning conditions could be derived, depending on the information about the clip gained during screening interviews. Clip length appears to be one of the most important information and a worst case clip length of 50 mm was identified. This result shows good agreement with both theory (50 mm is approximately half the wavelength in body tissue at 7 T) and realistic exposure scenarios. A conservative approach, developed in the absence of information and to generalize the results, was also developed. It allows safe scanning of patients with implanted clips, but lead to a significantly reduced input power and therefore a limitation of the possible sequences to be used. It should be noted that the assessment of radiofrequency safety of small implants based on spatially averaged specific absorption rate remained problematic and that this method may be irrelevant. In the case of multiple aneurysm clips, a minimum distance of 35 mm was determined to ensure that they remained uncoupled from one another. However, for cases in which multiple aneurysm clips are separated by less than 35 mm, dedicated and personalized safety assessments are still required. Furthermore, it should be emphasized that no patients or subjects with aneurysm clips should be imaged unless it is determined that B0‐induced torque and force are within safe limits. Amalgamation of the results of previous safety assessments concerning both cranial fixation and aneurysm clips with the results of this study support the conclusion that safe scanning conditions with respect to RF can be applied for neurosurgical implants. The clearance of patients with such implants for MR examination would lead to a significant increase in the usage of UHF MR for clinical workIn conclusion, the retrospective study on the safety of implants at 7 T at our institute shows that an overly conservative exclusion of all subjects with implants and/or tattoos from 7 T examinations is not warranted. Nevertheless, imaging should only be performed in carefully selected subjects after acquiring substantial information to enable a proper risk assessment. Furthermore, a new comprehensive test procedure for the safety assessment of implants at 7 T, taking into account the more complex coupling of electromagnetic field with the implant and the human body as well as polarization effects, was presented in the second part of the thesis. This new method was extensively applied to test one of the most common implants in neurosurgery: aneurysm clips. This study on potential RF heating of an aneurysm clip at 7 T indicates that safe scanning conditions could be derived, depending on the information about the clip gained during screening interviews. Clip length appears to be one of the most important information and a worst case clip length of 50 mm was identified. This result shows good agreement with both theory (50 mm is approximately half the wavelength in body tissue at 7 T) and realistic exposure scenarios. A conservative approach, developed in the absence of information and to generalize the results, was also developed. It allows safe scanning of patients with implanted clips, but lead to a significantly reduced input power and therefore a limitation of the possible sequences to be used. It should be noted that the assessment of radiofrequency safety of small implants based on spatially averaged specific absorption rate remained problematic and that this method may be irrelevant. In the case of multiple aneurysm clips, a minimum distance of 35 mm was determined to ensure that they remained uncoupled from one another. However, for cases in which multiple aneurysm clips are separated by less than 35 mm, dedicated and personalized safety assessments are still required. Furthermore, it should be emphasized that no patients or subjects with aneurysm clips should be imaged unless it is determined that B0‐induced torque and force are within safe limits. Amalgamation of the results of previous safety assessments concerning both cranial fixation and aneurysm clips with the results of this study support the conclusion that safe scanning conditions with respect to RF can be applied for neurosurgical implants. The clearance of patients with such implants for MR examination would lead to a significant increase in the usage of UHF MR for clinical work.