Reconfigurable MRI technology for safe and high-resolution imaging of deep brain stimulation at 3T

可重构 MRI 技术，可在 3T 下对深部脑刺激进行安全且高分辨率的成像

• 批准号: 10217692
• 负责人: Laleh Golestani Rad
• 金额: $ 55.64万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10217692
• 关键词: Acceleration; Alzheimer' s Disease; Anatomy; Area; Brain; Cell Nucleus; Cerebrum; Characteristics; Clinical Management; Clinical Trials; Cognition; Computer Assisted; Computer Models; Coupling; Deep Brain Stimulation; Development; Device Safety; Devices; Disease; Electrodes; Engineering; Epilepsy; Failure; Feasibility Studies; Fever; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Gold; Guidelines; Hand; Head; Heating; Image; Imaging Techniques; Imaging technology; Implant; Implanted Electrodes; Individual; Industry; Knowledge; Lead; Location; Magnetic Resonance Imaging; Major Depressive Disorder; Mechanics; Methodology; Methods; Modification; Monitor; Moods; Morphologic artifacts; Movement; Neurophysiology - biologic function; Neurosurgical Procedures; Operative Surgical Procedures; Parkinson Disease; Patients; Physiologic pulse; Pilot Projects; Positioning Attribute; Protocols documentation; Randomized; Reproducibility; Resolution; Risk; Safety; Scientist; Structure; Techniques; Technology; Testing; Therapeutic; Tissues; Variant; Visualization; Work; base; chronic pain; clinical application; deep brain stimulation array; deep field survey; design and construction; electric field; high resolution imaging; imaging approach; implantable device; implantation; improved; individual patient; innovation; instrumentation; lead optimization; neuroimaging; neuroregulation; neurosurgery; next generation; novel; radio frequency; response; safety assessment; side effect; simulation; soft tissue; standard care; standard of care; success; temporal measurement

Project Summary Deep brain stimulation (DBS) is a neurosurgical procedure that involves implanting electrodes into specific areas within the brain and delivering constant or intermittent electric pulses from an implanted pulse generator (IPG) to modulate neural function. DBS is the gold standard treatment for Parkinson’s disease, and has shown promise in treating other disorders, most notably chronic pain, epilepsy, major depression, and Alzheimer’s disease. Magnetic resonance imaging (MRI) is extremely useful in patients with DBS implants, as it can provide information on precise location of implanted electrodes and functional response to stimulation. Unfortunately, the interaction of radiofrequency (RF) fields generated by MRI scanners with the leads of DBS devices can trigger potentially fatal RF heating within the tissue. This means that current MRI technology is inaccessible to most patients with DBS implants, presenting a significant barrier to progress in the field of DBS therapeutics. This project seeks to develop novel MRI methodologies alongside DBS implantation techniques that together will make cutting-edge MRI technology fully compatible with implanted DBS devices. Here, this two-pronged approach takes the form of (1) building on our recently introduced concept of reconfigurable MRI technology; and (2) establishing surgical guidelines specific to DBS device implantation. Reconfigurable MRI technology is based on the idea that through innovative engineering we can control local electric fields generated by MR on a patient-by-patient basis, thus avoiding interactions with an implanted device, wherever it happens to be. Part and parcel with engineering-based solutions, we recognize the importance of DBS device lead placement in optimizing the success of the reconfigurable MRI approach. Although RF heating depends exquisitely on lead-trajectory, surgical guidelines are completely silent as to how to best place the extracranial portion of the leads. This in turn leads to arbitrary (and highly variable) lead positioning, which can make RF heating unpredictable even when using reconfigurable technology. Thus, we propose work to develop and validate novel MR technology (Aim 1), intra-surgical implantation strategies (Aim 2), and simulation-based, patient-specific approaches to defining safe imaging parameters (Aim 3). Together, these efforts will eliminate RF heating, reduce image artifact, and support the use of next generation MRI in patients with DBS implants. Our team includes experts in MRI hardware development and instrumentation, MRI computational modeling and safety assessment, FDA regulatory scientists, DBS clinical management and neurosurgery, as well as collaborators from DBS device industry. If successful, we will bring state-of-the-art 3T MRI to DBS patients in its full capacity. This will allow for methodical analysis of DBS parameters/targets in emerging applications, improve our understanding of DBS in existing indications, and bring standard-of-care imaging to patients with existing DBS implants.

项目摘要 深脑刺激（DBS）是一种神经外科手术，涉及将电极植入特定区域 在大脑中，从植入脉冲发生器（IPG）传递恒定或间歇性的电脉冲 调节神经功能。 DBS是帕金森氏病的黄金标准治疗方法，并显示出承诺 在治疗其他疾病时，最著名的是慢性疼痛，癫痫，严重抑郁症和阿尔茨海默氏病。 磁共振成像（MRI）在DBS凹入患者中非常有用，因为它可以提供 有关植入电子的精确位置以及对刺激的功能响应的信息。很遗憾， MRI扫描仪与DBS设备引线产生的射频（RF）字段的相互作用可以 触发组织内潜在致命的RF加热。这意味着当前的MRI技术无法访问 大多数DBS患者浸入了，在DBS治疗领域的进展范围很大。 该项目旨在与DBS植入技术一起开发新颖的MRI方法 将使尖端的MRI技术与植入的DBS设备完全兼容。在这里，这是两个人 方法以（1）为基础我们最近引入的可重构MRI技术概念的形式； （2）建立针对DBS设备植入的手术指南。 可重新配置的MRI技术基于这样的想法，即通过创新的工程我们可以控制本地 MR会逐个患者产生的电场，从而避免与植入设备的相互作用， 无论碰巧在哪里。我们认识到基于工程的解决方案的一部分和包裹，我们认识到的重要性 DBS设备引导放置在优化可重构MRI方法的成功方面。虽然RF加热 完全取决于铅牵引力，外科指南完全保持沉默，如何最好地放置 铅外部分。这反过 即使使用可重新配置技术，也可以使RF加热不可预测。那我们建议开发工作 并验证新颖的MR技术（AIM 1），外科内部植入策略（AIM 2）和基于模拟的策略， 定义安全成像参数的患者特定方法（AIM 3）。这些努力将消除 RF加热，减少图像伪像，并支持DBS INCTENT患者中下一代MRI的使用。 我们的团队包括MRI硬件开发和仪器，MRI计算建模和 安全评估，FDA监管科学家，DBS临床管理和神经外科手术以及 DBS设备行业的合作者。如果成功，我们将将最先进的3T MRI带给DBS患者 它的全部容量。这将允许对新兴应用程序中的DBS参数/目标进行有方法分析， 在现有适应症中提高我们对DBS的理解，并为患者带来护理标准成像 现有的DBS即兴。