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.

项目概要 深部脑刺激 (DBS) 是一种神经外科手术，涉及将电极植入特定区域 在大脑内并从植入的脉冲发生器 (IPG) 发出持续或间歇的电脉冲 调节神经功能。 DBS 是治疗帕金森病的黄金标准，并已显示出前景 治疗其他疾病，尤其是慢性疼痛、癫痫、重度抑郁症和阿尔茨海默病。 磁共振成像 (MRI) 对于接受 DBS 植入的患者非常有用，因为它可以提供 有关植入电极精确位置和对刺激的功能反应的信息。很遗憾， MRI 扫描仪产生的射频 (RF) 场与 DBS 设备引线的相互作用可以 触发组织内潜在致命的射频加热。这意味着目前的 MRI 技术无法实现 大多数患者接受 DBS 植入，这对 DBS 治疗领域的进展构成了重大障碍。 该项目旨在开发新颖的 MRI 方法和 DBS 植入技术， 将使尖端 MRI 技术与植入 DBS 设备完全兼容。在这里，这两个方面 方法采用以下形式：（1）建立在我们最近引入的可重构 MRI 技术概念的基础上； (2) 制定针对 DBS 装置植入的手术指南。 可重构 MRI 技术基于这样的理念：通过创新工程，我们可以控制局部 MR 在每个患者的基础上产生电场，从而避免与植入设备的相互作用， 无论它发生在哪里。作为基于工程的解决方案的重要组成部分，我们认识到以下方面的重要性： DBS 设备引线放置优化可重构 MRI 方法的成功。虽然射频加热 完全取决于引线轨迹，手术指南完全没有提及如何最好地放置引线 导线的颅外部分。这反过来又导致任意（且高度可变）的引线定位，这可以 即使使用可重构技术，射频加热也无法预测。因此，我们建议开展工作 并验证新颖的 MR 技术（目标 1）、手术内植入策略（目标 2）以及基于模拟的、 定义安全成像参数的针对患者的特定方法（目标 3）。这些努力共同将消除 射频加热，减少图像伪影，并支持在接受 DBS 植入的患者中使用下一代 MRI。 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，以及 来自 DBS 设备行业的合作者。如果成功，我们将为 DBS 患者带来最先进的 3T MRI 其全部容量。这将允许对新兴应用中的 DBS 参数/目标进行系统分析， 提高我们对现有适应症的 DBS 的理解，并为患有以下疾病的患者带来标准护理成像 现有的 DBS 植入物。