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: 10445316
• 负责人: Laleh Golestani Rad
• 金额: $ 48.76万
• 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/10445316
• 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 脑深部刺激(DBS)是一种将电极植入特定区域的神经外科手术。 在大脑内，并从植入的脉冲发生器(IPG)提供持续或间歇的电脉冲 来调节神经功能。DBS是帕金森氏症的黄金标准疗法，并已显示出希望 在治疗其他疾病方面，尤其是慢性疼痛、癫痫、严重抑郁症和阿尔茨海默病。 磁共振成像(MRI)对植入DBS的患者非常有用，因为它可以提供 关于植入电极的准确位置和对刺激的功能反应的信息。不幸的是， 核磁共振扫描仪产生的射频(RF)场与DBS设备的导线之间的相互作用可以 在组织内触发可能致命的射频加热。这意味着目前的核磁共振技术无法用于 大多数DBS患者植入了DBS，这对DBS治疗领域的进步构成了重大障碍。 该项目寻求开发新的MRI方法和DBS植入技术，这些技术一起 将使尖端MRI技术与植入的DBS设备完全兼容。这里，这是双管齐下的 方法采取的形式是(1)建立在我们最近引入的可重构MRI技术的概念上； 以及(2)制定专门针对DBS装置植入的手术指南。 可重构核磁共振技术基于这样一种想法，即通过创新的工程，我们可以控制局部 由MR在逐个患者的基础上产生的电场，从而避免了与植入设备的相互作用， 无论它碰巧在哪里。作为基于工程的解决方案的一部分，我们认识到 DBS设备引线放置在优化可重构MRI方法的成功方面。虽然射频加热 精确地依赖于导联轨迹，手术指南完全没有说明如何最好地放置 导联的颅外部分。这进而导致任意(且高度可变)的引线定位，这可能 即使在使用可重新配置技术时，也会使射频加热变得不可预测。因此，我们建议开展工作 并验证新的MR技术(AIM 1)、手术内植入策略(AIM 2)和基于模拟的， 确定安全成像参数的具体患者方法(目标3)。这些努力加在一起将消除 射频加热，减少图像伪影，并支持在DBS植入物患者中使用下一代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，星展银行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，我们将把最先进的3T MRI带给星展银行的患者 它满负荷运转。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中DBS的理解，并为患有DBS的患者带来标准护理成像 现有的DBS植入物。