• Benjamin Davidson, Fred Tam, Benson Yang, Ying Meng, Clement Hamani, Simon J Graham, and Nir Lipsman.
• Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
• Neurosurgery. 2021 Jan 13; 88 (2): 349-355.

BackgroundDeep brain stimulation (DBS) is a standard of care treatment for multiple neurologic disorders. Although 3-tesla (3T) magnetic resonance imaging (MRI) has become the gold-standard modality for structural and functional imaging, most centers refrain from 3T imaging in patients with DBS devices in place because of safety concerns. 3T MRI could be used not only for structural imaging, but also for functional MRI to study the effects of DBS on neurocircuitry and optimize programming.ObjectiveTo use an anthropomorphic phantom design to perform temperature and voltage safety testing on an activated DBS device during 3T imaging.MethodsAn anthropomorphic 3D-printed human phantom was constructed and used to perform temperature and voltage testing on a DBS device during 3T MRI. Based on the phantom assessment, a cohort study was conducted in which 6 human patients underwent MRI with their DBS device in an activated (ON) state.ResultsDuring the phantom study, temperature rises were under 2°C during all sequences, with the DBS in both the deactivated and activated states. Radiofrequency pulses from the MRI appeared to modulate the electrical discharge from the DBS, resulting in slight fluctuations of voltage amplitude. Six human subjects underwent MRI with their DBS in an activated state without any serious adverse events. One patient experienced stimulation-related side effects during T1-MPRAGE scanning with the DBS in an ON state because of radiofrequency-induced modulation of voltage amplitude.ConclusionFollowing careful phantom-based safety testing, 3T structural and functional MRI can be safely performed in subjects with activated deep brain stimulators.Copyright © 2020 by the Congress of Neurological Surgeons.

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