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CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels?

ABSTRACT: OBJECTIVE:To define thresholds of safe local temperature increases for MR equipment that exposes patients to radiofrequency fields of high intensities for long duration. These MR systems induce heterogeneous energy absorption patterns inside the body and can create localised hotspots with a risk of overheating. METHODS:The MRI + EUREKA research consortium organised a "Thermal Workshop on RF Hotspots". The available literature on thresholds for thermal damage and the validity of the thermal dose (TD) model were discussed. RESULTS/CONCLUSIONS:The following global TD threshold guidelines for safe use of MR are proposed: 1. All persons: maximum local temperature of any tissue limited to 39 °C 2. Persons with compromised thermoregulation AND (a) Uncontrolled conditions: maximum local temperature limited to 39 °C (b) Controlled conditions: TD?

SUBMITTER: van Rhoon GC

PROVIDER: S-EPMC3799975 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels?

van Rhoon Gerard C GC Samaras Theodoros T Yarmolenko Pavel S PS Dewhirst Mark W MW Neufeld Esra E Kuster Niels N

European radiology 20130404 8

<h4>Objective</h4>To define thresholds of safe local temperature increases for MR equipment that exposes patients to radiofrequency fields of high intensities for long duration. These MR systems induce heterogeneous energy absorption patterns inside the body and can create localised hotspots with a risk of overheating.<h4>Methods</h4>The MRI + EUREKA research consortium organised a "Thermal Workshop on RF Hotspots". The available literature on thresholds for thermal damage and the validity of th ...[more]

PMID: 23553588

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Project description:Respiratory motion management is crucial for high-resolution MRI of the heart, lung, liver and kidney. In this article, respiration guide using acoustic sound generated by pulsed gradient waveforms was introduced in the pulmonary ultrashort echo time (UTE) sequence and validated by comparing with retrospective respiratory gating techniques. The validated sound-guided respiration was implemented in non-contrast enhanced renal angiography. In the sound-guided respiration, breathe-in and-out instruction sounds were generated with sinusoidal gradient waveforms with two different frequencies (602 and 321 Hz). Performance of the sound-guided respiration was evaluated by measuring sharpness of the lung-liver interface with a 10-90% rise distance, w10-90, and compared with three respiratory motion managements in a free-breathing UTE scan: without respiratory gating (w/o gating), 0-dimensional k-space navigator (k-point navigator), and image-based self-gating (Img-SG). The sound-guided respiration was implemented in stack-of-stars balanced steady-state free precession with inversion recovery preparation for renal angiography. No subjects reported any discomfort or inconvenience with the sound-guided respiration in pulmonary or renal MRI scans. The lung-liver interface of the UTE images for sound-guided respiration (w10-90 = 6.99 ± 2.90 mm), k-point navigator (8.51 ± 2.71 mm), and Img-SG (7.01 ± 2.06 mm) was significantly sharper than that for w/o gating (17.13 ± 2.91 mm; p < 0.0001 for all of sound-guided respiration, k-point navigator and Img-SG). Sharpness of the lung-liver interface was comparable between sound-guided respiration and Img-SG (p = 0.99), but sound-guided respiration achieved better visualization of pulmonary vasculature. Renal angiography with the sound-guided respiration clearly delineated renal, segmental and interlobar arteries. In conclusion, the gradient sound guided respiration can facilitate a consistent diaphragm position in every breath and achieve performance of respiratory motion management comparable to image-based self-gating.

Project description:Some studies have shown that people living near a mobile phone base station may report sleep disturbances and discomfort. Using a rat model, we have previously shown that chronic exposure to a low-intensity radiofrequency electromagnetic field (RF-EMF) was associated with paradoxical sleep (PS) fragmentation and greater vasomotor tone in the tail. Here, we sought to establish whether sleep disturbances might result from the disturbance of thermoregulatory processes by a RF-EMF. We recorded thermal preference and sleep stage distribution in 18 young male Wistar rats. Nine animals were exposed to a low-intensity RF-EMF (900 MHz, 1 V x m(-1)) for five weeks and nine served as non-exposed controls. Thermal preference was assessed in an experimental chamber comprising three interconnected compartments, in which the air temperatures (Ta) were set to 24°C, 28°C and 31°C. Sleep and tail skin temperature were also recorded. Our results indicated that relative to control group, exposure to RF-EMF at 31°C was associated with a significantly lower tail skin temperature (-1.6°C) which confirmed previous data. During the light period, the exposed group preferred to sleep at Ta?=?31°C and the controls preferred Ta?=?28°C. The mean sleep duration in exposed group was significantly greater (by 15.5%) than in control group (due in turn to a significantly greater amount of slow wave sleep (SWS, +14.6%). Similarly, frequency of SWS was greater in exposed group (by 4.9 episodes.h-1). The PS did not differ significantly between the two groups. During the dark period, there were no significant intergroup differences. We conclude that RF-EMF exposure induced a shift in thermal preference towards higher temperatures. The shift in preferred temperature might result from a cold thermal sensation. The change in sleep stage distribution may involve signals from thermoreceptors in the skin. Modulation of SWS may be a protective adaptation in response to RF-EMF exposure.

Project description:Rationale: Pulmonary arterial hypertension (PAH) is a life-shortening condition. The European Society of Cardiology and European Respiratory Society and the REVEAL (North American Registry to Evaluate Early and Long-Term PAH Disease Management) risk score calculator (REVEAL 2.0) identify thresholds to predict 1-year mortality.Objectives: This study evaluates whether cardiac magnetic resonance imaging (MRI) thresholds can be identified and used to aid risk stratification and facilitate decision-making.Methods: Consecutive patients with PAH (n = 438) undergoing cardiac MRI were identified from the ASPIRE (Assessing the Spectrum of Pulmonary Hypertension Identified at a Referral Center) MRI database. Thresholds were identified from a discovery cohort and evaluated in a test cohort.Measurements and Main Results: A percentage-predicted right ventricular end-systolic volume index threshold of 227% or a left ventricular end-diastolic volume index of 58 ml/m2 identified patients at low (<5%) and high (>10%) risk of 1-year mortality. These metrics respectively identified 63% and 34% of patients as low risk. Right ventricular ejection fraction >54%, 37-54%, and <37% identified 21%, 43%, and 36% of patients at low, intermediate, and high risk, respectively, of 1-year mortality. At follow-up cardiac MRI, patients who improved to or were maintained in a low-risk group had a 1-year mortality <5%. Percentage-predicted right ventricular end-systolic volume index independently predicted outcome and, when used in conjunction with the REVEAL 2.0 risk score calculator or a modified French Pulmonary Hypertension Registry approach, improved risk stratification for 1-year mortality.Conclusions: Cardiac MRI can be used to risk stratify patients with PAH using a threshold approach. Percentage-predicted right ventricular end-systolic volume index can identify a high percentage of patients at low-risk of 1-year mortality and, when used in conjunction with current risk stratification approaches, can improve risk stratification. This study supports further evaluation of cardiac MRI in risk stratification in PAH.

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CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels?

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CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels?

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