Magnetic resonance imaging of time-varying magnetic fields from therapeutic devices.
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ABSTRACT:
SUBMITTER: Hernandez-Garcia L
PROVIDER: S-EPMC3645268 | biostudies-other | 2013 Jun
REPOSITORIES: biostudies-other
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Project description:Introduction: The selection of an appropriate window size, window function, and functional connectivity (FC) metric in the sliding window method is not straightforward due to the absence of ground truth. Methods: A previously proposed wavelet-based method was accordingly adjusted for estimating time-varying FC (TVFC) and was applied to a large high-quality, low-motion dataset of 400 resting-state functional magnetic resonance imaging data. Specifically, the wavelet coherence magnitude and relative phase were averaged across wavelet (frequency) scales to yield TVFC and synchronization patterns. To assess whether the observed fluctuations in TVFC were statistically significant (dynamic FC [dFC]; the distinction between TVFC and dFC is intentional), surrogate data were generated using the multivariate phase randomization (MVPR) and multivariate autoregressive randomization (MVAR) methods to define the null hypothesis of dFC absence. Results: By averaging across all frequencies, core regions of the default mode network (DMN; medial prefrontal and posterior cingulate cortices, inferior parietal lobes, hippocampal formation) were found to exhibit dFC (test-retest reproducibility of 90%) and were also synchronized in activity (-15° ≤ phase ≤15°). When averaging across distinct frequency bands, the same dynamic connections were identified, with the majority of them identified in the frequency range (0.01, 0.198) Hz, though with lower test-retest reproducibility (<66%). Additional analysis suggested that MVPR method better preserved properties (p < 10-10), including time-averaged coherence, of the original data compared with MVAR approach. Conclusions: The wavelet-based approach identified dynamic associations between the core DMN regions with fewer choices in parameters, compared with sliding window method. Impact statement We employed a wavelet-based method, previously used in the literature, and proposed modifications to assess time-varying functional connectivity in resting-state functional magnetic resonance imaging. With this approach, dynamic connections within the default mode network were identified, involving the medial prefrontal and posterior cingulate cortices, inferior parietal lobes, and hippocampal formation, which were also highly consistent in test-retest analysis (test-retest reproducibility of 90%), without the need to select window size, window function, and functional connectivity metric as with the sliding window method, whereby no consensus on the appropriate choices of hyperparameters currently exists in the literature.
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Project description:BackgroundPatients who have pacemakers or defibrillators are often denied the opportunity to undergo magnetic resonance imaging (MRI) because of safety concerns, unless the devices meet certain criteria specified by the Food and Drug Administration (termed "MRI-conditional" devices).MethodsWe performed a prospective, nonrandomized study to assess the safety of MRI at a magnetic field strength of 1.5 Tesla in 1509 patients who had a pacemaker (58%) or an implantable cardioverter-defibrillator (42%) that was not considered to be MRI-conditional (termed a "legacy" device). Overall, the patients underwent 2103 thoracic and nonthoracic MRI examinations that were deemed to be clinically necessary. The pacing mode was changed to asynchronous mode for pacing-dependent patients and to demand mode for other patients. Tachyarrhythmia functions were disabled. Outcome assessments included adverse events and changes in the variables that indicate lead and generator function and interaction with surrounding tissue (device parameters).ResultsNo long-term clinically significant adverse events were reported. In nine MRI examinations (0.4%; 95% confidence interval, 0.2 to 0.7), the patient's device reset to a backup mode. The reset was transient in eight of the nine examinations. In one case, a pacemaker with less than 1 month left of battery life reset to ventricular inhibited pacing and could not be reprogrammed; the device was subsequently replaced. The most common notable change in device parameters (>50% change from baseline) immediately after MRI was a decrease in P-wave amplitude, which occurred in 1% of the patients. At long-term follow-up (results of which were available for 63% of the patients), the most common notable changes from baseline were decreases in P-wave amplitude (in 4% of the patients), increases in atrial capture threshold (4%), increases in right ventricular capture threshold (4%), and increases in left ventricular capture threshold (3%). The observed changes in lead parameters were not clinically significant and did not require device revision or reprogramming.ConclusionsWe evaluated the safety of MRI, performed with the use of a prespecified safety protocol, in 1509 patients who had a legacy pacemaker or a legacy implantable cardioverter-defibrillator system. No long-term clinically significant adverse events were reported. (Funded by Johns Hopkins University and the National Institutes of Health; ClinicalTrials.gov number, NCT01130896 .).
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Project description:BackgroundPostmortem magnetic resonance imaging (MRI) has been used to investigate the cause of death, but due to time constraints, it is not widely applied to the heart. Therefore, MRI analysis of the heart after formalin fixation was previously performed. However, the changes in MRI signal values based on the fixation time of formalin were not investigated. The objective was to investigate changes over time in the T1- and T2-values of MRI signals in normal areas of hearts removed during autopsy, hearts subsequently fixed in formalin, and heart specimens sliced for the preparation of pathological specimens.MethodsThe study subjects were 21 autopsy cases in our hospital between May 26, 2019 and February 16, 2020 whose hearts were removed and scanned by MRI. The male:female ratio was 14:7, and their ages at death ranged from 9 to 92 years (mean age 65.0 ± 19.7 years). Postmortem (PM)-MRI was conducted with a 0.3-Tesla (0.3-T) scanner containing a permanent magnet. A 4-channel QD head coil was used as the receiver coil. Scans were performed immediately after removal, post-formalin fixation, and after slicing; 7 cases were scanned at all three time points.ResultsThe T1- and T2-values were calculated from the MRI signals of each sample organ at each scanning stage. Specimens were sliced from removed organs after formalin fixation, and the changes in T1- and T2-values over time were graphed to obtain an approximate curve. The median T1-values at each measurement time point tended to decrease from immediately after removal. The T2-values showed the same tendency to decrease, but this tendency was more pronounced for the T1-values.ConclusionMRI signal changes in images of heart specimens were investigated. Formalin fixation shortened both T1- and T2-values over time, and approximation formulae were derived to show these decreases over time. The shortening of T1- and T2-values can be understood as commensurate with the reduction in the water content (water molecules) of the formalin-fixed heart.
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