Skip to main content

Advertisement

SpringerLink
Log in

Clinical safety of intracranial EEG electrodes in MRI at 1.5 T and 3 T: a single-center experience and literature review

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Purpose

Intracranial electroencephalography (EEG) can be a critical part of presurgical evaluation for drug resistant epilepsy. With the increasing use of intracranial EEG, the safety of these electrodes in the magnetic resonance imaging (MRI) environment remains a concern, particularly at higher field strengths. However, no studies have reported the MRI safety experience of intracranial electrodes at 3 T. We report an MRI safety review of patients with intracranial electrodes at 1.5 and 3 T.

Methods

One hundred and sixty-five consecutive admissions for intracranial EEG monitoring were reviewed. A total of 184 MRI scans were performed on 135 patients over 140 admissions. These included 118 structural MRI studies at 1.5 T and 66 functional MRI studies at 3 T. The magnetic resonance (MR) protocols avoided the use of high specific energy absorption rate sequences that could result in electrode heating. The intracranial implantations included 114 depth, 15 subdural, and 11 combined subdural and depth electrodes. Medical records were reviewed for patient-reported complications and radiologic complications related to these studies. Pre-implantation, post-implantation, and post-explantation imaging studies were reviewed for potential complications.

Results

No adverse events or complications were seen during or after MRI scanning at 1.5 or 3 T apart from those attributed to electrode implantation. There was also no clinical or imaging evidence of worsening of pre-existing implantation-related complications after MR imaging.

Conclusion

No clinical or radiographic complications are seen when performing MRI scans at 1.5 or 3 T on patients with implanted intracranial EEG electrodes while avoiding high specific energy absorption rate sequences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

All relevant de-identified data are available on request.

Abbreviations

CT:

Computed tomography

fMRI:

Functional magnetic resonance imaging

FLAIR:

Fluid attenuated inversion recovery

FSE:

Fast spin echo

iEEG:

Intracranial electroencephalography

SAR:

Specific energy absorption rate

References

  1. Zumsteg D, Wieser HG (2000) Presurgical evaluation: current role of invasive EEG. Epilepsia. 41(Suppl 3):S55–S60

    Article  Google Scholar 

  2. Kovac S, Vakharia VN, Scott C, Diehl B (2017) Invasive epilepsy surgery evaluation. Seizure. 44:125–136

    Article  Google Scholar 

  3. Yang AI, Wang X, Doyle WK, Halgren E, Carlson C, Belcher TL et al (2012) Localization of dense intracranial electrode arrays using magnetic resonance imaging. Neuroimage. 63(1):157–165

    Article  Google Scholar 

  4. Katz JS, Abel TJ (2019) Stereoelectroencephalography versus subdural electrodes for localization of the epileptogenic zone: what is the evidence? Neurotherapeutics. 16(1):59–66

    Article  Google Scholar 

  5. Hunter JD, Hanan DM, Singer BF, Shaikh S, Brubaker KA, Hecox KE et al (2005) Locating chronically implanted subdural electrodes using surface reconstruction. Clin Neurophysiol 116(8):1984–1987

    Article  Google Scholar 

  6. Sebastiano F, Di Gennaro G, Esposito V, Picardi A, Morace R, Sparano A et al (2006) A rapid and reliable procedure to localize subdural electrodes in presurgical evaluation of patients with drug-resistant focal epilepsy. Clin Neurophysiol 117(2):341–347

    Article  CAS  Google Scholar 

  7. Boucousis SM, Beers CA, Cunningham CJ, Gaxiola-Valdez I, Pittman DJ, Goodyear BG et al (2012) Feasibility of an intracranial EEG-fMRI protocol at 3 T: risk assessment and image quality. Neuroimage. 63(3):1237–1248

    Article  Google Scholar 

  8. Henderson JM, Tkach J, Phillips M, Baker K, Shellock FG, Rezai AR (2005) Permanent neurological deficit related to magnetic resonance imaging in a patient with implanted deep brain stimulation electrodes for Parkinson's disease: case report. Neurosurgery 57(5):E1063 discussion E

    Article  Google Scholar 

  9. Zrinzo L, Yoshida F, Hariz MI, Thornton J, Foltynie T, Yousry TA et al (2011) Clinical safety of brain magnetic resonance imaging with implanted deep brain stimulation hardware: large case series and review of the literature. World Neurosurg 76(1-2):164–172

    Article  Google Scholar 

  10. Carmichael DW, Thornton JS, Rodionov R, Thornton R, McEvoy A, Allen PJ et al (2008) Safety of localizing epilepsy monitoring intracranial electroencephalograph electrodes using MRI: radiofrequency-induced heating. J Magn Reson Imaging 28(5):1233–1244

    Article  Google Scholar 

  11. Carmichael DW, Thornton JS, Rodionov R, Thornton R, McEvoy AW, Ordidge RJ et al (2010) Feasibility of simultaneous intracranial EEG-fMRI in humans: a safety study. Neuroimage. 49(1):379–390

    Article  Google Scholar 

  12. Beers CA, Williams RJ, Gaxiola-Valdez I, Pittman DJ, Kang AT, Aghakhani Y et al (2015) Patient specific hemodynamic response functions associated with interictal discharges recorded via simultaneous intracranial EEG-fMRI. Hum Brain Mapp 36(12):5252–5264

    Article  Google Scholar 

  13. Aghakhani Y, Beers CA, Pittman DJ, Gaxiola-Valdez I, Goodyear BG, Federico P (2015) Co-localization between the BOLD response and epileptiform discharges recorded by simultaneous intracranial EEG-fMRI at 3 T. Neuroimage Clin 7:755–763

    Article  Google Scholar 

  14. Cunningham CB, Goodyear BG, Badawy R, Zaamout F, Pittman DJ, Beers CA et al (2012) Intracranial EEG-fMRI analysis of focal epileptiform discharges in humans. Epilepsia. 53(9):1636–1648

    Article  Google Scholar 

  15. Chaudhary UJ, Centeno M, Thornton RC, Rodionov R, Vulliemoz S, McEvoy AW et al (2016) Mapping human preictal and ictal haemodynamic networks using simultaneous intracranial EEG-fMRI. Neuroimage Clin 11:486–493

    Article  Google Scholar 

  16. Carmichael DW, Vulliemoz S, Rodionov R, Thornton JS, McEvoy AW, Lemieux L (2012) Simultaneous intracranial EEG-fMRI in humans: protocol considerations and data quality. Neuroimage. 63(1):301–309

    Article  CAS  Google Scholar 

  17. Vulliemoz S, Carmichael DW, Rosenkranz K, Diehl B, Rodionov R, Walker MC et al (2011) Simultaneous intracranial EEG and fMRI of interictal epileptic discharges in humans. Neuroimage. 54(1):182–190

    Article  Google Scholar 

  18. Murta T, Hu L, Tierney TM, Chaudhary UJ, Walker MC, Carmichael DW et al (2016) A study of the electro-haemodynamic coupling using simultaneously acquired intracranial EEG and fMRI data in humans. Neuroimage. 142:371–380

    Article  CAS  Google Scholar 

  19. Peedicail JS, Almohawes A, Hader W, Starreveld Y, Singh S, Josephson CB et al (2020) Outcomes of stereoelectroencephalography exploration at an epilepsy surgery center. Acta Neurol Scand 141(6):463–472

    Article  Google Scholar 

  20. Fountas KN (2011) Implanted subdural electrodes: safety issues and complication avoidance. Neurosurg Clin N Am 22(4):519–531 vii

    Article  Google Scholar 

  21. Schmidt RF, Wu C, Lang MJ, Soni P, Williams KA Jr, Boorman DW et al (2016) Complications of subdural and depth electrodes in 269 patients undergoing 317 procedures for invasive monitoring in epilepsy. Epilepsia. 57(10):1697–1708

    Article  Google Scholar 

  22. Hartwig V, Giovannetti G, Vanello N, Lombardi M, Landini L, Simi S (2009) Biological effects and safety in magnetic resonance imaging: a review. Int J Environ Res Public Health 6(6):1778–1798

    Article  Google Scholar 

  23. Cohen MS, Weisskoff RM, Rzedzian RR, Kantor HL (1990) Sensory stimulation by time-varying magnetic fields. Magn Reson Med 14(2):409–414

    Article  CAS  Google Scholar 

  24. Serletis D, Bulacio J, Bingaman W, Najm I, Gonzalez-Martinez J (2014) The stereotactic approach for mapping epileptic networks: a prospective study of 200 patients. J Neurosurg 121(5):1239–1246

    Article  Google Scholar 

  25. Bhattacharyya PK, Mullin J, Lee BS, Gonzalez-Martinez JA, Jones SE (2017) Safety of externally stimulated intracranial electrodes during functional MRI at 1.5 T. Magn Reson Imaging 38:182–188

    Article  Google Scholar 

  26. Zhang J, Wilson CL, Levesque MF, Behnke EJ, Lufkin RB (1993) Temperature changes in nickel-chromium intracranial depth electrodes during MR scanning. AJNR Am J Neuroradiol 14(2):497–500

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Ciumas C, Schaefers G, Bouvard S, Tailhades E, Perrin E, Comte JC et al (2014) A phantom and animal study of temperature changes during fMRI with intracerebral depth electrodes. Epilepsy Res 108(1):57–65

    Article  Google Scholar 

  28. Duckwiler GR, Levesque M, Wilson CL, Behnke E, Babb TL, Lufkin R (1990) Imaging of MR-compatible intracerebral depth electrodes. AJNR Am J Neuroradiol 11(2):353–354

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Kratimenos GP, Thomas DG, Shorvon SD, Fish DR (1993) Stereotactic insertion of intracerebral electrodes in the investigation of epilepsy. Br J Neurosurg 7(1):45–52

    Article  CAS  Google Scholar 

  30. Meiners LC, Bakker CJ, van Rijen PC, van Veelen CW, van Huffelen AC, van Dieren A et al (1996) Fast spin-echo MR of contact points on implanted intracerebral stainless steel multicontact electrodes. AJNR Am J Neuroradiol 17(10):1815–1819

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Brooks ML, O’Connor MJ, Sperling MR, Mayer DP (1992) Magnetic resonance imaging in localization of EEG depth electrodes for seizure monitoring. Epilepsia. 33(5):888–891

    Article  CAS  Google Scholar 

  32. Davis LM, Spencer DD, Spencer SS, Bronen RA (1999) MR imaging of implanted depth and subdural electrodes: is it safe? Epilepsy Res 35(2):95–98

    Article  CAS  Google Scholar 

  33. Ross DA, Brunberg JA, Drury I, Henry TR (1996) Intracerebral depth electrode monitoring in partial epilepsy: the morbidity and efficacy of placement using magnetic resonance image-guided stereotactic surgery. Neurosurgery. 39(2):327–333 discussion 33-4

    Article  CAS  Google Scholar 

  34. Cordova JE, Rowe RE, Furman MD, Smith JR, Murro AM (1994) A method for imaging of intracranial EEG electrodes using magnetic resonance imaging. Comput Biomed Res 27(5):337–341

    Article  CAS  Google Scholar 

  35. Al-Otaibi FA, Alabousi A, Burneo JG, Lee DH, Parrent AG, Steven DA (2010) Clinically silent magnetic resonance imaging findings after subdural strip electrode implantation. J Neurosurg 112(2):461–466

    Article  Google Scholar 

  36. Georgi JC, Stippich C, Tronnier VM, Heiland S (2004) Active deep brain stimulation during MRI: a feasibility study. Magn Reson Med 51(2):380–388

    Article  Google Scholar 

  37. Dewhirst MW, Viglianti BL, Lora-Michiels M, Hanson M, Hoopes PJ (2003) Basic principles of thermal dosimetry and thermal thresholds for tissue damage from hyperthermia. Int J Hyperth 19(3):267–294

    Article  CAS  Google Scholar 

  38. 2182-02a A (2007) Standard test method for meausrement of radio frequency induced heating near implants during magnetic resonance imaging. Committee F04 on Medical and Surgical Materials and Devices, Subcommittee F04.15 on Material Test Methods. ASTM International, West Conshohocken

  39. Goc J, Liu JY, Sisodiya SM (2014) Thom M. A spatiotemporal study of gliosis in relation to depth electrode tracks in drug-resistant epilepsy. Eur J Neurosci 39(12):2151–2162

    Article  Google Scholar 

  40. Fong JS, Alexopoulos AV, Bingaman WE, Gonzalez-Martinez J, Prayson RA (2012) Pathologic findings associated with invasive EEG monitoring for medically intractable epilepsy. Am J Clin Pathol 138(4):506–510

    Article  Google Scholar 

Download references

Acknowledgements

The Calgary Comprehensive Epilepsy Program Collaborators are Drs. Karl Martin Klein, William Murphy, Neelan Pillay, Andrea Salmon, Shaily Singh, and Samuel Wiebe.

Funding

This study was funded by CIHR (MOP-136839).

Author information

Authors and Affiliations

  1. Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada

    J. S. Peedicail, T. Poulin, C. B. Josephson, W. Hader, Y. Starreveld & P. Federico

  2. Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada

    J. S. Peedicail, J. N. Scott, C. B. Josephson, W. Hader, Y. Starreveld & P. Federico

  3. Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada

    J. N. Scott, L. A. Bureau & P. Federico

  4. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada

    C. B. Josephson

  5. Seaman Family MR Research Centre, Cumming School of Medicine, University of Calgary, Calgary, Canada

    P. Federico

Authors
  1. J. S. Peedicail
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Poulin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. N. Scott
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. B. Josephson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. A. Bureau
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W. Hader
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y. Starreveld
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P. Federico
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the Calgary Comprehensive Epilepsy Program Collaborators

Corresponding author

Correspondence to P. Federico.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

Informed consent

For this type of study, formal consent is not required.

Consent to participate

Not applicable

Consent for publication

The authors consent for publication of this work in Neuroradiology.

Conflicts of interest

None of the authors has any conflict of interest to disclose.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peedicail, J.S., Poulin, T., Scott, J.N. et al. Clinical safety of intracranial EEG electrodes in MRI at 1.5 T and 3 T: a single-center experience and literature review. Neuroradiology 63, 1669–1678 (2021). https://doi.org/10.1007/s00234-021-02661-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-021-02661-7

Keywords

Search

Navigation