Special CommunicationNeurostimulation System Used for Deep Brain Stimulation (DBS) MR Safety Issues and Implications of Failing to Follow Safety RecommendationsRezai, Ali R. MD*; Phillips, Michael MD*; Baker, Kenneth B. PhD*; Sharan, Ashwini D. MD†; Nyenhuis, John PhD‡; Tkach, Jean PhD*; Henderson, Jaimie MD*; Shellock, Frank G. PhD§Author Information From *The Cleveland Clinic Foundation, Cleveland, OH; †Thomas Jefferson University, Philadelphia, PA; ‡Purdue University, West Lafayette, IN; and §University of Southern California, Los Angeles, CA. Received December 29, 2003 and accepted for publication, after revision, January 17, 2004. Supported by the National Institutes of Health, Grant No. NS44575-01, Evaluation of MRI Safety for Deep Brain Stimulation. Reprints: Frank G. Shellock, PhD, Institute for Magnetic Resonance, Safety, Education, and Research, 7511 McConnell Avenue, Los Angeles, CA 90045. E-mail: [email protected]; www.MRIsafety.com Investigative Radiology: May 2004 - Volume 39 - Issue 5 - p 300-303 doi: 10.1097/01.rli.0000124940.02340.ab Buy Metrics Abstract The use of magnetic resonance imaging (MRI) in patients with neurostimulation systems used for deep brain stimulation requires the utmost care, and no individual should undergo an MR examination in the absence of empirical evidence that the procedure can be performed safely. The risks of performing MRI in patients with neurostimulators include those associated with heating, magnetic field interactions, induced currents, and the functional disruption of these devices. The exact safety recommendations for the particular neurostimulation system with regard to the pulse generator, leads, electrodes, operational conditions for the device, the positioning of these components, and the MR system conditions must be carefully followed for MRI. As highlighted by 2 recent accidents, the failure to strictly follow safety recommendations (eg, use a 1.5-T MR system with a send/receive head radiofrequency coil only; limit the specific absorption rate to 0.4 W/kg; etc.) may result in serious, temporary, or permanent injury to the patient including the possibility of transient dystonia, paralysis, coma, or even death. © 2004 Lippincott Williams & Wilkins, Inc.