How Insights from EM Theory Have Guided Surgical Practice to Make MRI Safer for Patients with Active Electronic Implants

Magnetic resonance imaging (MRI) has revolutionized our understanding of human biology and pathology, yet its accessibility remains limited to a growing group of patients with conductive implants. This has become an increasingly critical issue, as it is estimated that 75% of patients with implants will need at least one MRI exam during their lifetime [1] with many requiring repeated examinations, highlighting the pressing need to find a solution to this problem. The major risk of MRI in patients with active implantable medical devices (AIMDs) is the RF heating of the tissue, which can result in serious injuries. Despite extensive regulatory and technical efforts spanning two decades to enhance MR-conditional devices, a significant obstacle continues to hinder patient care: RF heating in MRI is significantly influenced by the implant’s configuration, leading to a broad range of heating variation observed in patients with the same implant, up to two orders of magnitude. Here we show that simple EM-guided modifications in routing of AIMD leads can significantly reduce MRI-induced RF heating in patients with deep brain stimulation (DBS) devices and cardiac implantable medical devices (CIEDs).