Evaluation of epidural and peripheral nerve catheter heating during magnetic resonance imaging

Sean Owens, M. Erturk, Jean-Pierre Ouanes, Jamie Murphy, Christopher Wu, Paul A Bottomley

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Many epidural and peripheral nerve catheters contain conducting wire that could heat during magnetic resonance imaging (MRI), requiring removal for scanning. METHODS: We tested 2 each of 6 brands of regional analgesia catheters (from Arrow International [Reading, Pennsylvania], B. Braun Medical Inc [Bethlehem, Pennsylvania], and Smiths Medical/Portex [Keene, New Hampshire]) for exposure to clinical 1.5- and 3-T MRI. Catheters testing as nonmagnetic were placed in an epidural configuration in a standard human torso-sized phantom, and an MRI pulse sequence applied at the maximum scanner-allowed radiofrequency specific absorption rate (SAR) for 15 minutes. Temperature and SAR exposure were sampled during MRI using multiple fiberoptic temperature sensors. RESULTS: Two catheters (the Arrow StimuCath Peripheral Nerve and B. Braun Medical Perifix FX Epidural) were found to be magnetic and not tested further. At 3 T, exposure of the remaining 3 epidural and 1 peripheral nerve catheter to the scanner's maximum RF exposure elicited anomalous heating of 4°C to 7°C in 2 Arrow Epidural (MultiPort and Flex-Tip Plus) catheters at the entry points. Temperature increases for the other catheters at 3 T, and all catheters at 1.5 T were 1.4°C or less. When normalized to the body-average US Food and Drug Administration guideline SAR of 4 W/kg, maximum projected temperature increases were 0.1°C to 2.5°C at 1.5 T and 0.7°C to 2.7°C at 3 T, except for the Arrow MultiPort Flex-Tip Plus catheter at 3 T whose increase was 14°C. CONCLUSIONS: Most but not all catheters can be left in place during 1.5-T MRI scans. Heating of less than 3°C during MRI for most catheters is not expected to be injurious. While heating was lower at 1.5 T versus 3 T, performance differences between products underscore the need for safety testing before performing MRI.

Original languageEnglish (US)
Pages (from-to)534-539
Number of pages6
JournalRegional Anesthesia and Pain Medicine
Volume39
Issue number6
DOIs
StatePublished - Dec 12 2014

Fingerprint

Peripheral Nerves
Heating
Catheters
Magnetic Resonance Imaging
Temperature
Torso
United States Food and Drug Administration
Analgesia
Reading
Hot Temperature
Guidelines
Safety

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Evaluation of epidural and peripheral nerve catheter heating during magnetic resonance imaging. / Owens, Sean; Erturk, M.; Ouanes, Jean-Pierre; Murphy, Jamie; Wu, Christopher; Bottomley, Paul A.

In: Regional Anesthesia and Pain Medicine, Vol. 39, No. 6, 12.12.2014, p. 534-539.

Research output: Contribution to journalArticle

@article{c52d2d14f7744603b583c4add3701fc6,
title = "Evaluation of epidural and peripheral nerve catheter heating during magnetic resonance imaging",
abstract = "BACKGROUND: Many epidural and peripheral nerve catheters contain conducting wire that could heat during magnetic resonance imaging (MRI), requiring removal for scanning. METHODS: We tested 2 each of 6 brands of regional analgesia catheters (from Arrow International [Reading, Pennsylvania], B. Braun Medical Inc [Bethlehem, Pennsylvania], and Smiths Medical/Portex [Keene, New Hampshire]) for exposure to clinical 1.5- and 3-T MRI. Catheters testing as nonmagnetic were placed in an epidural configuration in a standard human torso-sized phantom, and an MRI pulse sequence applied at the maximum scanner-allowed radiofrequency specific absorption rate (SAR) for 15 minutes. Temperature and SAR exposure were sampled during MRI using multiple fiberoptic temperature sensors. RESULTS: Two catheters (the Arrow StimuCath Peripheral Nerve and B. Braun Medical Perifix FX Epidural) were found to be magnetic and not tested further. At 3 T, exposure of the remaining 3 epidural and 1 peripheral nerve catheter to the scanner's maximum RF exposure elicited anomalous heating of 4°C to 7°C in 2 Arrow Epidural (MultiPort and Flex-Tip Plus) catheters at the entry points. Temperature increases for the other catheters at 3 T, and all catheters at 1.5 T were 1.4°C or less. When normalized to the body-average US Food and Drug Administration guideline SAR of 4 W/kg, maximum projected temperature increases were 0.1°C to 2.5°C at 1.5 T and 0.7°C to 2.7°C at 3 T, except for the Arrow MultiPort Flex-Tip Plus catheter at 3 T whose increase was 14°C. CONCLUSIONS: Most but not all catheters can be left in place during 1.5-T MRI scans. Heating of less than 3°C during MRI for most catheters is not expected to be injurious. While heating was lower at 1.5 T versus 3 T, performance differences between products underscore the need for safety testing before performing MRI.",
author = "Sean Owens and M. Erturk and Jean-Pierre Ouanes and Jamie Murphy and Christopher Wu and Bottomley, {Paul A}",
year = "2014",
month = "12",
day = "12",
doi = "10.1097/AAP.0000000000000151",
language = "English (US)",
volume = "39",
pages = "534--539",
journal = "Regional Anesthesia and Pain Medicine",
issn = "1098-7339",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Evaluation of epidural and peripheral nerve catheter heating during magnetic resonance imaging

AU - Owens, Sean

AU - Erturk, M.

AU - Ouanes, Jean-Pierre

AU - Murphy, Jamie

AU - Wu, Christopher

AU - Bottomley, Paul A

PY - 2014/12/12

Y1 - 2014/12/12

N2 - BACKGROUND: Many epidural and peripheral nerve catheters contain conducting wire that could heat during magnetic resonance imaging (MRI), requiring removal for scanning. METHODS: We tested 2 each of 6 brands of regional analgesia catheters (from Arrow International [Reading, Pennsylvania], B. Braun Medical Inc [Bethlehem, Pennsylvania], and Smiths Medical/Portex [Keene, New Hampshire]) for exposure to clinical 1.5- and 3-T MRI. Catheters testing as nonmagnetic were placed in an epidural configuration in a standard human torso-sized phantom, and an MRI pulse sequence applied at the maximum scanner-allowed radiofrequency specific absorption rate (SAR) for 15 minutes. Temperature and SAR exposure were sampled during MRI using multiple fiberoptic temperature sensors. RESULTS: Two catheters (the Arrow StimuCath Peripheral Nerve and B. Braun Medical Perifix FX Epidural) were found to be magnetic and not tested further. At 3 T, exposure of the remaining 3 epidural and 1 peripheral nerve catheter to the scanner's maximum RF exposure elicited anomalous heating of 4°C to 7°C in 2 Arrow Epidural (MultiPort and Flex-Tip Plus) catheters at the entry points. Temperature increases for the other catheters at 3 T, and all catheters at 1.5 T were 1.4°C or less. When normalized to the body-average US Food and Drug Administration guideline SAR of 4 W/kg, maximum projected temperature increases were 0.1°C to 2.5°C at 1.5 T and 0.7°C to 2.7°C at 3 T, except for the Arrow MultiPort Flex-Tip Plus catheter at 3 T whose increase was 14°C. CONCLUSIONS: Most but not all catheters can be left in place during 1.5-T MRI scans. Heating of less than 3°C during MRI for most catheters is not expected to be injurious. While heating was lower at 1.5 T versus 3 T, performance differences between products underscore the need for safety testing before performing MRI.

AB - BACKGROUND: Many epidural and peripheral nerve catheters contain conducting wire that could heat during magnetic resonance imaging (MRI), requiring removal for scanning. METHODS: We tested 2 each of 6 brands of regional analgesia catheters (from Arrow International [Reading, Pennsylvania], B. Braun Medical Inc [Bethlehem, Pennsylvania], and Smiths Medical/Portex [Keene, New Hampshire]) for exposure to clinical 1.5- and 3-T MRI. Catheters testing as nonmagnetic were placed in an epidural configuration in a standard human torso-sized phantom, and an MRI pulse sequence applied at the maximum scanner-allowed radiofrequency specific absorption rate (SAR) for 15 minutes. Temperature and SAR exposure were sampled during MRI using multiple fiberoptic temperature sensors. RESULTS: Two catheters (the Arrow StimuCath Peripheral Nerve and B. Braun Medical Perifix FX Epidural) were found to be magnetic and not tested further. At 3 T, exposure of the remaining 3 epidural and 1 peripheral nerve catheter to the scanner's maximum RF exposure elicited anomalous heating of 4°C to 7°C in 2 Arrow Epidural (MultiPort and Flex-Tip Plus) catheters at the entry points. Temperature increases for the other catheters at 3 T, and all catheters at 1.5 T were 1.4°C or less. When normalized to the body-average US Food and Drug Administration guideline SAR of 4 W/kg, maximum projected temperature increases were 0.1°C to 2.5°C at 1.5 T and 0.7°C to 2.7°C at 3 T, except for the Arrow MultiPort Flex-Tip Plus catheter at 3 T whose increase was 14°C. CONCLUSIONS: Most but not all catheters can be left in place during 1.5-T MRI scans. Heating of less than 3°C during MRI for most catheters is not expected to be injurious. While heating was lower at 1.5 T versus 3 T, performance differences between products underscore the need for safety testing before performing MRI.

UR - http://www.scopus.com/inward/record.url?scp=84930021675&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930021675&partnerID=8YFLogxK

U2 - 10.1097/AAP.0000000000000151

DO - 10.1097/AAP.0000000000000151

M3 - Article

C2 - 25275576

AN - SCOPUS:84930021675

VL - 39

SP - 534

EP - 539

JO - Regional Anesthesia and Pain Medicine

JF - Regional Anesthesia and Pain Medicine

SN - 1098-7339

IS - 6

ER -