Safety of active auditory implants in magnetic resonance imaging

Magnetic resonance imaging(MRI)has become the gold standard for the diagnosis of many pathologies.Using MRI in patients with auditory implants can however raise concerns due to mutual interactions between the implant and imaging device,resulting in potential patient risks.Several implant manufacturers have been working towards more MRI safe devices.Older devices are however often labelled for more stringent conditions,possibly creating confusion with patients and professionals.With this myriad of different devices that are implanted in patients for lifetimes of at least 20 years,it is crucial that both patients and professionals have a clear understanding of the safety of their devices.This work aims at providing an exhaustive overview on the MRI safety of active auditory implants.The available industry standards that are followed by manufacturers are outlined and an overview of the latest scientific developments focusing on the last five years is provided.In addition,based on the analysis of the adverse events reported to the Food and Drug Administration(FDA)and in literature within the past ten years,a systematic review of the most commonly occurring issues for patients with auditory implants in the MRI environment is provided.Results indicate that despite the release of more MRI conditional active hearing implants on the market,adverse events still occur.An extensive overview is provided on the MRI safety of active auditory implants,aiming to increase the understanding of the topic for healthcare professionals and contribute to safer scanning conditions for patients.

Feasibility of MRI in Patients with Non-Pacemaker/Defibrillator Metallic Devices and Abandoned Leads

Objective: To evaluate feasibility of MRI in patients with non-pacemaker (PM)/Implantable cardioverter defibrillator (ICD) metallic devices and abandoned leads. Background: Relative safety of MRI performed using specified protocol has been established in MR non-conditional PM/ICDs. With limited safety data, many non-PM/ICD metallic devices and abandoned leads continue to be a contraindication for MRI. Methods: We retrospectively analyzed consecutive patients with extra-cardiac devices, non-programmable cardiac devices, and abandoned leads, who underwent MRI (GE 1.5 Tesla, WI) at a single tertiary care center over a span of 13 years. Scan protocol was designed to maintain specific absorption rate (SAR) < 4.0 W/kg and scan time < 60 minutes. Results: The cohort comprised 127 MRI exams representing 94 patients, with 13 patients having two or more scans. The devices consisted of: 23 vagal nerve stimulators (VNS), 22 implantable loop recorders, 16 spinal stimulators, 5 peripheral nerve stimulators, 3 bladder stimulators, 2 deep brain stimulators, 1 gastric stimulator, 1 bone stimulator, 1 WATCHMAN device, 22 abandoned PM/lCD leads and 1 VNS lead. There was no immediate (peri-MRI exam) morbidity or mortality. Patients did not report any discomfort, palpitations, heating, or sensation of device migration during the exam. Local follow-up data was available in 65% (100% for thoracic imaging) with a mean of 190 ± 475 days (median 13 days). No device malfunction was reported during follow-up. Conclusions: With appropriate precautions, MRI is feasible in patients with extracardiac devices, nonprogrammable cardiac devices, and abandoned leads.