Cognitive effects of head-movements in stray fields generated by a 7 Tesla whole-body MRI magnet

[Health risks for medical personnel due to magnetic fields in magnetic resonance imaging]

The current state of medical and scientific knowledge on the effects of exposure to electromagnetic fields on workers in the field of clinical magnetic resonance imaging (MRI) is summarized here.A systematic literature search was conducted to analyze the health risks to medical personnel from magnetic fields in MRI. A total of 7273 sources were identified, with 7139 being excluded after screening of the title and abstract. After full-text screening, 34 sources remained and were included in this paper.There are a number of scientific publications on the occurrence of short-term sensory effects such as vertigo, metallic taste, phosphenes as well as on the occurrence of neurocognitive and neurobehavioral effects. For example, short-term exposure to clinical magnetic fields has been reported to result in a 4% reduction in speed and precision and a 16% reduction in visual contrast sensitivity at close range. Both eye-hand precision and coordination speed are affected. The long-term studies concern, among other things, the influence of magnetic fields on sleep quality, which could be linked to an increased risk of accidents. The data on the exposure of healthcare workers to magnetic fields during pregnancy is consistently outdated. However, it has been concluded that there are no particular deviations with regard to the duration of pregnancy, premature births, miscarriages, and birth weight. Epidemiological studies are lacking. With a focus on healthcare personnel, there is a considerable need for high-quality data, particularly on the consequences of long-term exposure to electromagnetic fields from clinical MRI and the effects on pregnancy. · Short-term sensory effects such as vertigo, metallic taste, phosphenes as well as neurocognitive and neurological behavioral effects may occur upon exposure to magnetic fields.. · Long-term effects mainly concern quality of sleep, which can be associated with an increased risk of accidents.. · When pregnant women were exposed to magnetic fields, no particular deviations were found with regard to the duration of pregnancy, premature births, miscarriages, and birth weight.. · König AM, Pöschke A, Mahnken AH. Health risks for medical personnel due to magnetic fields in magnetic resonance imaging. Rofo 2025; 197: 135-144.

Induced electric fields in MRI settings and electric vestibular stimulations: same vestibular effects?

In Magnetic Resonance Imaging scanner environments, the continuous Lorentz Force is a potent vestibular stimulation. It is nowadays so well known that it is now identified as Magnetic vestibular stimulation (MVS). Alongside MVS, some authors argue that through induced electric fields, electromagnetic induction could also trigger the vestibular system. Indeed, for decades, vestibular-specific electric stimulations (EVS) have been known to precisely impact all vestibular pathways. Here, we go through the literature, looking at potential time varying magnetic field induced vestibular outcomes in MRI settings and comparing them with EVS-known outcomes. To date, although theoretically induction could trigger vestibular responses the behavioral evidence remains poor. Finally, more vestibular-specific work is needed.

Effects of ultra-high field MRI environment on cognitive performance in healthy participants

INTRODUCTION

Ultra-high field MRI (UHF MRI) is rapidly becoming an essential part of our toolbox within health care and research studies; therefore, we need to get a deeper understanding of the physiological effects of ultra-high field. This study aims to investigate the cognitive performance of healthy participants in a 7 T (T) MRI environment in connection with subjectively experienced effects.

METHODS

We measured cognitive performance before and after a 1-h 7T MRI scanning session using a Digit Symbol Substitution Test (DSST) in 42 subjects. Furthermore, a computer-based survey regarding the subjectively experienced effects in connection with the MRI examination was distributed. Similarly, two DSSTs were also performed by a control group of 40 participants.

RESULTS

Even though dizziness was the strongest sensory perception in connection to the MRI scanning, we did not find any correlation between dizziness and cognitive performance. Whilst the control group improved (p=<0.001) on their second DSST the MRI group showed no significant difference (p=0.741) in the DSST before and after MRI scanning.

CONCLUSION

Transient effect on cognition after undergoing MRI scanning can't be ruled out as the expected learning effect on the DSST was not observed.

IMPLICATIONS FOR PRACTICE

Increasing understanding of the possible adverse effects may guide operators in performing UHF MRI in a safe way and with person-centered care. Furthermore, it can guide researchers in setting up research protocols to minimize confounding factors in their fMRI studies due to the transient adverse effects of the UHF environment.

Electromagnetic Exposure of Personnel Involved in Cardiac MRI Examinations in 1.5T, 3T and 7T Scanners

(1) Background: It has been hypothesised that a significant increase in the use of cardiac magnetic resonance (CMR), for example, when examining COVID-19 convalescents using magnetic resonance imaging (MRI), has an influence the exposure profiles of medical personnel to static magnetic fields (STmf). (2) Methods: Static exposure to STmf (SEmf) was recorded during activities that modelled performing CMR by radiographers. The motion-induced time variability of that exposure (TVEmf) was calculated from SEmf samples. The results were compared with: (i) labour law requirements; (ii) the distribution of vertigo perception probability near MRI magnets; and (iii) the exposure profile when actually performing a head MRI. (3) Results: The exposure profiles of personnel managing 42 CMR scans (modelled using medium (1.5T), high (3T) and ultrahigh (7T) field scanners) were significantly different than when managing a head MRI. The majority of SEmf and TVEmf samples (up to the 95th percentile) were at low vertigo perception probability (SEmf < 500 mT, TVEmf < 600 mT/s), but a small fraction were at medium/high levels; (4) Conclusion: Even under the “normal working conditions” defined for SEmf (STmf < 2T) by labour legislation (Directive 2013/35/EC), increased CMR usage increases vertigo-related hazards experienced by MRI personnel (a re-evaluation of electromagnetic safety hazards is suggested in the case of these or similar changes in work organisation).

Subjective Symptoms in Magnetic Resonance Imaging Personnel: A Multi-Center Study in Italy

Introduction: Magnetic Resonance Imaging (MRI) personnel have significant exposure to static and low-frequency time-varying magnetic fields. In these workers an increased prevalence of different subjective symptoms has been observed. The aim of our study was to investigate the prevalence of non-specific subjective symptoms and of "core symptoms" in a group of MRI personnel working in different centers in Italy, and of possible relationships with personal and occupational characteristics. Methods: The occurrence of 11 subjective symptoms was evaluated using a specific questionnaire with 240 subjects working in 6 different Italian hospitals and research centers, 177 MRI health care and research personnel and 63 unexposed subjects employed in the same departments. Exposure was subjectively investigated according to the type of MRI scanner (≤1.5 vs. ≥3 T) and to the number of MRI procedures attended and/or performed by the personnel, even if no information on how frequently the personnel entered the scanner room was collected. The possible associations among symptoms and estimated EMF exposure, the main characteristics of the population, and job stress perception were analyzed. Results: Eighty-six percent of the personnel reported at least one symptom; drowsiness, headache, and sleep disorders were the most frequent. The total number of symptoms did not differ between exposed persons and controls. Considering the total number of annual MRI procedures reported by the personnel, no significant associations were found nor with the total number of symptoms, nor with "core symptoms." Only subjects complaining of drowsiness also reported a significantly higher mean annual number of MRI procedures with ≤ 1.5 T scanners when compared with exposed subjects without drowsiness. In a multivariate model, subjects with a high level of perceived stress complained of more symptoms (p = 0.0002). Conclusions: Our study did not show any association between the occurrence of reversible subjective symptoms, including the more specific "core symptoms," and the occupational exposure of MRI personnel to static and low-frequency time-varying magnetic fields. On the other hand, the role played by occupational stress appears to be not negligible. In further research in this field, measurements of EMF exposure should be considered.

Safety for Human MR Scanners at 7T

After introduction of the first human 7 tesla (7T) system in 1999, 7T MR systems have been employed as one of the most advanced platforms for human MR research for more than 20 years. Currently, two 7T MR models are approved for clinical use in the U.S.A. The approval facilitated introduction of the 7T system, summing up to around 100 worldwide. The approval in Japan is much awaited. As a clinical MR scanner, the 7T MR system is drawing attention in terms of safety.Several large-sized studies on bioeffects have been reported for vertigo, dizziness, motion disturbances, nausea, and others. Such effects might also be found in MR workers and researchers. Frequency and severity of reported bioeffects will be presented and discussed, including their variances. The high resonance frequency and shorter RF wavelength of 7T increase the concern about the safety. Homogeneous RF pulse excitation is difficult even for the brain, and a multi-channel parallel transmit (pTx) system is considered mandatory. However, pTx may create a hot spot, which makes the estimation of specific absorption rate (SAR) to be difficult. The stronger magnetic field of 7T causes a large force of displacement and heating on metallic implants or devices, and the scan of patients with them should not be conducted at 7T. However, there are some opinions that such patients might be scanned even at 7T, if certain criteria are met. This article provides a brief review on the effect of the static magnetic field on humans (MR subjects, workers, and researchers) and neurons, in addition to scan sound, SAR, and metal implants and devices. Understanding and avoiding adverse effects will contribute to the reduction in safety risks and the prevention of incidents.

10.5 T MRI static field effects on human cognitive, vestibular, and physiological function

PURPOSE

To perform a pilot study to quantitatively assess cognitive, vestibular, and physiological function during and after exposure to a magnetic resonance imaging (MRI) system with a static field strength of 10.5 Tesla at multiple time scales.

METHODS

A total of 29 subjects were exposed to a 10.5 T MRI field and underwent vestibular, cognitive, and physiological testing before, during, and after exposure; for 26 subjects, testing and exposure were repeated within 2-4 weeks of the first visit. Subjects also reported sensory perceptions after each exposure. Comparisons were made between short and long term time points in the study with respect to the parameters measured in the study; short term comparison included pre-vs-isocenter and pre-vs-post (1-24 h), while long term compared pre-exposures 2-4 weeks apart.

RESULTS

Of the 79 comparisons, 73 parameters were unchanged or had small improvements after magnet exposure. The exceptions to this included lower scores on short term (i.e. same day) executive function testing, greater isocenter spontaneous eye movement during visit 1 (relative to pre-exposure), increased number of abnormalities on videonystagmography visit 2 versus visit 1 and a mix of small increases (short term visit 2) and decreases (short term visit 1) in blood pressure. In addition, more subjects reported metallic taste at 10.5 T in comparison to similar data obtained in previous studies at 7 T and 9.4 T.

CONCLUSION

Initial results of 10.5 T static field exposure indicate that 1) cognitive performance is not compromised at isocenter, 2) subjects experience increased eye movement at isocenter, and 3) subjects experience small changes in vital signs but no field-induced increase in blood pressure. While small but significant differences were found in some comparisons, none were identified as compromising subject safety. A modified testing protocol informed by these results was devised with the goal of permitting increased enrollment while providing continued monitoring to evaluate field effects.

Musculoskeletal MRI at 7 T: do we need more or is it more than enough?

Ultra-high field magnetic resonance imaging (UHF-MRI) provides important diagnostic improvements in musculoskeletal imaging. The higher signal-to-noise ratio leads to higher spatial and temporal resolution which results in improved anatomic detail and higher diagnostic confidence. Several methods, such as T2, T2*, T1rho mapping, delayed gadolinium-enhanced, diffusion, chemical exchange saturation transfer, and magnetisation transfer techniques, permit a better tissue characterisation. Furthermore, UHF-MRI enables in vivo measurements by low-γ nuclei (²³Na, ³¹P, ¹³C, and ³⁹K) and the evaluation of different tissue metabolic pathways. European Union and Food and Drug Administration approvals for clinical imaging at UHF have been the first step towards a more routinely use of this technology, but some drawbacks are still present limiting its widespread clinical application. This review aims to provide a clinically oriented overview about the application of UHF-MRI in the different anatomical districts and tissues of musculoskeletal system and its pros and cons. Further studies are needed to consolidate the added value of the use of UHF-MRI in the routine clinical practice and promising efforts in technology development are already in progress.

Effect of Static Magnetic Field of Electric Vehicles on Driving Performance and on Neuro-Psychological Cognitive Functions

Human neuropsychological reactions and brain activities when driving electric vehicles (EVs) are considered as an issue for traffic and public safety purposes; this paper examined the effect of the static magnetic field (SMF) derived from EVs. A lane change task was adopted to evaluate the driving performance; and the driving reaction time test and the reaction time test were adopted to evaluate the variation of the neuro-psychological cognitive functions. Both the sham and the real exposure conditions were performed with a 350 μT localized SMF in this study; 17 student subjects were enrolled in this single-blind experiment. Electroencephalographs (EEGs) of the subjects were adopted and recorded during the experiment as an indicator of the brain activity for the variations of the driving performance and of the cognitive functions. Results of this study have indicated that the impact of the given SMF on both the human driving performance and the cognitive functions are not considerable; and that there is a correlation between beta sub-band of the EEGs and the human reaction time in the analysis

MR Imaging of the Musculoskeletal System Using Ultrahigh Field (7T) MR Imaging

MR imaging is an indispensable instrument for the diagnosis of musculoskeletal diseases. In vivo MR imaging at 7T offers many advantages, including increased signal-to-noise ratio, higher spatial resolution, improved spectral resolution for spectroscopy, improved sensitivity for X-nucleus imaging, and decreased image acquisition times. There are also however technical challenges of imaging at a higher field strength compared with 1.5 and 3T MR imaging systems. We discuss the many potential opportunities as well as the challenges presented by 7T MR imaging systems and highlight recent developments in in vivo research imaging of musculoskeletal applications in general and cartilage, skeletal muscle, and bone in particular.

Pros and cons of ultra-high-field MRI/MRS for human application

Magnetic resonance imaging and spectroscopic techniques are widely used in humans both for clinical diagnostic applications and in basic research areas such as cognitive neuroimaging. In recent years, new human MR systems have become available operating at static magnetic fields of 7 T or higher (≥300 MHz proton frequency). Imaging human-sized objects at such high frequencies presents several challenges including non-uniform radiofrequency fields, enhanced susceptibility artifacts, and higher radiofrequency energy deposition in the tissue. On the other side of the scale are gains in signal-to-noise or contrast-to-noise ratio that allow finer structures to be visualized and smaller physiological effects to be detected. This review presents an overview of some of the latest methodological developments in human ultra-high field MRI/MRS as well as associated clinical and scientific applications. Emphasis is given to techniques that particularly benefit from the changing physical characteristics at high magnetic fields, including susceptibility-weighted imaging and phase-contrast techniques, imaging with X-nuclei, MR spectroscopy, CEST imaging, as well as functional MRI. In addition, more general methodological developments such as parallel transmission and motion correction will be discussed that are required to leverage the full potential of higher magnetic fields, and an overview of relevant physiological considerations of human high magnetic field exposure is provided.

Development of hypertension after long-term exposure to static magnetic fields among workers from a magnetic resonance imaging device manufacturing facility

OBJECTIVE

To assess the association between long-term exposure to static magnetic fields (SMF) in a magnetic resonance imaging (MRI)-manufacturing environment and hypertension.

METHODS

In an occupational cohort of male workers (n = 538) of an MRI-manufacturing facility, the first and last available blood pressure measurements from the facility's medical surveillance scheme were associated with modeled cumulative exposure to SMF. Exposure modeling was based on linkage of individual job histories from the facility's personnel records with a facility specific historical job exposure matrix. Hypertension was defined as a systolic pressure of above 140 mm Hg and/or a diastolic blood pressure above 90 mm Hg. Logistic regression models were used to associate cumulative SMF exposure to hypertension while adjusting for age, body mass index and blood pressure at time of first blood pressure measurement. Stratified analysis by exposure duration was performed similarly.

RESULTS

High cumulative exposure to SMF (≥ 7.4 K Tesla minutes) was positively associated with development of hypertension (Odds Ratio [OR] 2.32, 95% confidence interval [CI] 1.27 - 4.25, P = 0.006). Stratified analysis showed a stronger association for those with high cumulative SMF exposure within a period up to 10 years (OR 3.96, 95% CI 1.62 - 9.69, P = 0.003), but no significant association was found for (high) cumulative exposure accumulated in a period of 10 or more years. Our findings suggest SMF exposure intensity to be more important than exposure duration for the risk of developing hypertension.

CONCLUSIONS

Our data revealed that exposure to high levels of MRI-related SMF during MRI-manufacturing might be associated with developing hypertension.

Clinical Neuroimaging Using 7 T MRI: Challenges and Prospects

The aim of this article is to illustrate the principal challenges, from the medical and technical point of view, associated with the use of ultrahigh field (UHF) scanners in the clinical setting and to present available solutions to circumvent these limitations. We would like to show the differences between UHF scanners and those used routinely in clinical practice, the principal advantages, and disadvantages, the different UHFs that are ready be applied to routine clinical practice such as susceptibility-weighted imaging, fluid-attenuated inversion recovery, 3-dimensional time of flight, magnetization-prepared rapid acquisition gradient echo, magnetization-prepared 2 rapid acquisition gradient echo, and diffusion-weighted imaging, the technical principles of these sequences, and the particularities of advanced techniques such as diffusion tensor imaging, spectroscopy, and functional imaging at 7TMR. Finally, the main clinical applications in the field of the neuroradiology are discussed and the side effects are reported.

MRI-related magnetic field exposures and risk of commuting accidents - A cross-sectional survey among Dutch imaging technicians

BACKGROUND

Imaging technicians working with magnetic resonance imaging (MRI) may experience acute effects such as vertigo or dizziness when being exposed. A previous study also reported an increased risk of accidents in MRI exposed staff.

OBJECTIVES

We aimed at evaluating commuting accident risk in Dutch imaging technicians.

METHODS

Of invited imaging technicians, 490 (29%) filled in a questionnaire pertaining to (near) accidents when driving or riding a bike, health, lifestyle and work practices. We used logistic regression to evaluate the association between exposure to MRI-related electromagnetic fields and risk of commuting (near) accidents in the year prior to the survey, adjusted for a range of potential confounders.

RESULTS

Our cross-sectional study indicated an increased risk of (near) accidents if imaging technicians had worked with MRI in the year prior to the survey (odds ratio OR 2.13, 95%CI 1.23-3.69). Risks were higher in persons who worked with MRI more often (OR 2.32, 95%CI 1.25-4.31) compared to persons who worked sometimes with MRI (OR 1.91, 95%CI 0.98-3.72), and higher in those who had likely experienced higher peak exposures to static and time-varying magnetic fields (OR 2.18, 95%CI 1.06-4.48). The effect was seen on commuting accidents that had occurred on the commute from home to work as well as accidents from work to home or elsewhere.

CONCLUSION

Imaging technicians working with MRI scanners may be at an increased risk of commuting (near) accidents. This result needs confirmation and potential risks for other groups (volunteers, patients) should be investigated.

Prolongation of ERP latency and reaction time (RT) in simultaneous EEG/fMRI data acquisition

BACKGROUND

Recording EEG and fMRI data simultaneously inside a fully-operating scanner has been recognized as a novel approach in human brain research. Studies have demonstrated high concordance between the EEG signals and hemodynamic response. However, a few studies reported altered cognitive process inside the fMRI scanner such as delayed reaction time (RT) and reduced and/or delayed N100 and P300 event-related brain potential (ERP) components.

NEW METHOD

The present study investigated the influence of electromagnetic field (static magnetic field, radio frequency (RF) pulse, and gradient switching) and experimental environment on posterior N100 and P300 ERP components in four different settings with six healthy subjects using a visual oddball task: (1) classic fMRI acquisition inside the scanner (e.g., supine position, mirror glasses for stimulus presentation), (2) standard behavioral experiment outside the scanner (e.g., seated position, keyboard response), (3) controlled fMRI acquisition inside the scanner (e.g., organic light-emitting diode (OLED) goggles for stimulus presentation) inside; and (4) modified behavioral experiment outside the scanner (e.g., supine position, OLED goggles).

RESULTS

The study findings indicated that the experimental environment in simultaneous EEG/fMRI acquisition could substantially delay N1P, P300 latency, and RT inside the scanner, and was associated with a reduced N1P amplitude.

COMPARISON WITH EXISTING METHODS

There was no effect of electromagnetic field in the prolongation of RT, N1P and P300 latency inside the scanner. N1P, but not P300, latency was sensitive to stimulus presentation method inside the scanner.

CONCLUSION

Future simultaneous EEG/fMRI data collection should consider experimental environment in both design and analysis.

Magnetic resonance safety

Magnetic resonance imaging (MRI) has a superior soft-tissue contrast compared to other radiological imaging modalities and its physiological and functional applications have led to a significant increase in MRI scans worldwide. A comprehensive MRI safety training to protect patients and other healthcare workers from potential bio-effects and risks of the magnetic fields in an MRI suite is therefore essential. The knowledge of the purpose of safety zones in an MRI suite as well as MRI appropriateness criteria is important for all healthcare professionals who will work in the MRI environment or refer patients for MRI scans. The purpose of this article is to give an overview of current magnetic resonance safety guidelines and discuss the safety risks of magnetic fields in an MRI suite including forces and torque of ferromagnetic objects, tissue heating, peripheral nerve stimulation, and hearing damages. MRI safety and compatibility of implanted devices, MRI scans during pregnancy, and the potential risks of MRI contrast agents will also be discussed, and a comprehensive MRI safety training to avoid fatal accidents in an MRI suite will be presented.

Vestibular stimulation by magnetic fields

Individuals working next to strong static magnetic fields occasionally report disorientation and vertigo. With the increasing strength of magnetic fields used for magnetic resonance imaging studies, these reports have become more common. It was recently learned that humans, mice, and zebrafish all demonstrate behaviors consistent with constant peripheral vestibular stimulation while inside a strong, static magnetic field. The proposed mechanism for this effect involves a Lorentz force resulting from the interaction of a strong static magnetic field with naturally occurring ionic currents flowing through the inner ear endolymph into vestibular hair cells. The resulting force within the endolymph is strong enough to displace the lateral semicircular canal cupula, inducing vertigo and the horizontal nystagmus seen in normal mice and in humans. This review explores the evidence for interactions of magnetic fields with the vestibular system.

Exposure to static and time-varying magnetic fields from working in the static magnetic stray fields of MRI scanners: a comprehensive survey in the Netherlands

Clinical and research staff who work around magnetic resonance imaging (MRI) scanners are exposed to the static magnetic stray fields of these scanners. Although the past decade has seen strong developments in the assessment of occupational exposure to electromagnetic fields from MRI scanners, there is insufficient insight into the exposure variability that characterizes routine MRI work practice. However, this is an essential component of risk assessment and epidemiological studies. This paper describes the results of a measurement survey of shift-based personal exposure to static magnetic fields (SMF) (B) and motion-induced time-varying magnetic fields (dB/dt) among workers at 15 MRI facilities in the Netherlands. With the use of portable magnetic field dosimeters, >400 full-shift and partial shift exposure measurements were collected among various jobs involved in clinical and research MRI. Various full-shift exposure metrics for B and motion-induced dB/dt exposure were calculated from the measurements, including instantaneous peak exposure and time-weighted average (TWA) exposures. We found strong correlations between levels of static (B) and time-varying (dB/dt) exposure (r = 0.88-0.92) and between different metrics (i.e. peak exposure, TWA exposure) to express full-shift exposure (r = 0.69-0.78). On average, participants were exposed to MRI-related SMFs during only 3.7% of their work shift. Average and peak B and dB/dt exposure levels during the work inside the MRI scanner room were highest among technical staff, research staff, and radiographers. Average and peak B exposure levels were lowest among cleaners, while dB/dt levels were lowest among anaesthesiology staff. Although modest exposure variability between workplaces and occupations was observed, variation between individuals of the same occupation was substantial, especially among research staff. This relatively large variability between workers with the same job suggests that exposure classification based solely on job title may not be an optimal grouping strategy for epidemiological purposes.

Vestibular effects of a 7 Tesla MRI examination compared to 1.5 T and 0 T in healthy volunteers

Ultra-high-field MRI (7 Tesla (T) and above) elicits more temporary side-effects compared to 1.5 T and 3 T, e.g. dizziness or “postural instability” even after exiting the scanner. The current study aims to assess quantitatively vestibular performance before and after exposure to different MRI scenarios at 7 T, 1.5 T and 0 T. Sway path and body axis rotation (Unterberger's stepping test) were quantitatively recorded in a total of 46 volunteers before, 2 minutes after, and 15 minutes after different exposure scenarios: 7 T head MRI (n = 27), 7 T no RF (n = 22), 7 T only B₀ (n = 20), 7 T in & out B₀ (n = 20), 1.5 T no RF (n = 20), 0 T (n = 15). All exposure scenarios lasted 30 minutes except for brief one minute exposure in 7 T in & out B₀. Both measures were documented utilizing a 3D ultrasound system. During sway path evaluation, the experiment was repeated with eyes both open and closed. Sway paths for all long-lasting 7 T scenarios (normal, no RF, only B₀) with eyes closed were significantly prolonged 2 minutes after exiting the scanner, normalizing after 15 minutes. Brief exposure to 7 T B₀ or 30 minutes exposure to 1.5 T or 0 T did not show significant changes. End positions after Unterberger's stepping test were significantly changed counter-clockwise after all 7 T scenarios, including the brief in & out B₀ exposure. Shorter exposure resulted in a smaller alteration angle. In contrast to sway path, reversal of changes in body axis rotation was incomplete after 15 minutes. 1.5 T caused no rotational changes. The results show that exposure to the 7 Tesla static magnetic field causes only a temporary dysfunction or “over-compensation” of the vestibular system not measurable at 1.5 or 0 Tesla. Radiofrequency fields, gradient switching, and orthostatic dysregulation do not seem to play a role.

Does assessment of personal exposure matter during experimental neurocognitive testing in MRI-related magnetic fields?

PURPOSE

To determine whether the use of quantitative personal exposure measurements in experimental research would result in better estimates of the associations between static and time-varying magnetic field exposure and neurocognitive test performance than when exposure categories were based solely on distance to the magnetic field source.

METHODS

In our original analysis, based on distance to the magnet of a 7 T MRI scanner, an effect of exposure to static magnetic fields was observed. We performed a sensitivity analysis of test performance on a reaction task and line bisection task with different exposure measures that were derived from personal real-time measurements.

RESULTS

The exposure measures were highly comparable, and almost all models resulted in significant associations between exposure to time-varying magnetic fields within a static magnetic field and performance on a reaction and line bisection task.

CONCLUSION

In a controlled experimental setup, distance to the bore is a good proxy for personal exposure when placing subjects at fixed positions with standardized head movements in the magnetic stray fields of a 7 T MRI. Use of a magnetic field dosimeter is, however, important for estimating quantitative exposure response associations.

[Problems and chances of high field magnetic resonance imaging]

CLINICAL/METHODICAL ISSUE

The spatial, temporal and spectral resolution in magnetic resonance imaging (MRI) is in many cases currently not sufficient to detect submillimeter lesions or to image the dynamics of the beating heart.

STANDARD RADIOLOGICAL METHODS

At present MRI systems at 1.5 T and 3 T are the standard units for clinical imaging.

METHODICAL INNOVATIONS

The use of ultrahigh magnetic fields of 7 T and higher increases the signal-to-noise ratio, which holds promise for a significant improvement of the spatial and/or temporal resolution as well as for new contrast mechanisms.

PERFORMANCE

With 7 T MRI, images of the brain have been acquired routinely with a spatial resolution of 0.3 mm. The theoretical improvement of the signal-to-noise ratio is often not fully realized due to B1 inhomogeneities and contrast variations.

ACHIEVEMENTS

With MRI at 7 T a notable increase in spatial resolution can be achieved. Methods such as time-of-flight MR angiography and susceptibility-weighted imaging (e.g. neurofunctional MRI, fMRI) profit especially from the higher field strengths. Transmission field inhomogeneities are still a major challenge for ultrahigh field (UHF) MRI and are also a partially unsolved safety problem.

PRACTICAL RECOMMENDATIONS

The use of UHF MRI is currently limited to special applications and the expected gain of the high field must be weighed against technical limitations in both image acquisition and interpretation.

Retrospective assessment of exposure to static magnetic fields during production and development of magnetic resonance imaging systems

At present, the relationship between chronic exposure to static magnetic fields (SMF) and health effects is unclear. We developed a task-based deterministic model for estimating historical electromagnetic field exposure from the static B-field (B0) of magnetic resonance imaging (MRI) systems, for a cohort of employees working at an MRI systems development and production facility. Technical maps describing the spatial distribution of fringe fields of B0 surrounding different types of MRI systems of various core strengths were exploited to derive estimates of static B0 exposure as a function of distance from the bore of the MRI system. Detailed information on tasks performed per exposed job and other model determinants were acquired through face-to-face interviews and used to derive base estimates of most recent exposure (2009) for each job title. The model was partially validated with actual exposure measurements. The exposure estimates from the deterministic model were used to construct a job-exposure matrix that will enable estimation of cumulative exposures for each cohort member. The generic approach described for estimating chronic MRI-related SMF exposure makes it universally applicable in other studies investigating health effects of MRI-related SMF exposure.

Exposure system and dosimetry for in vitro studies of biocompatibility of pulse-modulated RF signals of ultrahigh field MRI

A new setup for exposure of human cells in vitro at 37 °C to pulse-modulated 300 and 500 MHz signals of future magnetic resonance imaging (MRI) systems is designed, built up, and characterized. Two dipole antennas, specifically designed for ultrahigh field MRI, are used as radiating structures. The electromagnetic (EM) field distribution inside the incubator containing the cells is computed, and it is shown to be in a good agreement with measurements. The electric field at the cell level is quantified numerically. Local, 1-g average, and averaged over the culture medium volume SAR are provided along with the standard deviation values for each well. Temperature increments are measured inside the culture medium during the exposure using an optical fiber thermometer. Then, we identify the pulse parameters corresponding to the thermal threshold of 1 °C, usually considered as a threshold for thermally induced biological effects. For these parameters, the induction of heat shock proteins is assessed to biologically verify a potential thermal response of cells. The data demonstrate that, under the considered experimental conditions, exposure to pulse-modulated radiations emulating typical ultrahigh field MRI signals, corresponding to temperature increments below 1 °C, does not trigger any heat shock response in human brain cells.

A historical overview of magnetic resonance imaging, focusing on technological innovations

Magnetic resonance imaging (MRI) has now been used clinically for more than 30 years. Today, MRI serves as the primary diagnostic modality for many clinical problems. In this article, historical developments in the field of MRI will be discussed with a focus on technological innovations. Topics include the initial discoveries in nuclear magnetic resonance that allowed for the advent of MRI as well as the development of whole-body, high field strength, and open MRI systems. Dedicated imaging coils, basic pulse sequences, contrast-enhanced, and functional imaging techniques will also be discussed in a historical context. This article describes important technological innovations in the field of MRI, together with their clinical applicability today, providing critical insights into future developments.

Cognition and sensation in very high static magnetic fields: a randomized case-crossover study with different field strengths

PURPOSE

To establish the extent to which representative cognitive functions in subjects undergoing magnetic resonance (MR) imaging are acutely impaired by static magnetic fields of varying field strengths.

MATERIALS AND METHODS

This study was approved by the local ethics committee, and informed consent was obtained from all subjects. In this single-blind case-crossover study, 41 healthy subjects underwent an extensive neuropsychologic examination while in MR units of differing field strengths (1.5, 3.0, and 7.0 T), including a mock imager with no magnetic field as a control condition. Subjects were blinded to field strength. Tests were performed while subjects were lying still in the MR unit and while the examination table was moved. The tests covered a representative set of cognitive functions, such as memory, eye-hand coordination, attention, reaction time, and visual discrimination. Subjective sensory perceptions were also assessed. Effects were analyzed with a repeated-measures analysis of variance; the within-subject factors were field strength (0, 1.5, 3.0, and 7.0 T) and state (static, dynamic).

RESULTS

Static magnetic fields were not found to have a significant effect on cognitive function at any field strength. However, sensory perceptions did vary according to field strength. Dizziness, nystagmus, phosphenes, and head ringing were related to the strength of the static magnetic field.

CONCLUSION

Static magnetic fields as high as 7.0 T did not have a significant effect on cognition.

MRI-related static magnetic stray fields and postural body sway: a double-blind randomized crossover study

We assessed postural body sway performance after exposure to movement induced time-varying magnetic fields in the static magnetic stray field in front of a 7 Tesla (T) magnetic resonance imaging scanner. Using a double blind randomized crossover design, 30 healthy volunteers performed two balance tasks (i.e., standing with eyes closed and feet in parallel and then in tandem position) after standardized head movements in a sham, low exposure (on average 0.24 T static magnetic stray field and 0.49 T·s(-1) time-varying magnetic field) and high exposure condition (0.37 T and 0.70 T·s(-1)). Personal exposure to static magnetic stray fields and time-varying magnetic fields was measured with a personal dosimeter. Postural body sway was expressed in sway path, area, and velocity. Mixed-effects model regression analysis showed that postural body sway in the parallel task was negatively affected (P < 0.05) by exposure on all three measures. The tandem task revealed the same trend, but did not reach statistical significance. Further studies are needed to investigate the possibility of independent or synergetic effects of static magnetic stray field and time-varying magnetic field exposure. In addition, practical safety implications of these findings, e.g., for surgeons and others working near magnetic resonance imaging scanners need to be investigated.

7-T MR--from research to clinical applications?

Over 20,000 MR systems are currently installed worldwide and, although the majority operate at magnetic fields of 1.5 T and below (i.e. about 70%), experience with 3-T (in high-field clinical diagnostic imaging and research) and 7-T (research only) human MR scanners points to a future in functional and metabolic MR diagnostics. Complementary to previous studies, this review attempts to provide an overview of ultrahigh-field MR research with special emphasis on emerging clinical applications at 7 T. We provide a short summary of the technical development and the current status of installed MR systems. The advantages and challenges of ultrahigh-field MRI and MRS are discussed with special emphasis on radiofrequency inhomogeneity, relaxation times, signal-to-noise improvements, susceptibility effects, chemical shifts, specific absorption rate and other safety issues. In terms of applications, we focus on the topics most likely to gain significantly from 7-T MR, i.e. brain imaging and spectroscopy and musculoskeletal imaging, but also body imaging, which is particularly challenging. Examples are given to demonstrate the advantages of susceptibility-weighted imaging, time-of-flight MR angiography, high-resolution functional MRI, (1)H and (31)P MRSI in the human brain, sodium and functional imaging of cartilage and the first results (and artefacts) using an eight-channel body array, suggesting future areas of research that should be intensified in order to fully explore the potential of 7-T MR systems for use in clinical diagnosis.

Exposure classification of MRI workers in epidemiological studies

We estimate that there are about 100,000 workers from different disciplines, such as radiographers, nurses, anesthetists, technicians, engineers, etc., who can be exposed to substantial electromagnetic fields (compared to normal background levels) around magnetic resonance imaging (MRI) scanners. There is a need for well-designed epidemiological studies of MRI workers but since the exposure from MRI equipment is a very complex mixture of static magnetic fields, switched gradient magnetic fields, and radiofrequency electromagnetic fields (RF EMF), it is necessary to discuss how to assess the exposure in epidemiological studies. As an alternative to the use of job title as a proxy of exposure, we propose an exposure categorization for the different professions working with MRI equipment. Specifically, we propose defining exposure in three categories, depending on whether people are exposed to only the static field, to the static plus switched gradient fields or to the static plus switched gradient plus RF fields, as a basis for exposure assessment in epidemiological studies.

Occupational exposure in MRI

This article reviews occupational exposure in clinical MRI; it specifically considers units of exposure, basic physical interactions, health effects, guideline limits, dosimetry, results of exposure surveys, calculation of induced fields and the status of the European Physical Agents Directive. Electromagnetic field exposure in MRI from the static field B(0), imaging gradients and radiofrequency transmission fields induces electric fields and currents in tissue, which are responsible for various acute sensory effects. The underlying theory and its application to the formulation of incident and induced field limits are presented. The recent International Commission on Non-Ionizing Radiation Protection (ICNIRP) Bundesministerium für Arbeit und Soziales and Institute of Electrical and Electronics Engineers limits for incident field exposure are interpreted in a manner applicable to MRI. Field measurements show that exposure from movement within the B(0) fringe field can exceed ICNIRP reference levels within 0.5 m of the bore entrance. Rate of change of field dB/dt from the imaging gradients is unlikely to exceed the new limits, although incident field limits can be exceeded for radiofrequency (RF) exposure within 0.2-0.5 m of the bore entrance. Dosimetric surveys of routine clinical practice show that staff are exposed to peak values of 42 ± 24% of B(0), with time-averaged exposures of 5.2 ± 2.8 mT for magnets in the range 0.6-4 T. Exposure to time-varying fields arising from movement within the B(0) fringe resulted in peak dB/dt of approximately 2 T s(-1). Modelling of induced electric fields from the imaging gradients shows that ICNIRP-induced field limits are unlikely to be exceeded in most situations; however, movement through the static field may still present a problem. The likely application of the limits is discussed with respect to the reformulation of the European Union (EU) directive and its possible implications for MRI.

Effects of a 1.5 T time-varying magnetic field on cell volume regulation of bovine adrenal chromaffin cells in hyposmotic media

Effects of a time-varying magnetic field on cell volume regulation by hyposmotic stress in cultured bovine adrenal chromaffin cells were examined. Through regulatory volume decrease (RVD), cell volume of chromaffin cells that were incubated in a hypotonic medium initially increased, reached a peak and finally recovered to the initial value. Two hour exposure to a magnetic field and addition of cytochalasin D increased peak value and delayed return to initial value. Intracellular F-actin contents initially decreased but returned to normal levels after 10 sec. Two hour exposure to the magnetic field and addition of cytochalasin D continuously reduced the F-actin content. Results suggest that exposure to the magnetic field stimulated disruption of the actin cytoskeleton and that the disruption delayed the recovery to the volume prior to osmotic stress.

Acoustic pressure waves induced in human heads by RF pulses from high-field MRI scanners

The current evolution toward greater image resolution from magnetic resonance image (MRI) scanners has prompted the exploration of higher strength magnetic fields and use of higher levels of radio frequencies (RFs). Auditory perception of RF pulses by humans has been reported during MRI with head coils. It has shown that the mechanism of interaction for the auditory effect is caused by an RF pulse-induced thermoelastic pressure wave inside the head. We report a computational study of the intensity and frequency of thermoelastic pressure waves generated by RF pulses in the human head inside high-field MRI and clinical scanners. The U.S. Food and Drug Administration (U.S. FDA) guides limit the local specific absorption rate (SAR) in the body-including the head-to 8 W kg(-1). We present results as functions of SAR and show that for a given SAR the peak acoustic pressures generated in the anatomic head model were essentially the same at 64, 300, and 400 MHz (1.5, 7.0, and 9.4 T). Pressures generated in the anatomic head are comparable to the threshold pressure of 20 mPa for sound perception by humans at the cochlea for 4 W kg(-1). Moreover, results indicate that the peak acoustic pressure in the brain is only 2 to 3 times the auditory threshold at the U.S. FDA guideline of 8 W kg(-1). Even at a high SAR of 20 W kg(-1), where the acoustic pressure in the brain could be more than 7 times the auditory threshold, the sound pressure levels would not be more than 17 db above threshold of perception at the cochlea.

Circular swimming in mice after exposure to a high magnetic field

There is increasing evidence that exposure to high magnetic fields of 4T and above perturbs the vestibular system of rodents and humans. Performance in a swim test is a sensitive test of vestibular function. In order to determine the effect of magnet field exposure on swimming in mice, mice were exposed for 30 min within a 14.1T superconducting magnet and then tested at different times after exposure in a 2-min swim test. As previously observed in open field tests, mice swam in tight counter-clockwise circles when tested immediately after magnet exposure. The counter-clockwise orientation persisted throughout the 2-min swim test. The tendency to circle was transient, because no significant circling was observed when mice were tested at 3 min or later after magnet exposure. However, mice did show a decrease in total distance swum when tested between 3 and 40 min after magnet exposure. The decrease in swimming distance was accompanied by a pronounced postural change involving a counter-clockwise twist of the pelvis and hindlimbs that was particularly severe in the first 15s of the swim test. Finally, no persistent difference from sham-exposed mice was seen in the swimming of magnet-exposed mice when tested 60 min, 24h, or 96 h after magnet exposure. This suggests that there is no long-lasting effect of magnet exposure on the ability of mice to orient or swim. The transient deficits in swimming and posture seen shortly after magnet exposure are consistent with an acute perturbation of the vestibular system by the high magnetic field.

Exposure to alternating electromagnetic fields and effects on the visual and visuomotor systems

Acute effects on the visual and visuo-motor systems by exposure to electromagnetic fields (EMFs) at a frequency and amplitude similar to those produced by MR imaging gradient coils were assessed. 40 volunteers were exposed in random order to three, time varying, magnetic field gradients (0, 20 and 10 mT m(-1)r.m.s.). The waveform was 50 cycles of a 490 Hz sinusoidal waveform repeated every second with a total duration of 10 min for each trial. The EMFs were generated using an in-house designed and built magnetic gradient coil and waveform generator. During each trial, a test battery assessing the visual sensory (FACT) and visuo-motor (Pursuit Aiming II and visual tracking) neurobehavioral domains was completed by all volunteers. The sequence of these tests was assigned at random for each volunteer. Performance in these tests was analysed using linear mixed effects models adjusted for confounding factors collected in a pre-trial questionnaire. Variability of the estimates was assessed using a delete-1 jack-knife procedure. There was a trend for visuo-motor accuracy to be reduced (p = 0.06) by 1% during high exposure, but not at medium exposure. There was a weaker trend for visual contrast sensitivity to be improved by 12% and 21% during medium and high exposure, respectively, compared with the non-exposed sessions (p = 0.08). These effects did not reach 5% statistical significance within a population of 40 volunteers, but also the magnitude of these effects did not depend on single "extreme" observations.