Wireless Resonant Circuits Printed Using Aerosol Jet Deposition for MRI Catheter Tracking

Conformal printed electronics on flexible substrates and inflatable catheters using lathe-based aerosol jet printing

With the growth of additive manufacturing (AM), there has been increasing demand for fabricating conformal electronics that directly integrate with larger components to enable unique functionality. However, fabrication of conformal electronics is challenging because devices must merge with host substrates regardless of curvilinearity, topography, or substrate material. In this work, we employ aerosol jet (AJ) printing, an AM method for jet printing electronics using ink-based materials, and a custom-made lathe mechanism for mounting flexible substrates and 3D objects on a rotating axis. Using this method of lathe-based AJ printing, conformal electronics are printed around the circumference of rotational bodies with 3D curvilinear surfaces through cylindrical-coordinate motion. We characterize the diverse capabilities of lathe AJ (LAJ) printing and demonstrate flexible conformal electronics including multilayer carbon nanotube transistors. Lastly, a graphene sensor is conformally printed on an inflated catheter balloon for temperature and inflation monitoring, thus highlighting the versatilities of LAJ printing.

Electric field and SAR reduction in high-impedance RF arrays by using high permittivity materials for 7T MR imaging

In the field of ultra-high field MR imaging, the challenges associated with higher frequencies and shorter wavelengths necessitate rigorous attention to multichannel array design. While the need for such arrays remains, and efforts to increase channel counts continue, a persistent impediment-inter-element coupling-constantly hinders development. This coupling degrades current and field distribution, introduces noise correlation between channels, and alters the frequency of array elements, affecting image quality and overall performance. The goal of optimizing ultra-high field MRI goes beyond resolving inter-element coupling and includes significant safety considerations related to the design changes required to achieve high-impedance coils. Although these coils provide excellent isolation, the higher impedance needs special design changes. However, such changes pose a significant safety risk in the form of strong electric fields across low-capacitance lumped components. This process may raise Specific Absorption Rate (SAR) values in the imaging subject, increasing power deposition and, as a result, the risk of tissue heating-related injury. To balance the requirement of inter-element decoupling with the critical need for safety, we suggest a new solution. Our method uses high-dielectric materials to efficiently reduce electric fields and SAR values in the imaging sample. This intervention tries to maintain B1 efficiency and inter-element decoupling within the existing array design, which includes high-impedance coils. Our method aims to promote the full potential of ultra-high field MRI by alleviating this critical safety concern with minimal changes to the existing array setup.

Omnidirectional Monolithic Marker for Intra-Operative MR-Based Positional Sensing in Closed MRI

We present a design of an inductively coupled radio frequency (ICRF) marker for magnetic resonance (MR)-based positional tracking, enabling the robust increase of tracking signal at all scanning orientations in quadrature-excited closed MR imaging (MRI). The marker employs three curved resonant circuits fully covering a cylindrical surface that encloses the signal source. Each resonant circuit is a planar spiral inductor with parallel plate capacitors fabricated monolithically on flexible printed circuit board (FPC) and bent to achieve the curved structure. Size of the constructed marker is Ø3-mm ×5 -mm with quality factor > 22, and its tracking performance was validated with 1.5 T MRI scanner. As result, the marker remains as a high positive contrast spot under 360° rotations in 3 axes. The marker can be accurately localized with a maximum error of 0.56 mm under a displacement of 56 mm from the isocenter, along with an inherent standard deviation of 0.1-mm. Accrediting to the high image contrast, the presented marker enables automatic and real-time tracking in 3D without dependency on its orientation with respect to the MRI scanner receive coil. In combination with its small form-factor, the presented marker would facilitate robust and wireless MR-based tracking for intervention and clinical diagnosis. This method targets applications that can involve rotational changes in all axes (X-Y-Z).

A Novel Three-Channel Endorectal Coil for Prostate Magnetic Resonance Imaging at 3T

OBJECTIVE

The purpose of this work is to develop a 3-channel endorectal coil (ERC-3C) structure to obtain higher signal-to-noise (SNR) and better parallel imaging performance for prostate magnetic resonance imaging (MRI) at 3T.

METHODS

The coil performance was validated by in vivo studies and the SNR, g-factor, and diffusion-weighted imaging (DWI) were compared. A 2-channel endorectal coil (ERC-2C) with two orthogonal loops and a 12-channel external surface coil were employed for comparison.

RESULTS

Compared with the ERC-2C with a quadrature configuration and the external 12-channel coil array, the proposed ERC-3C improved SNR performance by 23.9% and 428.9%, respectively. The improved SNR enables the ERC-3C to produce spatial high-resolution images of 0.24 mm × 0.24 mm × 2 mm (0.1152 μL) in the prostate area within 9 minutes.

CONCLUSION

We developed an ERC-3C and validated its performance through in vivo MR imaging experiments.

SIGNIFICANCE

The results demonstrated the feasibility of an ERC with more than two channels and that a higher SNR can be achieved using the ERC-3C compared with an orthogonal ERC-2C of the same coverage.

MRI-guided endovascular intervention: current methods and future potential

INTRODUCTION

Image-guided endovascular interventions, performed using the insertion and navigation of catheters through the vasculature, have been increasing in number over the years, as minimally invasive procedures continue to replace invasive surgical procedures. Such endovascular interventions are almost exclusively performed under x-ray fluoroscopy, which has the best spatial and temporal resolution of all clinical imaging modalities. Magnetic resonance imaging (MRI) offers unique advantages and could be an attractive alternative to conventional x-ray guidance, but also brings with it distinctive challenges.

AREAS COVERED

In this review, the benefits and limitations of MRI-guided endovascular interventions are addressed, systems and devices for guiding such interventions are summarized, and clinical applications are discussed.

EXPERT OPINION

MRI-guided endovascular interventions are still relatively new to the interventional radiology field, since significant technical hurdles remain to justify significant costs and demonstrate safety, design, and robustness. Clinical applications of MRI-guided interventions are promising but their full potential may not be realized until proper tools designed to function in the MRI environment are available. Translational research and further preclinical studies are needed before MRI-guided interventions will be practical in a clinical interventional setting.

High-resolution intravascular magnetic resonance imaging of the coronary artery wall at 3.0 Tesla: toward evaluation of atherosclerotic plaque vulnerability

Background

To validate the feasibility of generating high-resolution intravascular 3.0 Tesla (T) magnetic resonance imaging of the coronary artery wall to further plaque imaging.

Methods

A receive-only 0.014-inch diameter magnetic resonance imaging guidewire (MRIG) was manufactured for intravascular imaging within a phantom experiment and the coronary artery wall of the swine. For coronary artery wall imaging, both high-resolution images and conventional resolution images were acquired. A 16-channel commercial surface coil for magnetic resonance imaging was employed for the control group.

Results

For the phantom experiment, the MRIG showed a higher signal-to-noise ratio than the surface coil. The peak signal-to-noise ratio of the MRIG and the surface coil-generated imaging were 213.6 and 19.8, respectively. The signal-to-noise ratio decreased rapidly as the distance from the MRIG increased. For the coronary artery wall experiment, the vessel wall imaging by the MRIG could be identified clearly, whereas the vessel wall imaging by the surface coil was blurred. The average signal-to-noise ratio of the artery wall was 21.1±5.40 by the MRIG compared to 8.4±2.19 by the surface coil, where the resolution was set at 0.2 mm × 0.2 mm × 2 mm. As expected, the high-resolution sequence clearly showed more details than the conventional resolution sequence set at 0.7 mm × 0.7 mm × 2.0 mm. Histological examination showed no evidence of mechanical injuries in the target vessel walls.

Conclusions

The study validated the feasibility of generating magnetic resonance imaging (MRI) at 0.2 mm × 0.2 mm × 2 mm for the coronary artery wall using a 0.014 inch MRIG.

Challenges to the development of the next generation of self-reporting cardiovascular implantable medical devices

Cardiovascular disease (CVD) is a group of heart and vasculature conditions which are the leading form of mortality worldwide. Blood vessels can become narrowed, restricting blood flow, and drive the majority of hearts attacks and strokes. Surgical interventions are frequently required; including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Despite successful opening of vessels and restoration of blood flow, often in-stent restenosis (ISR) and graft failure can still occur, resulting in subsequent patient morbidity and mortality. A new generation of cardiovascular implants that have sensors and real-time monitoring capabilities are being developed to combat ISR and graft failure. Self-reporting stent/graft technology could enable precision medicine-based healthcare by detecting the earliest features of disease, even before symptoms occur. Bringing an implantable medical device with wireless electronic sensing capabilities to market is complex and often obstructive undertaking. This critical review analyses the obstacles that need to be overcome for self-reporting stents/grafts to be developed and provide a precision-medicine based healthcare for cardiovascular patients. Here we assess the latest research and technological advancement in the field, the current devices and the market potential for their end-user implementation.

A 20-gauge active needle design with thin-film printed circuitry for interventional MRI at 0.55T

PURPOSE

This work aims to fabricate RF antenna components on metallic needle surfaces using biocompatible polyester tubing and conductive ink to develop an active interventional MRI needle for clinical use at 0.55 Tesla.

METHODS

A custom computer numeric control-based conductive ink printing method was developed. Based on electromagnetic simulation results, thin-film RF antennas were printed with conductive ink and used to fabricate a medical grade, 20-gauge (0.87 mm outer diameter), 90-mm long active interventional MRI needle. The MRI visibility performance of the active needle prototype was tested in vitro in 1 gel phantom and in vivo in 1 swine. A nearly identical active needle constructed using a 44 American Wire Gauge insulated copper wire-wound RF receiver antenna was a comparator. The RF-induced heating risk was evaluated in a gel phantom per American Society for Testing and Materials (ASTM) 2182-19.

RESULTS

The active needle prototype with printed RF antenna was clearly visible both in vitro and in vivo under MRI. The maximum RF-induced temperature rise of prototypes with printed RF antenna and insulated copper wire antenna after a 3.96 W/kg, 15 min. long scan were 1.64°C and 8.21°C, respectively. The increase in needle diameter was 98 µm and 264 µm for prototypes with printed RF antenna and copper wire-wound antenna, respectively.

CONCLUSION

The active needle prototype with conductive ink printed antenna provides distinct device visibility under MRI. Variations on the needle surface are mitigated compared to use of a 44 American Wire Gauge copper wire. RF-induced heating tests support device RF safety under MRI. The proposed method enables fabrication of small diameter active interventional MRI devices having complex geometries, something previously difficult using conventional methods.

Combined Use of X-ray Angiography and Intraprocedural MRI Enables Tissue-based Decision Making Regarding Revascularization during Acute Ischemic Stroke Intervention

Background For patients with acute ischemic stroke undergoing endovascular mechanical thrombectomy with x-ray angiography, the use of adjuncts to maintain vessel patency, such as stents or antiplatelet medications, can increase risk of periprocedural complications. Criteria for using these adjuncts are not well defined. Purpose To evaluate use of MRI to guide critical decision making by using a combined biplane x-ray neuroangiography 3.0-T MRI suite during acute ischemic stroke intervention. Materials and Methods This retrospective observational study evaluated consecutive patients undergoing endovascular intervention for acute ischemic stroke between July 2019 and May 2020 who underwent either angiography with MRI or angiography alone. Cerebral tissue viability was assessed by using MRI as the reference standard. For statistical analysis, Fisher exact test and Student t test were used to compare groups. Results Of 47 patients undergoing acute stroke intervention, 12 patients (median age, 69 years; interquartile range, 60-77 years; nine men) underwent x-ray angiography with MRI whereas the remaining 35 patients (median age, 80 years; interquartile range, 68-86 years; 22 men) underwent angiography alone. MRI results influenced clinical decision making in one of three ways: whether or not to perform initial or additional mechanical thrombectomy, whether or not to place an intracranial stent, and administration of antithrombotic or blood pressure medications. In this initial experience, decision making during endovascular acute stroke intervention in the combined angiography-MRI suite was better informed at MRI, such that therapy was guided in real time by the viability of the at-risk cerebral tissue. Conclusion Integrating intraprocedural 3.0-T MRI into acute ischemic stroke treatment was feasible and guided decisions of whether or not to continue thrombectomy, to place stents, or to administer antithrombotic medication or provide blood pressure medications. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Lev and Leslie-Mazwi in this issue.

Wireless Powered Encoding and Broadcasting of Frequency Modulated Detection Signals

Wireless transmission of locally detected RF signals is necessary for long-term operation of batteryless and embedded transducers. To improve signal transmission efficiency over larger distances, multi-stage circuits were employed to down-convert RF signals before encoding them onto the emitted carrier wave. Such multi-stage arrangement had complicated design and high-power consumption. Here, a compact and low-power wireless modulator is introduced to directly encode input RF signals onto its oscillation carrier wave. The modulator consists of a double frequency parametric resonator that is overlaid with a single frequency passive resonator to create three resonance modes. By properly adjusting the substrate thickness between resonators, the highest resonance frequency is tuned to approximately the sum of lower two resonance frequencies, enabling efficient conversion of wireless pumping power into sustained oscillation currents. When an input RF signal is present with a certain frequency offset, the oscillation signal can be frequency modulated by the input signal to create multiple modulation sidebands separated by the offset frequency. The frequency encoded carrier wave can transmit MRI signals over larger distance separations to maintain constant image sensitivity, making the modulator useful to improve the remote detectability of miniaturized implantable and interventional devices.

Wireless Reconfigurable RF Detector Array for Focal and Multiregional Signal Enhancement

Wirelessly Amplified NMR Detectors (WAND) can utilize wireless pumping power to amplify MRI signals in situ for sensitivity enhancement of deep-lying tissues that are difficult to access by conventional surface coils. To reconfigure between selective and simultaneous activation in a multielement array, each WAND has a dipole resonance mode for MR signal acquisition and two butterfly modes that support counter-rotating current circulation. Because detectors in the same row share the same lower butterfly frequency but different higher butterfly frequency, a pumping signal at the sum frequency of the dipole mode and the higher butterfly mode can selectively activate individual resonators, leading to 4-fold sensitivity gain over passive coupling. Meanwhile, a pumping signal at the sum frequency of the dipole mode and the lower butterfly mode can simultaneously activate multiple resonators in the same row, leading to 3-fold sensitivity gain over passive coupling. When multiple rows of detectors are parallelly aligned, each row has a unique lower butterfly frequency for consecutive activation during the acquisition interval of the others. This wireless detector array can be embedded beneath a headpost that is normally required for multi-modal brain imaging, enabling easy reconfiguration between focal imaging of individual vessels and multiregional mapping of brain connectivity.

Fabrication and Characterization of a Flexible Fluxgate Sensor with Pad-Printed Solenoid Coils

This paper presents the fabrication and characterization of a flexible, flat, miniaturized fluxgate sensor with a thin amorphous rectangular magnetic core fabricated by the pad/printing technique. Both the design and the various printing steps of the sensor are presented. The fluxgate sensor comprises of solenoid coils, and to the best of our knowledge, is the first to be printed with a conventional micro-printing technique. The magnetic core is a non-printed component, placed between the printed layers. The sensor’s linear measuring range is ±40 µT with 2% full-scale linearity error, at 100 kHz excitation frequency. The highest measured sensitivity reaches 14,620 V/T at 200 kHz, while the noise of the sensor was found to be 10 nT/Hz at 1 Hz.