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<meta name="DC.Title" content="The Contribution of Common Surgically Implanted Hardware to Functional MR Imaging Artifacts" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4419" />
<meta name="DC.Date" content="2015-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2015 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Blood oxygenation level–dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level–dependent MR imaging artifact impact arising from surgically implanted hardware.

MATERIALS AND METHODS: A retrospective analysis of all blood oxygenation level–dependent MRIs ( n = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006–2014) at our hospital was performed. Blood oxygenation level–dependent MRIs were most commonly prescribed for patients with cerebrovascular disease ( n = 80) or patients undergoing language or motor localization ( n = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist.

RESULTS: Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm3 (range = 1.1–9.4 cm3). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm3 (range = 6.1–61.7 cm3), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 3± 27.0 cm3 (range = 6.9–77.1 cm3). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm3 (range = 64.0–139.6 cm3). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation.

CONCLUSIONS: Blood oxygenation level–dependent MR imaging yields interpretable functional maps in most patients beyond a small (30–40 cm3) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.

BOLD
:   blood oxygenation level–dependent
CVR
:   cerebrovascular reactivity
VP
:   ventriculoperitoneal" />
<meta name="DC.Contributor" content="A.A. Desai" />
<meta name="DC.Contributor" content="M.K. Strother" />
<meta name="DC.Contributor" content="C.C. Faraco" />
<meta name="DC.Contributor" content="V.L. Morgan" />
<meta name="DC.Contributor" content="T.R. Ladner" />
<meta name="DC.Contributor" content="L.M. Dethrage" />
<meta name="DC.Contributor" content="L.C. Jordan" />
<meta name="DC.Contributor" content="M.J. Donahue" />
<meta name="article:published_time" content="2015-11-01" />
<meta name="article:section" content="FUNCTIONAL" />
<meta name="citation_title" content="The Contribution of Common Surgically Implanted Hardware to Functional MR Imaging Artifacts" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Blood oxygenation level–dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level–dependent MR imaging artifact impact arising from surgically implanted hardware.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A retrospective analysis of all blood oxygenation level–dependent MRIs (&lt;i&gt;n&lt;/i&gt; = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006–2014) at our hospital was performed. Blood oxygenation level–dependent MRIs were most commonly prescribed for patients with cerebrovascular disease (&lt;i&gt;n&lt;/i&gt; = 80) or patients undergoing language or motor localization (&lt;i&gt;n&lt;/i&gt; = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm&lt;sup&gt;3&lt;/sup&gt; (range = 1.1–9.4 cm&lt;sup&gt;3&lt;/sup&gt;). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm&lt;sup&gt;3&lt;/sup&gt; (range = 6.1–61.7 cm&lt;sup&gt;3&lt;/sup&gt;), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 &lt;sup&gt;3&lt;/sup&gt;± 27.0 cm&lt;sup&gt;3&lt;/sup&gt; (range = 6.9–77.1 cm&lt;sup&gt;3&lt;/sup&gt;). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm&lt;sup&gt;3&lt;/sup&gt; (range = 64.0–139.6 cm&lt;sup&gt;3&lt;/sup&gt;). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Blood oxygenation level–dependent MR imaging yields interpretable functional maps in most patients beyond a small (30–40 cm&lt;sup&gt;3&lt;/sup&gt;) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.&lt;/p&gt;" />
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<meta name="twitter:title" content="The Contribution of Common Surgically Implanted Hardware to Functional MR Imaging Artifacts" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Blood oxygenation level–dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level–dependent MR imaging artifact impact arising from surgically implanted hardware.

MATERIALS AND METHODS: A retrospective analysis of all blood oxygenation level–dependent MRIs ( n = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006–2014) at our hospital was performed. Blood oxygenation level–dependent MRIs were most commonly prescribed for patients with cerebrovascular disease ( n = 80) or patients undergoing language or motor localization ( n = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist.

RESULTS: Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm3 (range = 1.1–9.4 cm3). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm3 (range = 6.1–61.7 cm3), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 3± 27.0 cm3 (range = 6.9–77.1 cm3). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm3 (range = 64.0–139.6 cm3). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation.

CONCLUSIONS: Blood oxygenation level–dependent MR imaging yields interpretable functional maps in most patients beyond a small (30–40 cm3) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.

BOLD
:   blood oxygenation level–dependent
CVR
:   cerebrovascular reactivity
VP
:   ventriculoperitoneal" />
<meta name="og-title" property="og:title" content="The Contribution of Common Surgically Implanted Hardware to Functional MR Imaging Artifacts" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/36/11/2068" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Blood oxygenation level–dependent MR imaging is increasingly used clinically to noninvasively assess cerebrovascular reactivity and/or language and motor function. However, many patients have metallic implants, which will induce susceptibility artifacts, rendering the functional information uninformative. Here, we calculate and interpret blood oxygenation level–dependent MR imaging artifact impact arising from surgically implanted hardware.

MATERIALS AND METHODS: A retrospective analysis of all blood oxygenation level–dependent MRIs ( n = 343; B0 = 3T; TE = 35 ms; gradient echo EPI) acquired clinically (year range = 2006–2014) at our hospital was performed. Blood oxygenation level–dependent MRIs were most commonly prescribed for patients with cerebrovascular disease ( n = 80) or patients undergoing language or motor localization ( n = 263). Artifact volume (cubic centimeters) and its impact on clinical interpretation were determined by a board-certified neuroradiologist.

RESULTS: Mean artifact volume associated with intracranial hardware was 4.3 ± 3.2 cm3 (range = 1.1–9.4 cm3). The mean artifact volume from extracranial hardware in patients with cerebrovascular disease was 28.4 ± 14.0 cm3 (range = 6.1–61.7 cm3), and in patients with noncerebrovascular disease undergoing visual or motor functional mapping, it was 39.9 3± 27.0 cm3 (range = 6.9–77.1 cm3). The mean artifact volume for ventriculoperitoneal shunts was 95.7 ± 39.3 cm3 (range = 64.0–139.6 cm3). Artifacts had no-to-mild effects on clinical interpretability in all patients with intracranial implants. Extracranial hardware artifacts had no-to-moderate impact on clinical interpretability, with the exception of 1 patient with 12 KLS-Martin maxDrive screws with severe artifacts precluding clinical interpretation. All examined ventriculoperitoneal shunts resulted in moderate-to-severe artifacts, limiting clinical interpretation.

CONCLUSIONS: Blood oxygenation level–dependent MR imaging yields interpretable functional maps in most patients beyond a small (30–40 cm3) artifact surrounding the hardware. Exceptions were ventriculoperitoneal shunts, particularly those with programmable valves and siphon gauges, and large numbers of KLS-Martin maxDrive screws.

BOLD
:   blood oxygenation level–dependent
CVR
:   cerebrovascular reactivity
VP
:   ventriculoperitoneal" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.A. Desai</span>, <span class="highwire-citation-author" data-delta="1">M.K. Strother</span>, <span class="highwire-citation-author" data-delta="2">C.C. Faraco</span>, <span class="highwire-citation-author" data-delta="3">V.L. Morgan</span>, <span class="highwire-citation-author" data-delta="4">T.R. Ladner</span>, <span class="highwire-citation-author" data-delta="5">L.M. Dethrage</span>, <span class="highwire-citation-author" data-delta="6">L.C. Jordan</span> and <span class="highwire-citation-author" data-delta="7">M.J. Donahue</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2068-2073; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4419 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14282--61045495178" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.A. Desai </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.A.%2BDesai%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Desai%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.A.%2BDesai%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M.K. Strother </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.K.%2BStrother%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strother%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.K.%2BStrother%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.C. Faraco </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.C.%2BFaraco%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Faraco%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.C.%2BFaraco%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">V.L. Morgan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Radiological Sciences (A.A.D., M.K.S., C.C.F., V.L.M., T.R.L., L.M.D., M.J.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.L.%2BMorgan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Morgan%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.L.%2BMorgan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">T.R. 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      <div class="highwire-cite-title">The Contribution of Common Surgically Implanted Hardware to Functional MR Imaging Artifacts</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.A.</span> <span class="nlm-surname">Desai</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.K.</span> <span class="nlm-surname">Strother</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.C.</span> <span class="nlm-surname">Faraco</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">V.L.</span> <span class="nlm-surname">Morgan</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">T.R.</span> <span class="nlm-surname">Ladner</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">L.M.</span> <span class="nlm-surname">Dethrage</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">L.C.</span> <span class="nlm-surname">Jordan</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">M.J.</span> <span class="nlm-surname">Donahue</span></span></span></div>
  
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