IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO.

3, SEPTEMBER 2005 467

MRI and Implanted Medical Devices:
Basic Interactions With an Emphasis on Heating
John A. Nyenhuis, Senior Member, IEEE, Sung-Min Park, Rungkiet Kamondetdacha, Arslan Amjad,
Frank G. Shellock, and Ali R. Rezai
AbstractThere are three principal magnetic elds in mag-
netic resonance imaging (MRI) that may interact with medical
implants. The static eld will induce force and torque on ferro-
magnetic objects. The pulsed gradients are of audio frequency
and the implant may concentrate the induced currents, with a po-
tential for nerve stimulation or electrical inference. The currents
induced in the body by the radio frequency (RF) eld may also
be concentrated by an implant, resulting in potentially dangerous
heating of surrounding tissues. This paper presents basic infor-
mation about MRI interactions with implants with an emphasis
on RF-induced heating of leads used for deep brain stimulation
(DBS). The temperature rise at the electrodes was measured
in vitro as a function of the overall length of a DBS lead at an RF
frequency of 64 MHz. The maximal temperature rise occurred for
an overall length of 41 cm. The method of moments was used to
calculate the current induced in the lead. From the induced cur-
rents, the RF power deposition near the electrodes was calculated
and the heat equation was used to model the temperature rise. The
calculated temperature rises as a function of lead length were in
good agreement with the measured values.
Index TermsHeating, implant, magnetic resonance imaging
(MRI), radio frequency (RF), safety.
I. INTRODUCTION
M
AGNETIC resonance imaging (MRI) is an imaging
modality in which the image is reconstructed from the
radio frequency (RF) signal fromthe precession of the magnetic
moments of hydrogen protons. MRI is an excellent means
for imaging soft tissues and more than ten million scans are
performed each year.
Fig. 1 depicts a typical whole-body cylindrical bore MR
system. Three types of magnetic elds are utilized.
1) The Static Magnetic Field B
0
. A key component of the
MR system is the very uniform static eld that typically
ranges from 0.2 to 3.0 T, but may be as great as 9.4 T.
For a cylindrical bore scanner, the direction of the static
magnetic eld is along the length of the patient, which is
usually dened to be the z-direction.
Manuscript received April 21, 2005; revised July 1, 2005. This work was
supported in part by the National Institutes of Health under Grant NS44575-01,
Evaluation of MRI Safety for Deep Brain Stimulation, and by Medtronic
Corporation.
J. A. Nyenhuis, S.-M. Park, R. Kamondetdacha, and A. Amjad are with
the School of Electrical and Computer Engineering, Purdue University, West
Lafayette, IN 47907 USA (e-mail: nyenhuis@purdue.edu).
F. G. Shellock is with the Keck School of Medicine, University of Southern
California, Los Angeles, CA 90089 USA.
A. R. Rezai is with the Cleveland Clinic Foundation, Cleveland, OH 44195
USA.
Digital Object Identier 10.1109/TDMR.2005.859033
Fig. 1. MR system with cylindrical whole-body coil.
2) Pulsed Gradient Fields. Gradient magnetic elds are spa-
tial variations in the static magnetic eld. They are used
in MR scanners to a) spatially select the portion of the
patient in which the protons will be in resonance (slice
select), b) spatially alter the phase relative to some refer-
ence (phase encode), and c) spatially vary the frequency
of the protons while the time-varying ux is being mea-
sured by the receiver coil (frequency encode). Three sets
of gradient coils are present in a typical scanner. Assum-
ing B
0
in the z-direction, these coils produce the eld
gradients B
z
/x, B
z
/y, and B
z
/z. Diagrams of
magnetic eld maps for gradient coils for whole-body
cylindrical bore scanners have been presented [1]. The
z-gradient coil produces a longitudinal magnetic eld that
has the greatest intensity of about 35 cm on either side
of the bore center. The maximal magnetic eld intensity
for the x- and y-gradient coils is the transverse compo-
nent at a distance of about 30 cm on either side of the
bore center.
3) The RF Field. The RF eld is applied perpendicular
to the static eld to induce precession in the nuclei of
interest. The RF eld, frequently referred to as the B
1
eld, usually has circular polarization in an MR system
with a cylindrical bore and a quadrature-driven coil. For
hydrogen, the RF frequency is 42.58 MHz/T, and thus an
RF frequency of 63.86 MHz is required for B
0
= 1.5 T.
The RF pulses have a complicated shape, resembling a
sinc function, with typical bandwidth of 1250 Hz and
representative peak amplitude of 14 T.
Shellock and Crues [2] recently reviewed the biologic effects
of magnetic elds in MRI and the precautions that should
be taken for the safe care of patients. MRI procedures for
1530-4388/$20.00 2005 IEEE
468 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
patients with implants and devices are discussed in their paper.
In this paper, we review the interactions of magnetic elds
in MRI with implanted medical devices. The intention is to
explain quantitatively the underlying physical mechanisms. The
greatest emphasis will be on the potential for heating by the
RF eld, since this poses signicant potential for patient risk
and there is considerable variation among different implants in
susceptibility to RF-induced heating. Furthermore, additional
variability is associated with the MRI procedure.
II. INTERACTIONS WITH THE STATIC MAGNETIC FIELD
A. Magnetic Force
Assume that the implant has an overall magnetic dipole
moment p. Also assume that the implant is sufciently small
that variations of the magnetic eld B over its volume are
accurately described with rst-order derivatives. The magnetic
force F
m
on the implant is then well approximated by [3]
F
m
= (p )B. (1)
In Cartesian coordinates, the magnetic force is then
expressed as
F
m
=
_
p
x
B
x
x
+ p
y
B
x
y
+ p
z
B
x
z
_
x
+
_
p
x
B
y
x
+ p
y
B
y
y
+ p
z
B
y
z
_
y
+
_
p
x
B
z
x
+ p
y
B
z
y
+ p
z
B
z
z
_
z. (2)
Consider now the force on an implant on the z-axis of
the imager. Assume that p
z
is the only component of the
magnetization. The force then is
F
m
= p
z
B
z
z
z. (3)
Consider an object of volume V and saturation magnetization
M
s
. The magnitude of the force then is
F
m
= p
z
B
z
z
=
M
s
V

0
B
z
z
(4)
where
0
= 4 10
7
H/m is the permeability of free space.
The gravity force on the object is
F
g
=
m
gV (5)
where
m
is the mass density and g = 9.8 m/s
2
is the gravita-
tional acceleration. The ratio of magnetic force to gravitational
force is
Force ratio =
F
m
F
g
=
M
s

m
g
B
z
z
. (6)
For an object made from iron with M
s
2.2 T and
m
=
8900 kg/m
3
and a eld gradient of 2 T
2
/m, the magnetic force
is about 40 times the gravitational force. This will obviously be
Fig. 2. Diagram of the deection angle method for evaluation of translational
force for an implant.
Fig. 3. Measured force normalized to the gravitational attraction versus
distance along axis of bore of a 1.5-T MR system for Medtronic Itrel 3 IPG.
Positive distance is away from the center of the bore and a distance of 0
corresponds to the edge of the bore.
a massive force, and in general strongly magnetic objects are a
hazard in the MRI environment.
The magnetic force on an implant may be evaluated [4] using
the deection angle technique shown in Fig. 2. Along the axis
of a cylindrical bore with magnetization along the bore axis, the
force ratio is given on the tangent of the deection angle . As
an example, Fig. 3 shows the force versus position along the
axis of the bore of a 1.5-T MR system for an implantable pulse
generator (IPG) used for neurostimulation [5]. For this device,
the greatest force ratio is about 0.4, and this force occurs near
the edge of the bore.
B. Magnetic Torque
For a nonspherical magnetic object, the magnetization will
not be precisely along the magnetic eld and thus there will be
a magnetic torque. The torque will be in a direction such that
the long axis of a ferromagnetic object will tend to align along
the magnetic eld [6]. Fig. 4 shows the geometry for calculation
of the torque. The magnetic eld H
0
is assumed to be along the
z-axis and the object is assumed to be uniformly magnetized
with saturation magnetization M
s
in the xz plane.
The relevant magnetic energies are those due to external and
demagnetizing elds. Using SI units, the total magnet static
energy per unit volume is written as
W
T
=
M
2
s
2
0
(N
n
N
t
) sin
2
M
s
H
o
sin( + ) (7)
where N
n
and N
t
are the normal and transverse demagnetizing
factors, respectively.
NYENHUIS et al.: MRI AND IMPLANTED MEDICAL DEVICES: BASIC INTERACTIONS WITH AN EMPHASIS ON HEATING 469
Fig. 4. Geometry for evaluation of the torque on a soft ferromagnetic object.
is the device angle relative to the x-axis and is the direction of the
magnetization relative to the normal.
At equilibrium, it is required that W
T
/ = 0. Thus
M
2
s
2
0
(N
n
N
t
) sin 2 M
s
H
o
cos( + ) = 0. (8)
Make the denition
=
M
s
2
0
H
0
(N
n
N
t
). (9)
The energy minimization (8) can then be written as
cos( + ) + sin 2 = 0. (10)
The torque about the y-axis is

y
= M
s
H
0
cos( + ) volume (11)
where volume is the device volume.
The maximal amplitude of the torque is

max
=
M
2
s
2
0
(N
n
N
t
) volume. (12)
Note that the maximum torque is relatively insensitive to the
value of the static magnetic eld, though the angular depen-
dence will depend somewhat on the strength of H
0
.
The maximal difference in demagnetizing factors will occur
for a long needle-shaped object. In this case, N
n
N
t
0.5.
Note that the maximal torque is proportional to the square of
the magnetization for objects made from a single material. The
torque and magnetic force are correlated; objects exhibiting
minimal force will generally exhibit minimal torque. It is
noteworthy that the maximal torque does not increase with
eld strength.
Torque may be measured by placing the implant in a holder
suspended by a torsional spring [6]. The torque is proportional
to the deection angle of the spring from the equilibrium
position. The angular dependence of the torque is determined
by measurement of the deection angle as a function of the
device position. Fig. 5 shows the measured angular dependence
of the torque for an IPG used for a neurostimulation system in a
1.5-T static magnetic eld. The torque curves are well t by the
solid lines for = 0.25 and maximum torque = 0.018 N m.
There is qualitative agreement between the measured and the
tted torque, even though the magnetic structure of an IPG is
very different from the idealized geometry of Fig. 4.
Fig. 5. Measured torque versus angle for a Medtronic Itrel 3 IPG. The points
are measured and the solid line is calculated for = 0.25 and maximum
torque = 0.018 N m.
Magnetic forces on implants that are less than the force of
gravity (i.e., deection angle less than 45

) or torque less than

the gravity torque (product of device length and weight) are not
expected to pose added risk to the patient [4]. Larger values of
force and torque may still be safe, depending on in situ counter-
forces, especially if time is allowed after implantation for the
device to be encapsulated in the tissue [7].
Conducting objects turning in the static magnetic eld will
experience a torque due to the induced eddy currents. The
greatest torque will occur for large conducting objects. This
effect can be qualitatively observed, for example, by measuring
the time required for a sheet of aluminum or other good
conductor to fall at in the static eld. Eddy current torque has
been reported for metallic heart valves [8]. This torque is not
believed to pose an MRI safety issue for most implants.
III. INTERACTIONS WITH PULSED GRADIENT FIELDS
The time-varying gradients apply a time-varying magnetic
ux and thus induce currents in the body. Fig. 6 qualitatively
depicts the current pattern in the body for a patient with the
umbilicus landmarked (i.e., the center portion used for the MR
imaging procedure) at the center of a whole-body cylindrical
bore MR system. The two principal current patterns are a
consequence of the symmetry of the gradient coil winding
pattern. Quantitative calculation of the currents induced by coils
similar to those used in MRI has been reported by So et al. [9].
The present International Electrotechnical Commission (IEC)
standard [10] limits currents associated with the pulsed gradient
elds for the MR system operating in the normal mode to
80% of the mean threshold for peripheral nerve stimulation.
Expressed in terms of the maximum value of dB/dt in tesla
per second on a 20-cm-radius cylinder surrounding the patient,
this limit is
dB
dt

max
= 16 T/s
_
1 +
0.36 ms
t
s
_
(13)
where t
s
is the duration of a rectangular dB/dt pulse. Ac-
cording to the IEC standard, MRI investigators may also use
experimental data obtained from human subjects to determine
the limiting gradient output.
A metallic implant that has conducting components will tend
to concentrate the induced gradient currents [11]. The greatest
470 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
Fig. 6. Qualitative distribution of currents in a human subject induced by
pulsed gradients for (a) the y-gradient coil and (b) the z-gradient coil.
focusing is expected to occur if the implant has the shape of
a long wire or forms a closed loop of sufcient size, such as
lead used for a neurostimulation system, cardiac pacemaker,
or guidewire. If there were indeed a signicant concentration
of the gradient currents, this could result in nerve stimulation.
However, electric eld enhancements less than a factor of three
should not result in nerve stimulation because inhomogeneities
in conductivity within the body also provide a similar level
of enhancement. The electrical impedance between metal and
surrounding tissues will tend to limit the concentration of the
currents. The higher intensity gradients available in echo-planar
or fast gradient echo MR imaging may enhance the likelihood
of nerve stimulation. The induced voltages may also interfere
with the operation of active medical devices.
The gradient elds induce a current in a metallic object.
This induces a magnetic moment in the object and thus there
is a torque induced by the MRI static eld. The implant will
then exhibit a high-frequency vibration, which is potentially
uncomfortable for large highly conductive implants. This effect
may have been observed in a cervical xation device [12].
IV. INTERACTIONS WITH THE RF FIELD
Fig. 7 shows a representative modulation shape of an RF
pulse associated with MRI. While the actual modulation is
complicated [13], it can be idealized by a sinc function. The
sinc pulse has a maximal amplitude of B
10
and the time
modulation dependence is given by
B
1
(t) = B
10
sinc
_

1
t
_
. (14)
The bandwidth f of the pulse is given by
f =
1

1
. (15)
Fig. 7. Modulation of an RF pulse used for MRI.
Fig. 8. Model for current induced in a lead wire by coupling with the electric
eld induced by the RF magnetic eld associated with MRI.
The pulse amplitude B
10
is adjusted to achieve the desired
ip angle of the nuclear magnetization. In the absence of loss,
the relationship between B
10
and ip angle is
B
10
=
f

(16)
where = 2.675 10
4
radians/(G s) is the nuclear gyro-
magnetic constant. As an example, consider a pulse with a
bandwidth of 1250 Hz and producing a ip angle = (180

pulse). The amplitude in the rotating frame for the idealized

sinc pulse is 14.68 T. A calculation for the truncated sinc
pulse in Fig. 7 yields B
10
= 13.8 T. A representative intense
RF sequence, such as fast spin echo, will apply about 50
pulses per second, resulting in a mean square eld of about
7.4 10
12
T
2
or a root mean square eld B
rms
= 2.7 T.
The heat deposited into the body is quantied by the specic
absorption rate (SAR), which is expressed in watts per kilo-
gram, i.e.,
SAR =
0.5E
2
10

(17)
where is the conductivity, E
10
is the electric eld amplitude,
and is the mass density. The IEC standard limits the whole-
body average SAR to 2 W/kg in normal mode operation [10].
Neglecting thermal transport, the time rate of temperature
rise dT/dt in response to the SAR is given by
dT
dt
=
SAR
C
(18)
where C

= 4186 J/(kg

C) is the specic heat.

Fig. 8 depicts the interaction of a lead used for the electric
eld induced by the MRI RF eld. There is a current induced in
the lead. As a result, a scattered electric eld is induced in the
tissue, with the greatest intensity near the ends. The geometry is
essentially that of a receiving antenna in a lossy medium. The
power deposition near the ends of a lead wire can be locally
NYENHUIS et al.: MRI AND IMPLANTED MEDICAL DEVICES: BASIC INTERACTIONS WITH AN EMPHASIS ON HEATING 471
very intense. For example, Yeung et al. [14] calculated that the
local SAR near the end of a lead can exceed the average back-
ground level by a factor of as much as 7000! As explained be-
low, thermal transport will spread the very locally intense SAR.
Nonetheless, excessive temperature increases are possible.
Large metallic implants with smooth edges, such as articial
joints and cases of IPGs, have been demonstrated to experience
minimal RF-induced heating [11] because the self-inductance
will limit the currents and the smooth edges will limit the
concentration of power deposition. As is reviewed in the next
section, the greatest potential for RF heating of implants is for
very elongated structures, such as guide wires and leads, and
also structures that form a resonance loop.
V. IMAGE ARTIFACTS
Imaging artifacts (including MR signal changes and distor-
tion) in the vicinity of an implant will occur if the implant
perturbs one of the magnetic elds in MRI. The magnetic
susceptibility of a nonferromagnetic material will be different
than that of tissue. This yields a local perturbation of the
homogeneity of the static eld near the implant, producing
a susceptibility artifact [15]. The ferromagnetic material in
an implant may produce a large region of distortion, with
the extent of image artifact depending on the pulse sequence
and the quantity of the magnetic material. For instance, the
Medtronic SynchoMed pump, which contains a motor with
a magnet, may have an image artifact of 2025 cm across
in a spin echo pulse sequence [16]. As described in detail
below, currents at the B
1
frequency will be induced in a lead.
Nitz et al. [17] summarized how these induced currents will
result in distortion of the image due to perturbation of the
local RF eld. The American Society for Testing and Materials
(ASTM) has published a standard for measurement of the
image artifact in the vicinity of passive implants [18].
VI. REVIEW OF HEATING OF LEADS BY THE
RF FIELD USED FOR MRI
In this section, reports of RF-induced temperature increases
for implants, especially elongated structures such as implanted
leads, are summarized.
In measurements of heating with wires simulating elongated
medical implants, Smith et al. [19] measured temperature rises
as great as 16.8

C above baseline, which was observed for a
40-cm wire with insulation. Liu et al. [20] reported a temper-
ature increase of up to 17

C while imaging a guidewire in an
off-center position (i.e., close to the transmit RF body coil) in a
1.5-T MR system. Nitz et al. also [17] measured temperature
rises near guidewires. The temperature rise depended on the
guidewire length and exceeded 30

C in some circumstances.
Konings et al. [21] reported temperature increases as great as
48

C for intravascular guidewires.
Ladd et al. [22] described heating that occurred for catheters
and guidewires that are used during intravascular interventions
under MRI guidance. With the coil used for visualization
immersed in saline and the connecting coaxial cable in air,
the resonant length was found to be 140 cm and the maximal
temperature rise was about 18

C.
The opportunity to perform MRI on patients with cardiac
pacemakers and implanted cardioverter debrillators could
benet many patients. Unfortunately, these cardiovascular im-
plants are currently considered contraindicated for MR proce-
dures. One reason that the MR safety of these cardiac implants
has not been established is the RF-induced heating of the
electrode at the end of the lead. Sommer et al. [23] measured an
in vivo temperature rise at the lead tips of cardiac pacemakers of
23.5

C at 0.5 T for an SAR of 1.3 W/kg. Achenbach et al. [24]
reported a temperature increase of 63.1

C at the electrode tip
for a pacing lead not connected to an IPG at a static magnetic
eld strength of 1.5 T. Luechinger [25] measured temperature
rises in a saline phantom at the electrodes of a large variety of
pacing leads. The greatest rise of about 13

C was measured for
a unipolar lead. Luechinger also measured the RF-induced tem-
perature rise in vivo in a pig. A temperature increase in excess
of up to 15

C was measured for a passive xation lead and a
rise in excess of 30

C was measured with a screw-in lead. No
signicant threshold or impedance changes of the leads were
measured, nor did pathology indicate any heat-related damage.
In a recent clinical investigation of nonpacemaker-dependent
patients [26], 54 patients underwent a total of 62 MRI exam-
inations at 1.5 T using various whole-body averaged SARs.
A total of 107 leads and 61 IPGs were evaluated. No adverse
events occurred, although ten of the leads underwent signi-
cant changes that were not clinically important, two of which
required a change in programmed output. A conclusion was
. . .the belief in the presence of a pacemaker as an absolute
contraindication to MRI should be re-evaluated. A possible
limitation of the study was identied to be . . .effects of MRI-
related heating were not directly measured.
In a recent work reported in the popular press, Roguin et al.
[27] concluded that . . .modern pacemaker and implantable
debrillator systems may indeed be MRI safe. This may have
major clinical implications for current imaging practices. One
reason for this conclusion is that their in vivo measurements
yielded temperature increases less than 0.5

C across measure-
ments on a number of cardiac lead systems. It is not clear why
Roguin et al. [27] measured much smaller in vivo temperature
rises than did Luechinger [25].
There have been a number of reports on RF-induced heating
of lead systems used for deep brain stimulation system (DBS).
It has unfortunately been clinically established that an RF eld
of sufcient intensity will result in thermal harm to the patient
with a DBS system. In one tragic case [28], a DBS patient
became comatose after 15 min of diathermy, a procedure in
which an RF magnetic eld is used to heat tissue, on each side
of the jaw, in proximity to DBS leads. After the procedure, the
patient was found to be unresponsive and a neurological exam
conrmed the comatose condition. An MRI of the brain showed
distinct areas of edema centered at the electrodes, suggesting
a thermal lesion. Ruggera et al. [29] made measurements
that showed diathermy can produce a large SAR near a DBS
electrode.
In a case involving MRI, a patient with a DBS system
developed a thermocoagulation lesion adjacent to the tip of
the electrode after undergoing MRI [30][32]. The patient was
projected to have severe permanent disability. The MR scan
472 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
was performed at 1 T with a body transmit RF coil. The
implant manufacturer (Medtronic, Minneapolis, MN) species
that MRI for a DBS patient must only be performed using a
transmit RF head transmit coil at a eld strength of 1.5 T and
head SAR less than 0.4 W/kg.
There are several reports on in vitro temperature rises on DBS
leads. Schueler et al. [33] evaluated several implants, including
DBS systems. The phantom material was saline. They reported
that No heating of any of the devices, catheters, extensions or
leads was detected in several experiments. . .. Rezai et al. [34]
undertook a study of DBS heating involving arguably a more
realistic phantom with gelled material to prevent thermal con-
vection and taking care to place the temperature probes on the
electrodes, where the temperature rise is greatest. For a whole-
body averaged SAR of 3.9 W/kg, the rise was 25.3

C for no
loops in the lead and 6.1

C when the leads were positioned
with two small loops (approximately 2.5 cm in diameter) in
an axial orientation at the top of the head portion of the
phantom, simulating a loop near the burr hole cover. Similarly,
Baker et al. found that the presence of loops in the lead resulted
in decreased temperature rise [35]. Kainz et al. [36] also
undertook a study of heating of neurostimulation systems. The
maximal temperature increase at the electrode was 2.1

C. It
was concluded that reduction of the number of loops at the IPG
was a practical method to reduce heating associated with MRI
procedures. Finelli et al. [37] measured temperature increases
for DBS leads at 1.5 T with a transmit RF head coil. The
temperature elevation was found to be approximately 0.9 times
the local SAR value. It was recommended that magnetization
transfer imaging techniques, which inherently use high levels
of RF power, be avoided until more specic testing establishes
safe parameters.
Nyenhuis et al. [38] measured heating of the Cyberonics 100
NCP Generator and Model 300 Series Lead (NCP System).
The NCP System is an implanted system for the treatment of
epilepsy by stimulation of the vagus nerve. The in vitro testing
yielded electrode heating as great as 5.8

C for the RF eld ap-
plied by the transmit body RF coil, whereas the temperature rise
was less than 0.2

C when the RF eld was applied by the trans-

mit head RF coil. It was concluded that patients could be safely
imaged when the RF eld is applied with the head transmit coil.
A survey of centers reporting 27 MRI scans in 25 patients,
26 of which were performed with a head coil, yielded no
reports of discomfort around the lead or the generator [39].
An adverse event with the Cyberonics NCP Bipolar Lead is
reported on a web page for the FDA Center for Devices and
Radiological Health [40]. In this report, the VNS patients va-
gus nerve was fried after undergoing an MRI of the brain. . ..
The MRI was reportedly performed per manufacturers recom-
mendations. The patient has reportedly fully recovered. The
details of the MRconditions are not provided, though it is stated
that The MRI was reportedly performed per manufacturers
recommendations. The manufacturer narrative points out that
MRI should not be performed with the RF body transmit coil.
Heating of external medical devices may also be induced
by the RF eld [41], [42]. Dempsey et al. [43] investigated
mechanisms for burns during MRI. Resonant circuits with in-
ductance and capacitance were found to have signicant heating
potential. Extended wires were found to also have potential for
thermal injury. Methods for how to reduce the risk of thermal
injury for externalized medical devices have been proposed
[44], [45].
Park et al. [46] evaluated temperature rises of DBS leads
with phantom material of different levels of viscosity. The
material with the greatest gelling agent yielded a temperature
rise more than ve times greater than a saline-only phantom.
(The phantom used in [34], [35], and [37] yields a temperature
rise similar to that of the greatest gelling agent concentration
considered by Park et al.) Differences in phantom material may
thus account for some of the differences in RF-induced heating
reported in the peer-reviewed literature.
VII. REVIEW OF CALCULATION OF RF HEATING
OF LEADS DURING MRI
Several investigators have presented methods for the model-
ing of RF-induced heating. Nitz et al. [17] presented a model
for the lead consisting of a lossy transmission line that couples
with the surrounding electric eld. However, no quantitative
results from this model were presented. Golombeck et al. [47]
calculated heating of DBS electrodes by calculating the energy
loss in the frequency domain. However, the lead does not appear
to be placed in a manner that will result in a realistic heating
estimate. Konings et al. [21] presented a semi-quantitative
model based upon resonating RF waves. The resonant con-
dition was identied to produce the greatest heating. The
difculty in using qualitative factors to accurately predict the
RF-induced temperature rise is manifested in conclusions made
by Konings et al.:
1) The occurrence of resonant RF heating depends on
a large set of factors in the environment and is hard to
predict. 2) There is no clear ceiling to the amount of heat
that can be produced if a specic situation gives rise to
resonance.
Ho [48] used a commercial nite-difference time-domain
(FDTD) program to calculate the SAR near the tips that mod-
eled metallic implants. The 1/8-g averaged SAR was calculated
to be as great as 310 W/kg. The moment method was used
in [14] to analyze heating of guidewires used in interventional
MRI. The current distribution is calculated along the guidewire
from the requirement that the tangential electric eld is essen-
tially zero at the surface of a good conductor. The calculated
maximal local SAR at the tip of the guidewire was a great as
7000 times the background value. Since the power deposition
at the tip of a guidewire is very concentrated, the average SAR
in the 1/8 volume evaluated by Ho will be much less than the
value at a point near the tip.
Park et al. [49] calculated the temperature rise for straight
bare and insulated wires with exposed metal at the ends that
were intended to simulate implant leads. The calculated temper-
ature rises were compared with values measured in a phantom.
There was good agreement between calculation and measure-
ment for wire lengths up to 30 cm in length, the approximate
length of the region of uniform electric eld in the phantom
container used in the measurements. The bare wire exhibited
a maximal temperature rise at a length of about 20 cm, which
NYENHUIS et al.: MRI AND IMPLANTED MEDICAL DEVICES: BASIC INTERACTIONS WITH AN EMPHASIS ON HEATING 473
was close to the half wavelength in phantom. For lengths up to
40 cm, the temperature rise increased with increasing length of
insulated wire. The insulation thus affects the resonant length
for maximal temperature rise.
The moment method has the feature that the electric eld
in the tissue and hence the heating are calculated from rst
principles from the knowledge of the properties of the lead
and electrode. The transmission line method outlined in [17]
may be able to make better use of tting parameters derived by
measurements.
Another appealing feature of the moment method is that the
lead can be meshed separately from the surrounding tissue,
which is much more coarsely meshed. This permits evaluation
of the electric eld around the electrode at a much higher
resolution than is possible if the lead and tissue were both
meshed together.
Calculation of the background currents in the body can
be done with standard methods, such as the FDTD method.
Gandhi [50] and Nguyen [51] have reported on SAR dis-
tribution in the body in MRI. Collins et al. [52] calculated
the temperature rise in an MRI coil including the effects of
blood perfusion. Athey [53] developed analytical expressions
for determining the ameliorating effects of blood perfusion on
the RF-induced temperature rise.
VIII. MEASUREMENT OF RF-INDUCED
TEMPERATURE RISE
In order to predict tissue heating that would occur in vivo,
measurements of temperature rise are made in a phantom
that simulates the electrical and thermal characteristics of the
human body [54]. A representative phantom formulation con-
sists of saline solution with a gelling agent in order to mini-
mize the thermal convection that would occur in a nongelled
phantom [46].
A rectangular phantom with a narrow section on top to
represent the head has been used in MR heating measure-
ments [34]. The SAR pattern in this phantom as a function
of landmark and phantom conductivity has been calculated by
Amjad et al. [55] for a whole-body coil at 64 MHz. As ex-
pected, the greatest power deposition occurs at the periphery of
the phantom container.
In vitro measurement of RF-induced temperature rise is
generally done with uoroptic temperature probes. Another
method for the evaluation of induced temperature rise is to
evaluate the phase change in the MR signal due to the proton
resonance frequency (PRF) thermal shift. The shift is about
0.009 ppm

C
1
[56]. The PRF method has been demon-
strated to measure the temperature rise in vivo for hyperthermia.
However, due to the relatively smaller temperature rise, the
signal to noise ratio in MRI will be less than is available in
hyperthermia.
IX. MEASURES OF RF MAGNETIC FIELD INTENSITY
The usual method of quantifying the RF intensity is the SAR.
The IEC standard [10] denes the SAR as the radio frequency
power adsorbed per unit of mass of an object (W/kg). Four
different measures of SAR are dened in the standard. These
are enumerated as follows.
1) Whole-body SAR. SAR averaged over the total mass
of the patients body over a specied time. The limit is
2 W/kg in normal operation.
2) Partial-Body SAR. SAR averaged over the mass of the
patients body that is exposed by the volume RF transmit
coil and over a specied time. The limit is 210 W/kg in
normal operation, depending on the amount of exposed
patient mass.
3) Head SAR. SAR averaged over the mass of the patients
head and over a specic time. The limit is 3.2 W/kg in
normal operation.
4) Local SAR. SAR averaged over any 10 g of patient body
and over a specied time. The limit is 1020 W/kg,
depending on the part of the body.
The IEC SAR limits are for an averaging time of 6 min. It
is specied that the SAR limits over any 10-s period shall not
exceed three times the stated values.
For implants, it may be desirable to specify a limiting SAR
to which a patient with an implant may be exposed. There are a
couple of potentially complicating factors with specication of
a maximal SAR.
1) For a given pulse sequence, the SAR values will depend
on the axial location of the patient in the coil, i.e., the
landmark. However, the temperature rise of the implant
will depend on both the landmark and the SAR. It is then
difcult to specify in device labeling a single limiting
value of SAR that will be universally valid. For example,
Baker et al. found in in vitro studies that the temperature
rise of DBS electrodes per unit whole-body SAR changed
dramatically for different landmarks [57].
2) An extreme use of the averaging time specication would
be to apply an SAR of three times the 6-min limit for
2 min and no SAR for the following 4 min. The tem-
perature versus time relationship at the ends of leads
may exhibit a time constant of less than 60 s. In this
case, applying the SAR at three times the limit for 2 min
could result in a nearly threefold increase of the temper-
ature rise compared to the rise that would occur for an
approximately uniformSARover a 6-min averaging time.
Note that the instantaneous SAR may be quite large during
a single RF pulse, such as the one depicted in Fig. 7. However,
a single pulse is unlikely to provide sufcient energy to result
in signicant heating.
A supplemental measure of RF intensity in MR systems
may be useful in determining safe sequences for patients with
implants. One possibility in a cylindrical bore system would
be for the software to report the mean square B
1
intensity in
(T)
2
, over several averaging times, such as 10 s, 1 min, 2 min,
and 6 min. The location for evaluation of B
1
intensity would
conveniently be the center of the bore.
474 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
Fig. 9. (a) Top view diagram of Medtronic 3389 lead and 7482 in the phantom container used in the measurements of RF-induced temperature rise. (b) Locations
of ber-optic temperature probes in the vicinity of the electrodes on the 3389.
X. CASE STUDY: MEASUREMENT AND CALCULATION
OF HEATING OF A DBS LEAD
A. Measurement of Temperature Rise
The temperature rise at the electrodes of a DBS lead and
extension was measured to evaluate the potential of heating
for these components used for a neurostimulation system. The
subject medical device consisted of lead model 3389 with
28-cm initial length and the model 7482 extension (Medtronic
Inc., Minneapolis, MN). Fig. 9 shows the geometry of the lead
in the phantom container and the locations of the temperature
probes near the electrodes of the 3389 lead. The 3389 lead
has at its end four cylindrical platinum/iridium electrodes of
outer diameter 1.3 mm, length 1.5 mm, and spacing of 0.5 mm.
Luxtron uoroptic (Luxtron, Inc., Santa Clara, CA) temperature
probes with 0.6-mm diameter were used in the measurements.
As diagrammed in Fig. 9, temperature probe 1 was placed at
the surface of the most distal of the electrodes (electrode 0).
Probe 2 was placed at the surface of electrode 3 and probe 3
was placed 5 mm lateral of electrode 0.
The circularly polarized RF eld was applied to a contin-
uous wave as has been previously described [11]. Power was
supplied to the coil with a Wavetek 3200 RF generator and
an ENI 3200L RF power amplier. A branch line coupler was
used to produce the two quadrature RF waveforms so that a
circularly polarized magnetic eld was produced in the coil.
The RF voltage was applied at 64 MHz to simulate a 1.5-T MR
system.
The phantom container was lled with 30 L of phantom
material. The phantom material was composed of 5.85 g/L of
polyacrylic acid partial sodium salt (PAA, item 43 636-4 from
Aldrich Chemical) and 0.8 g/L of NaCl, and had a conductivity
of about 0.27 S/m. As indicated in Fig. 9, the landmark (center
of the RF coil) was 26 cm below the shoulder of the phantom.
This location for landmark resulted in strong coupling between
the RF eld and the phantom. The edge of electrode 0 was
20 cm above the landmark, i.e., 6 cm below the shoulder. Up
to 40 cm of the combined 3389 and 7482 systems was laid a
distance of 4.5 cmfromthe left edge of the phantom. Additional
lengths of the 7482 extension were laid in a transverse line
along the lower edge of the phantom container.
In the measurements, rst the extension wire and then the
lead wire were progressively cut so that the temperature rise
as a function of length could be determined. Fig. 10 shows
the temperature rise versus time relationship for an overall
length of 41 cm, which yielded the greatest heating. The applied
background SAR at the landmark was 1.2 W/kg. (See [55] for
distribution of SAR in the phantom.) The probe at the surface
of electrode 0 experiences a temperature rise of 37.4

C after
6 min of RF application. The rise at a distance of 5 mm from
electrode 0 is 15.6

C, less than 50% of the rise at the surface.
The rate of the temperature increase is greater at the surface of
NYENHUIS et al.: MRI AND IMPLANTED MEDICAL DEVICES: BASIC INTERACTIONS WITH AN EMPHASIS ON HEATING 475
Fig. 10. Temperature rise at the surface of electrode 0 and 5 mm away for a local SAR of 1.2 W/kg at the landmark. A 13-cm capped section of model 7481
extension is connected to the 28-cm-long 3389 lead. This overall length of 41 cm yielded the greatest overall temperature rise. The RF eld is applied at t = 0
and turned off at t = 360 s.
Fig. 11. Temperature rise at the surface of electrode 0 of the DBS lead (Fig. 9)
versus overall length of lead wire and extension as depicted in Fig. 9. The local
SAR is 1 W/kg at the landmark.
the electrode. (The temperature rise at electrode 3, not shown
in Fig. 10, was 31.3

C.)
Fig. 11 shows the measured temperature rise at electrode 0
versus the overall length of the lead system consisting of the
3389 lead and the 7482 extension. For these measurements, the
cut end of the lead was capped, as was the connector connecting
the lead to the extension. The temperature rises in Fig. 11 are
scaled from the measured to an SAR of 1 W/kg at the landmark.
The maximal temperature rise occurs for an overall length of
about 41 cm; in this case, the entire length of the lead system
was parallel to the side of the phantom.
B. Calculation of Induced Currents and Temperature Rise
The 3389 lead has four tightly coiled thinly insulated wires
surrounded by an insulating sheath. Assuming that the interac-
tion of the four wires is similar to that of a single solid wire,
this resembles the geometry of the insulated wires for which
we have calculated and measured the RF-induced temperature
rise in a phantom [49]. (The Model 7482 extension has a more
complex geometry consisting of four wires in parallel and thus
Fig. 12. Model for calculation of RF-induced temperature rise at the surface
of electrodes for the Model 3389 lead wire depicted in Fig. 9.
the calculations are here restricted to the Model 3389 lead.)
Fig. 12 shows the model used for the computations. The wire
diameter was 0.7 mm and the insulation outer diameter was
1.3 mm. 6 mm of insulation was removed from one end of the
wire to simulate the electrodes. The relative permittivity of the
insulation is 3.
The DBS or other type of lead acts as a scatterer for the
incident electric eld induced by the RF magnetic eld. The
situation is essentially the same as that of an insulated antenna
in lossy medium. An integral equation based on the reaction
concept described in [58] and [59] was employed to solve this
scattering problem. The overall equation is
_
1
j
m
L
_
z=0
2
_
=0
L
_
z

=0
2
_

=0
I
t
(z

)
(2)
2
_

2
z
2
+ k
2
_

e
jkR
4R
d

dz

I
s
(z)ddz
+
L
_
z=0
2
_
=0
b
_
r=a
j
2r
m
dI
t
(z)
dz

(
m

i
)
2r
i
dI
s
(z)
dz
rdrddz
_
=
L
_
z=0
E
sz
(z)I
t
(z)dz (19)
476 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
Fig. 13. Electric eld intensity versus position along the length of the
DBS lead for calculation of the current distribution shown in Fig. 14.
Z = 0 is the center of the Model 3389 DBS lead and the landmark is at
Z = 0.06 m.
where I
s
and I
t
are the unknown surface current on the
wire to be determined and the known testing current. E
sz
=
E
0
z, where E
0
is the incident electric eld. R is the
distance from the current source point to the evaluation point,

m
= j(/) is the complex permittivity of the medium,
is the conductivity of the medium, and
i
are the
permittivity of the medium and insulation, k =

m
is
the medium wave number, L is the length of the wire, a is
the radius of the conductor, and b is the outer radius of the
insulation.
Equation (19) can be solved by applying the Galerkin method
of moments, where the unknown current I
s
is assumed to be
the linear combination of the basis functions and the testing
functions I
t
are all of the basis functions. As a result, (19)
will form a set of linear equations with the number of variables
(the weights of the basis functions of the unknown current) and
equations equal to the number of basis functions. The set of
basis functions is the one described in [59].
A more detailed description of the method can be found
in [49] and [59]. Compared to the previous work, where a uni-
form electric eld was assumed, the calculations here make use
of the nonuniform electric eld in the phantom. The incident
electric eld distribution along the length of the lead position
was obtained from our FDTD program that includes the RF
coil and the phantom [55]. Fig. 13 shows the electric eld
distribution used in the calculations. The electric eld is scaled
for the calculations so that the maximum amplitude is 86 V/m,
which corresponds to an SAR of 1 W/kg.
Fig. 14 shows currents induced on the lead wire for the
electric eld distribution in Fig. 13. The peak current amplitude
on the wire is about 0.14 A. There is a discontinuity in current
at the end of the wire. There is thus a charge accumulation at
the end, which results in a concentration of electric eld.
The SAR distribution in watt per kilogram surrounding the
lead model was obtained using (17). From the calculated SAR
distribution, the temperature distribution near the end of the
Fig. 14. Calculated real, imaginary, and magnitude components of the current
distribution along a 28-cm-long insulated wire according to the model in
Fig. 13 with 6 mm of insulation removed from the end. The electric eld
distribution is shown in Fig. 13.
lead was evaluated by using the standard bioheat equation
given by
C
p
T
t
= K
2
T + SAR b(T T
b
) (20)
where T = T(r, z, t) is the temperature (

C) at time t, C
p
is
the specic heat (J/(kg

C)), K is the thermal conductivity

(W/(m

C)), b is a constant related to the blood ow, and

T
b
is the blood temperature. Equation (20) was numerically
solved via the FDTD scheme [60] in cylindrical coordinate. The
thermal properties used in this calculation can also be found in
[49, Table 1]. In this study, the perfusion effect was neglected
(b = 0) because the phantom material ow was assumed to be
negligible in this phantom study. The whole domain had
104 76 cells near the tip of the lead and the size of each
cell was 0.1 0.1 mm
2
.
Fig. 15 compares measured and calculated temperature rises
at the surface of electrode 0 as a function of length of sections
of the model 3389 lead. The RF application time was 6 min.
There are no tting parameters in the calculations and the
agreement between measurement and calculation is considered
to be good, considering the neglect of lead resistance and other
approximations in the model.
In a lossy medium, the wavelength is given as
=

0
_
1
2
_
1 +
_
1 +
_

2

2
_
_
1
2
. (21)
For /(2) = 64 MHz and relative dielectric constant
/
0
= 77, the wavelength
0
in the absence of loss is 0.52
m. For the phantom material with conductivity = 0.27 S/m,
the wavelength is calculated to be 0.48 cm. With no insulation,
a maximum in temperature rise is expected for lead length
approximately equal to half a wavelength. However, there is no
evidence of resonance in the measurements and calculations in
NYENHUIS et al.: MRI AND IMPLANTED MEDICAL DEVICES: BASIC INTERACTIONS WITH AN EMPHASIS ON HEATING 477
Fig. 15. Solid line is the measured temperature rise at the surface of electrode
0 (probe 1 in Fig. 9) versus length of section of the Medtronic Model 3389 lead.
Circles are the calculated temperature rise according to the model in Fig. 12.
The electric eld is that shown in Fig. 13.
Fig. 15. This is because the insulation increases the length for
maximal heating since its dielectric constant is less than that of
the phantom material.
XI. EFFECT OF LOOPS ON THE RF-INDUCED
TEMPERATURE RISE DURING MRI
Baker et al. [35] reported that loops in the lead could reduce
the RF-induced temperature rise in a neurostimulation system
used for DBS. In measurements with bare and insulated wires,
Nyenhuis et al. [61] found that the temperature rise for the
bare wires decreased as the number of loops increased from
0 to 2, whereas the temperature rise for the insulated wires
was relatively independent of the number of loops. To further
investigate the potential effects of loops on heating of a DBS
system, we consider a lead wire model with the geometry
shown in Fig. 12. The induced current is calculated for loops of
2-cm diameter centered 11 cm from the end of the lead. The end
to end length of the lead wire is constrained to be 28 cm. The
background electric eld is assumed to be 86 V/m, yielding an
SARof 1 W/kg, and the frequency is 64 MHz. Other parameters
are the same as used to calculate the current distribution shown
in Fig. 14.
The calculation is made using the method of moments. As
for the current calculations on straight wires, it is assumed
that the lead wire is a good conductor and thus the boundary
condition is that the electric eld is zero at the surface of the
wire. By including the polarization charges and currents due to
the insulator and assuming that the wire is thin, the electric eld
integro-differential equation to calculate the induced current on
an insulated wire is given by [62], [63]
E
i
t
=
j

m
_
L
_
k
2
G
a
(s, s

)I(s

) s s

+

m

i
dI(s

)
ds

G
a
(s, s

)
s
+

i

i
dI(s

)
ds

G
b
(s, s

)
s
_
ds

(22)
Fig. 16. Calculated current distribution versus normalized distance along the
length of the lead wire model of Fig. 12 with zero, one, two, three, and
four loops of 1-cm diameter and 3.l4-mm pitch. The 2-cm-diameter loops are
centered 11 cm from the right side. The end to end length is 28 cm and there
are 6 mm of insulation removed from the end. The uniform background electric
eld is 86 V/m, yielding a background SAR of 1 W/kg. Other parameters are
the same as used to calculate the current distribution shown in Fig. 14.
where E
i
t
is the tangential incident eld; I(s

) is the current
at s

; s and s

are unit vectors along the wire at s and s

m
= j(/) is the complex permittivity of the medium;
k =

m
is the medium wave number; and are the
permittivity and conductivity of the medium;
i
is the permittiv-
ity of the insulator; G
a
(s, s

) = e
jkR
a
/4R
a
and G
b
(s, s

) =
e
jkR
b
/4R
b
are Greens functions dened for inner radius
a and outer radius b, where R
a
=
_
|r(s) r(s

)| + a
2
and
R
b
=
_
|r(s) r(s

)| + b
2
; and r(s) and r(s

) are the po-

sition vectors at s and s

. In the calculations, the wires are

modeled by sets of parametric equations.
Fig. 16 shows the calculated distributions of current magni-
tude for leads with zero, one, two, three, or four loops. Para-
meters for the calculations are summarized in the caption. The
key parameter that will affect the heating is the discontinuity
in current at the end of the wire. For the wire with zero loops,
the peak current is about 0.15 A and the current discontinuity at
the end is about 0.08 A. As the number of loops increases from
zero to three, the peak current increases and the discontinuity at
the end increases as well, which would result in greater electric
eld and thus more heating at the ends of the wire. However,
for four loops, the peak current decreases compared to two
and three loops and the current discontinuity at the end is less.
Thus, the case of four loops is expected to yield the lowest
temperature rise.
The calculated current distributions for the different number
of loops are not consistent with the measured approximately
50% reduced temperature rise when the number of loops in a
DBS lead was increased from zero to two as was observed by
Baker et al. [35]. One possible reason for the difference could
be that since the end to end length of the lead is constrained to
28 cm in the calculations, the total length of wire will increase
with increasing number of loops. On the other hand, in the
experiments of Baker et al. [35], the total length of lead was
constrained to remain the same. From Fig. 16, three loops are
expected to yield the greatest temperature rise and the total lead
length is 47 cm. This is not very different from the measured
478 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
overall 3389/7482 system length of 41 cm for the greatest
temperature rise, as can be seen in Fig. 11. Further work to
elucidate the impact of loops on heating seems appropriate.
XII. SUMMARY AND CONCLUSION
The static magnetic eld in MRI will induce force and
torque on ferromagnetic medical implants. Concentration of
the pulsed gradient currents may be sufcient to result in
nerve stimulation for implants with conductive components.
The induced gradient voltages may interfere with the operation
of active implants. The RF-induced currents will result in tissue
heating, and there is the potential for dangerous heating at the
ends of leads. As a case study, the heating for a DBS lead
system was measured and calculated, yielding good agreement
between measured and calculated temperature rises for the
case of a DBS lead wire. Practical leads will have turns and
loops. The computational methods outlined here are expected to
prove useful for the calculation of heating in implants with
curved leads.
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John A. Nyenhuis (M83SM91) received the B.S.
degree in physics from Indiana University, Bloom-
ington, in 1975, and the Ph.D. degree from Purdue
University, West Lafayette, IN, in 1983.
He is currently a Professor and an Associate Head
at the School of Electrical and Computer Engineer-
ing, Purdue University. His research interests include
bioeffects of time-varying magnetic elds and the
MRI compatibility of medical implants.
Dr. Nyenhuis is a Fellow of the American Institute
for Medical and Biological Engineering. He is a
Member of the Sub-Committee on MR Safety and Compatibility for the
American Society for Testing and Materials and the International Electrical
Commission Working Group on MR safety.
Sung-Min Park was born in Seoul, Korea, in 1974.
He received the B.S. degree in electrical engineering
from Purdue University, West Lafayette, IN, where
he is currently working toward the Ph.D. degree in
electrical and computer engineering.
His research is on MRI safety issues for implanted
deep brain stimulators and cardiac pacemakers.
Rungkiet Kamondetdacha received the B.Eng. de-
gree fromChulalongkorn University, Bangkok, Thai-
land, in 1997, and the M.S. and Ph.D. degrees from
Purdue University, West Lafayette, IN, in 2000 and
2003, respectively, all in electrical engineering.
He is currently a Postdoctoral Research Asso-
ciate in the School of Electrical and Computer
Engineering, Purdue University. His research inter-
ests include numerical electromagnetic calculations,
inverse problem in electromagnetics, and signal
processing.
Arslan Amjad is working toward the Ph.D. degree in the School of Electrical
and Computer Engineering, Purdue University, West Lafayette, IN.
His research interests involve numerical computation of bioeffects of time-
varying magnetic elds and the MRI compatibility of medical implants.
480 IEEE TRANSACTIONS ON DEVICE AND MATERIALS RELIABILITY, VOL. 5, NO. 3, SEPTEMBER 2005
Frank G. Shellock is a physiologist with more than
20 years of experience, conducting laboratory and
clinical investigations in the eld of magnetic reso-
nance imaging. He is an Adjunct Clinical Professor
of Radiology and Medicine at the Keck School of
Medicine, University of Southern California, Los
Angeles, and the Founder of the Institute for Mag-
netic Resonance Safety, Education, and Research,
Los Angeles, CA.
Dr. Shellock is a member of the Guidelines and
Standards Committee (Body MRI), Commission on
Neuroradiology and Magnetic Resonance for the American College of Radi-
ology, and a Member of the Sub-Committee on MR Safety and Compatibility
for the American Society for Testing and Materials. He was the recipient of
a National Research Service Award from the National Institutes of Health,
National Heart, Lung, and Blood Institute.
Ali R. Rezai received the M.D. degree from the
University of Southern California, Los Angeles, in
1990 and underwent neurosurgical training at New
York University, New York, NY.
He is currently a Staff Neurosurgeon and the Co-
Chairman of the Center for Neurological Restora-
tion, Cleveland Clinic Foundation, Cleveland, OH.
His current research interests are the clinical appli-
cation of neuromodulation, neuromodulation device
MRI safety and functional MRI, and development
of next-generation neuromodulation devices and
surgical tools.
Dr. Rezai is a member of the Executive Committee of the Congress of
Neurological Surgeons, the Executive Board of the American Association
of Neurological Surgeons/Congress of Neurological Surgeons Joint Section
of Stereotactic and Functional Neurosurgery and Pain. He is the Chief Editor of
the Congress of Neurological Surgeons website (www.nekurosurgeon.org).