Surgical modification of deep brain stimulation lead trajectories reduces RF heating during 3 T MRI: From phantoms to implementation in patients

MRI at 3 T is restricted for patients with deep brain stimulation (DBS) systems due to potential radiofrequency (RF) heating. Here, we present the first large-scale, systematic study to determine how trajectory-related parameters affect RF heating and quantify the extent of RF heating reduction. Introducing concentric loops close to the surgical burr hole substantially reduced RF heating. Increasing the number of loops correlated well with decreased heating. Recommendations based on the results from phantom experiments were easily adopted during the surgical procedure within 30 seconds. Subsequent replication of the trajectories based on postoperative computed tomography images confirmed low RF heating.