title: Technical challenges and safety of magnetic resonance imaging with in situ neuromodulation from spine to brain.
abstract: OBJECTIVE
  This review summarises the need for MRI with in situ neuromodulation, the key safety challenges and how they may be mitigated, and surveys the current status of MRI safety for the main categories of neuro-stimulation device, including deep brain stimulation, vagus nerve stimulation, sacral neuromodulation, spinal cord stimulation systems, and cochlear implants.
  
  
  RESULTS
  When neuro-stimulator systems are introduced into the MRI environment a number of hazards arise with potential for patient harm, in particular the risk of thermal injury due to MRI-induced heating. For many devices however, safe MRI conditions can be determined, and MRI safely performed, albeit with possible compromise in anatomical coverage, image quality or extended acquisition time.
  
  
  CONCLUSIONS
  The increasing availability of devices conditional for 3 T MRI, whole-body transmit imaging, and imaging in the on-stimulation condition, will be of significant benefit to the growing population of patients benefitting from neuromodulation therapy, and open up new opportunities for functional imaging research.
authors.affiliation: Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, Queen Square, London, UK; Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, UK. Electronic address: john.thornton@ucl.ac.uk.
authors.forename: John S
authors.initials: JS
authors.lastname: Thornton
mesh_terms: D001921:Brain / Q000473:pathology; D000075202:Contraindications; D046690:Deep Brain Stimulation / Q000295:instrumentation*; D004869:Equipment Safety; D006801:Humans; D008279:Magnetic Resonance Imaging; D062187:Spinal Cord Stimulation / Q000295:instrumentation*
keywords: MR imaging; MRI; Neuromodulation; Neurostimulation; Safety