MRI Metal Artifact Reduction Sequence for Auditory Implants: First Results with a Transcutaneous Bone Conduction Implant

Wimmer, Wilhelm; Hakim, Arsany; Kiefer, Claus; Pastore-Wapp, Manuela; Anschütz, Lukas Peter; Caversaccio, Marco; Wagner, Franca (2019). MRI Metal Artifact Reduction Sequence for Auditory Implants: First Results with a Transcutaneous Bone Conduction Implant. Audiology & Neurotology, 24(2), pp. 56-64. Karger 10.1159/000500513

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Objective: Magnetic resonance imaging (MRI) is often limited in patients with auditory implants because of the presence of metallic components and magnets. The aim of this study was to evaluate the clinical usefulness of a customized MRI sequence for metal artifact suppression for patients with implants in the temporal bone region, specifically patients with a transcutaneous bone conduction implant.
Methods: Two whole head specimens were unilaterally implanted with a transcutaneous bone conduction implant. MRI examinations with and without a primarily self-build sequence (SEMAC-VAT WARP) for metal artifact suppression were performed. The diagnostic usefulness of the acquired MRI scans was rated independently by two neuroradiologists. The sequence was also used to acquire postimplantation follow-up MRI in a patient with a transcutaneous bone conduction implant.
Results: The customized SEMAC-VAT WARP sequence significantly improved the diagnostic usefulness of the postimplantation MRIs. The image acquisition time was 12 min and 20 s for the T1-weighted and 12 min and 12 s for the T2-weighted MRI. There was good agreement between the two blinded raters (Cohen’s κ = 0.61, p < 0.001).
Conclusion: The sequence for metal artifact reduction optimized in Bern enables MRI at 1.5 T in patients with active transcutaneous bone conduction implants without sacrificing diagnostic imaging quality. Particularly on the implanted side, imaging of intracranial and supra- and infratentorial brain pathologies is clinically more valuable than standard diagnostic MRI without any artifact reduction sequences.

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