Hawsawi, Hassan Bakr; (2021) Safety of Simultaneous Scalp and Intracranial Electroencephalography Functional Magnetic Resonance Imaging. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Understanding the brain and its activity is one of the great challenges of modern science. Normal brain activity (cognitive processes, etc.) has been extensively studied using electroencephalography (EEG) since the 1930’s, in the form of spontaneous fluctuations in rhythms, and patterns, and in a more experimentally-driven approach in the form of event-related potentials allowing us to relate scalp voltage waveforms to brain states and behaviour. The use of EEG recorded during functional magnetic resonance imaging (EEG-fMRI) is a more recent development that has become an important tool in clinical neuroscience, for example, for the study of epileptic activity. The primary aim of this thesis is to devise a protocol in order to minimise the health risks that are associated with simultaneous scalp and intracranial EEG during fMRI (S- icEEG-fMRI). The advances in this technique will be helpful in presenting a new imaging method that will allow the measurement of brain activity with unprecedented sensitivity and coverage. However, this cannot be achieved without assessing the safety implications of such a technique. Therefore, five experiments were performed to fulfil the primary aim. First, the safety of icEEG- fMRI using body transmit RF coil was investigated to improve the results of previous attempts using a head transmit coil at 1.5T. The results of heating increases during a high-SAR sequence were in the range of 0.2-2.4 °C at the contacts with leads positioned along the central axis inside the MRI bore. These findings suggest the need for careful lead placement. Second, also for the body transmit coil we compared the heating in the vicinity of icEEG electrodes placed inside a realistically-shaped head phantom following the addition of scalp EEG electrodes. The peak temperature change was +2.7 °C at the most superior icEEG electrode contact without scalp electrodes, and +2.1 °C at the same contact and the peak increase in the vicinity of a scalp electrode contact was +0.6 °C (location FP2). These findings show that the S-icEEG-fMRI technique is feasible if our protocol is followed carefully. Third, the heating of a realistic 3D model of icEEG electrode during MRI using EM computational simulation was investigated. The resulting peak 10 g averaged SAR was 20% higher than without icEEG. Moreover, the superior icEEG placed perpendicular to B0 showed significant local SAR increase. These results were in line with previous studies. Fourth, the possibility of simplifying a complete 8-contact with 8 wires depth icEEG electrode model into an electrode with 1-contact and 1 wire using EM simulations was addressed. The results showed similar patterns of averaged SAR values around the electrode tip during phantom and electrode position along Z for the Complete and Simplified models, except an average maximum at Z = ~2.5 W/kg for the former. The SAR values during insertion depth for the Simplified model were double those for the Complete model. The effect of extension cable length is in agreement with previous experiments. Fifth, further simulations were implemented using two more simplified models: 8-contact with 1 wire shared with all contact and 8-contact 1 wire connected to each contact at a time as well as the previously modelled simplified 1-contact 1 wire. Two sets of simulations were performed: with a single electrode and with multiple electrodes. For the single electrode, three scenarios were tested: the first simplified model used only, the second simplified models used only and the third model positioned in different 13 locations. The results of these simulations showed about 11.4-20.5-fold lower SAR for the first model than the second and 0.29-5.82-fold lower SAR for the first model than the complete model. The results also showed increased SAR for the electrode close to the head coil than the ones away from it. For the multiple electrodes, three scenarios were tested: two 1-contact and wire electrodes in different separations, multiple electrodes with their wires separated and multiple electrodes with their wires shorted. The results showed interaction between the two tested electrodes. The results of the multiple electrodes presented 2 to ~10 times higher SAR for the separated setup than the shorted. The comparison between the 1-contact with 1 wire model and the complete model is still unknown and more tests are required to show it. From the findings of this PhD research, we conclude that a body RF coil can be utilized for icEEG-fMRI at 1.5 T; however, the safety protocol has to be implemented. In addition, scalp EEG can be used in conjunction with icEEG electrodes inside the body RF coil at 1.5 T and the safety protocol has to be followed. Finally, it is feasible to perform EM computational simulations using realistic icEEG electrodes on a human model. However, simplifying the realistic icEEG electrode model might result in overestimations of the heating, although it is possible that the simplification of the model can help to simulate more complex implantations such as the implantation of multiple electrodes with their leads open circuited or short circuited, which can provide more information about the safety of implanted patients inside the MRI.

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