B. Condon et D. Hadley, ERRORS IN MR STEREOTAXY DUE TO UNDETECTED EXTRANEOUS METAL OBJECTS, Physics in medicine and biology, 42(9), 1997, pp. 1779-1789
MR stereotaxic procedures are being increasingly used, particularly in
functional neurosurgery where very high levels of localization accura
cy are required. Whilst many studies have investigated intrinsic cause
s of non-linearity, potential errors due to an extrinsic cause are not
generally appreciated. It is not uncommon to find objects such as hai
r clips, paper clips and pins inside high-held magnets. They can remai
n undetected for long periods because they can reach positions not ope
n to Visual inspection and because they often do not produce observabl
e deterioration in routine image quality. In this study we measured th
e maximum absolute positional shifts caused by such objects and found
that these can be significant (>1 mm, even up to 200 mm from one such
object). Additional measurements were performed using an MR compatible
Leksell stereotaxic frame to calculate actual stereotaxic coordinate
errors. The encompassing nature of the frame is such that some degree
of compensation for such nonlinearities is inherent, and so errors for
areas of the brain more proximal to the object are found to be reduce
d but not eliminated. Stereotaxic coordinate errors will not be reduce
d in non-encompassing designs and in frameless stereotaxy. The prevale
nce of such objects in clinical systems and the measures required to d
etect their presence are discussed. The need for quality control testi
ng before each stereotaxic procedure is highlighted.