Artifacts and Safety of Oral Metals in Subjects Undergoing High-field Strength Brain Magnetic Resonance Imaging
Objective:
To inform best practices, safety for patients, research participants and healthcare workers in our academic tertiary center for the recently installed Siemens 7.0T magnetic resonance imaging (MRI), we conducted a systematic literature review on the impact of dental metallic materials on 7.0T brain MRI scans.
Background:
Dental metals (e.g. fillings, crowns, implants) could introduce artifacts into brain MRIs, potentially impacting image interpretation. The advent of 7.0T MRI, with its higher-field strength and improved image quality, has signaled potential safety risks associated with dental metalwork.
Design/Methods:
We searched PubMed/Medline, Embase, Scopus and Web of Science. Following PRISMA guidelines, we included all studies reporting dental metallic materials’ behavior on 7.0T MRI. We collected patient characteristics, dental metalwork details, MRI parameters, artifact assessment scores, diagnostic outcomes, and adverse events. We assessed risk of bias using Quality Assessment Tool for Diagnostic Accuracy Studies and the quality of evidence using GRADE scale.
Results:
From 109 studies selected for full-reading, 21 were eligible. Most studies (n=14, 66.6%) were ex-vivo electromagnetic simulations or experimental results in tissue-mimicking phantoms or human models and only 7 (33.3%) in-vivo human imaging. 75% of studies showed lack of substantial heating and insignificant image distortions from the dental retainers and orthodontic wires. All ex-vivo studies highlighted substance release from fillings. The risk of enhanced specific absorption rates in location-specific dental implants was poorly interrogated.
Conclusions:
The findings of this systematic review significantly contributed to the development of protocols for the safe and effective use of 7.0T brain MRI in patients with oral metallic materials. Further research is warranted to address the current literature limitations, especially the restricted in-vivo investigation of artifact severity, diagnostic influence, and safety in high-field imaging environment. A prospective registry of clinical and research 7.0T brain MRI cases with dental metals is essential to inform the development of evidence-based guidelines for future practice.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.