Recent advances in managing MRI artifacts caused by auditory implants: the effect of Metal Artifact Reduction Sequences

The efforts made over the years to improve the implantable auditory devices technology has led to overcome the concerns related to the interaction between their magnetic system and the complex magnetic resonance (MR) environment. Nowadays, an increasing number of devices has become MR compatible. However, when dealing with patients with implantable auditory devices and cerebral MR, the presence of signal void areas and distortion signals limiting the depiction of the intracranial structures still remains an outstanding issue. Among the strategies to improve the quality of MR image (MRI), the application of metal artifact reduction sequences (MARS) in MRI has been proposed. This review provides a critical analysis of the current literature regarding the utilization of the MARS in cerebral MRI performed in presence of auditory implants. Methods: Data sources included PubMed, EMBASE, Web of Science and Scopus. The main eligibility criteria were English-language articles investigating the use of MARS in implantable auditory devices recipients. Data was extracted according to PRISMA guidelines. Results: Four articles were identified, the oldest one dated January 2019: two studies dealing with cochlear implants (CI) and two dealing with bone conduction implants (BCI). Three out of four paper were ex vivo, whereas the remaining article was a clinical study. Conclusion and relevance: To our knowledge, this is the first review on this emerging topic. Encouraging results with the application of MARS have been reported in all the works consulted, although in our opinion these findings present some restriction and need confirmation