Risk assessment of copper-containing contraceptives: the impact for women with implanted intrauterine devices during clinical MRI and CT examinations

Abstract

Objectives

To assess the risks for implant users with copper-containing intrauterine devices (IUDs) during MR and CT examinations.

Methods

A tissue-mimicking phantom suitable for all experiments within this study was developed. Seven different types of copper IUDs were evaluated. Heating and dislocation of each IUD were investigated at two clinically relevant positions in 1.5 T and 3 T MR scanners. Artifacts in the field of view caused by each tested IUD were determined for clinical MR and CT imaging.

Results

No significant heating of any tested IUD was detected during MR measurements. The temperature increase was less than 0.6 K for all IUDs. Neither angular deflection nor translation of any IUD was detected. Artifacts in MR images were limited to the very vicinity of the IUDs except for one IUD containing a steel-visualizing element. Streaking artifacts in CT were severe (up to 75.5%) in the slices including the IUD.

Conclusion

No significant risk possibly harming the patient was determined during this phantom study, deeming MR examinations safe for women with an implanted copper IUD. Image quality was more impaired for CT than for MR imaging and needs careful consideration during diagnosis.

Key Points

• Risk assessment of copper-containing IUDs with regard to heating, dislocation, and artifacts during MR and CT imaging.

• Neither significant heating nor dislocation was determined in MR; image quality was more impaired for CT than for MR imaging and needs careful consideration during diagnosis.

• The tested IUDs pose no additional risks for implant users during MR and CT examinations.

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Abbreviations

ASTM:

American Society for Testing Materials

FoV:

Field of view

IUD:

Intrauterine device

RF:

Radiofrequency

TRUFI:

True fast imaging with steady-state free precession

TSE:

Turbo spin echo

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Acknowledgements

The authors are grateful to Marius Siegfarth (Fraunhofer PAMP) for his assistance during temperature measurements.

The IUDs used for this study were supplied by the manufacturers who had no further influence on the study.

Funding

This research project is part of the Research Campus M2OLIE and funded by the German Federal Ministry of Education and Research (BMBF) within the Framework “Forschungscampus: public-private partnership for Innovations” under the funding code 13GW0092D.

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Correspondence to Wiebke Neumann.

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Guarantor

The scientific guarantor of this publication is Frank G. Zöllner.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because it was a phantom study.

Ethical approval

Institutional Review Board approval was not required because it was a phantom study.

Methodology

• Prospective

• Experimental

• Performed at one institution

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Neumann, W., Uhrig, T., Malzacher, M. et al. Risk assessment of copper-containing contraceptives: the impact for women with implanted intrauterine devices during clinical MRI and CT examinations. Eur Radiol 29, 2812–2820 (2019). https://doi.org/10.1007/s00330-018-5864-6

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Keywords

  • Intrauterine devices, copper
  • Patient safety
  • Magnetic resonance imaging
  • Phantoms, imaging
  • Tomography, X-ray computed