To assess the risks for implant users with copper-containing intrauterine devices (IUDs) during MR and CT examinations.
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.
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.
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.
• 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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
American Society for Testing Materials
Field of view
True fast imaging with steady-state free precession
Turbo spin echo
Kavanaugh ML, Jerman J (2018) Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014. Contraception 97:14–21
United Nations Population Fund (2016) TCu380A intrauterine contraceptive device (IUD) WHO/UNFPA technical specification and prequalification guidance. United Nations Population Fund, NY, USA
World Health Organization (ed) (2009) Medical eligibility criteria for contraceptive use – 4th ed. World Health Organization, Geneva
United Nations Department of Economic and Social Affairs (2011) World contraceptive use 2011. United Nations Department of Economic and Social Affairs, NY, USA. Available via http://www.un.org/esa/population/publications/contraceptive2011/wallchart_front.pdf. Accessed 01 Aug 2018
Dietrich O, Reiser MF, Schoenberg SO (2008) Artifacts in 3-T MRI: physical background and reduction strategies. Eur J Radiol 65:29–35
Guerin B, Serano P, Iacono MI et al (2018) Realistic modeling of deep brain stimulation implants for electromagnetic MRI safety studies. Phys Med Biol 63:095015
Golestanirad L, Angelone LM, Iacono MI, Katnani H, Wald LL, Bonmassar G (2017) Local SAR near deep brain stimulation (DBS) electrodes at 64 and 127 MHz: a simulation study of the effect of extracranial loops. Magn Reson Med 78:1558–1565
Noureddine Y, Kraff O, Ladd ME et al (2018) In vitro and in silico assessment of RF-induced heating around intracranial aneurysm clips at 7 Tesla. Magn Reson Med 79:568–581
Bhusal B, Bhattacharyya P, Baig T, Jones S, Martens M (2018) Measurements and simulation of RF heating of implanted stereo-electroencephalography electrodes during MR scans. Magn Reson Med. https://doi.org/10.1002/mrm.27144
Winter L, Oberacker E, Özerdem C et al (2015) On the RF heating of coronary stents at 7.0 Tesla MRI. Magn Reson Med 74:999–1010
Tse ZT, Elhawary H, Montesinos CA, Rea M, Young I, Lampérth M (2011) Testing MR image artifacts generated by engineering materials. Concepts Magn Reson 39B:109–117
Santoro D, Winter L, Müller A et al (2012) Detailing radio frequency heating induced by coronary stents: a 7.0 Tesla magnetic resonance study. PLoS One 7:e49963
Elhawary H, Zivanovic A, Davies B, Lamperth M (2006) A review of magnetic resonance imaging compatible manipulators in surgery. Proc Inst Mech Eng H 220:413–424
Christoforou EG, Tsekos NV, Özcan A (2006) Design and testing of a robotic system for MR image-guided interventions. J Intell Robot Syst 47:175–196
Tse ZT, Janssen H, Hamed A, Ristic M, Young I, Lamperth M (2009) Magnetic resonance elastography hardware design: a survey. Proc Inst Mech Eng H 223:497–514
Barrett JF, Keat N (2004) Artifacts in CT: recognition and avoidance. Radiographics 24:1679–1691
Lee MJ, Kim S, Lee SA et al (2007) Overcoming artifacts from metallic orthopedic implants at high-field-strength MR imaging and multi-detector CT. Radiographics 27:791–803
Kalender WA (2011) Computer Tomography, 3rd edn. Publicis MCD Verlag, Germany
Mark AS, Hricak H (1987) Intrauterine contraceptive devices: MR imaging. Radiology 162:311–314
Hess T, Stepanow B, Knopp MV (1996) Safety of intrauterine contraceptive devices during MR imaging. Eur Radiol 6:66–68
Pasquale SA, Russer TJ, Foldesy R, Mezrich RS (1997) Lack of interaction between magnetic resonance imaging and the copper-T380A IUD. Contraception 55:169–173
Berger-Kulemann V, Einspieler H, Hachemian N et al (2013) Magnetic field interactions of copper-containing intrauterine devices in 3.0-Tesla magnetic resonance imaging: in vivo study. Korean J Radiol 14:416–422
ASTM Standard F2119-07 (2007) Standard test method for evaluation of MR image artifacts from passive implants. ASTM International, West Conshohocken
ASTM Standard F2182-11a (2011) Standard test method measurements of radio frequency induced heating on or near passive implants during magnetic resonance imaging. ASTM International, West Conshohocken
ASTM Standard F2213-06 (2006) Standard test method for measurement of magnetically induced torque on medical devices in the magnetic resonance environment. ASTM International, West Conshohocken
EN60601 (2017) Medical electrical equipment - Part 2–33: particular requirements for the basic safety and essential performance of magnetic resonance equipment for medical diagnosis. Beuth Verlag, Berlin
Neumann W, Lietzmann F, Schad LR, Zöllner FG (2017) Design of a multimodal (1H/23NaMR/CT) anthropomorphic thorax phantom. Z Med Phys 27:124–131
Kato H, Kuroda M, Yoshimura K et al (2005) Composition of MRI phantom equivalent to human tissues. Med Phys 32:3199–3208
Schuenke P, Koehler C, Korzowski A et al (2017) Adiabatically prepared spin-lock approach for T1ρ-based dynamic glucose enhanced MRI at ultrahigh fields. Magn Reson Med 78:215–225
Nordbeck P, Fidler F, Weiss I et al (2008) Spatial distribution of RF-induced E-fields and implant heating in MRI. Magn Reson Med 60:312–319
Optocon AG (2012). Reference manual for fiber optic thermometer FOTEMP1-4. Available via http://www.optocon.de/en/products/fiber-optic-temperature-signal-conditioners/fotemp1-4-fiber-optic-single-channel-thermometer/. Accessed 01 Aug 2018
Shellock FG (2002) Biomedical implants and devices: assessment of magnetic field interactions with a 3.0-Tesla MR system. J Magn Reson Imaging 16(6):721–732
van der Schaaf I, van Leeuwen M, Vlassenbroek A, Velthuis B (2006) Minimizing clip artifacts in multi CT angiography of clipped patients. AJNR Am J Neuroradiol 27:60–66
Ulaby FT, Michielssen E, Ravaioli U (2015) Fundamentals of applied electromagnetics, global edition. Pearson Education Limited, Essex
Yeung CJ, Susil RC, Atalar E (2002) RF safety of wires in interventional MRI: using a safety index. Magn Reson Med 47:187–193
Samoudi AM, Vermeeren G, Tanghe E, Van Holen R, Martens L, Josephs W (2016) Numerically simulated exposure of children and adults to pulsed gradient fields in MRI. J Magn Reson Imaging 44:1360–1367
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.
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.
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.
Written informed consent was not required for this study because it was a phantom study.
Institutional Review Board approval was not required because it was a phantom study.
• Performed at one institution
About this article
Cite this article
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
- Intrauterine devices, copper
- Patient safety
- Magnetic resonance imaging
- Phantoms, imaging
- Tomography, X-ray computed