7 Tesla magnetic resonance imaging in deep brain stimulation [Neurosurgery Wiki]

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====== 7 Tesla magnetic resonance imaging in deep brain stimulation ======

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====== Multi‑institutional Recommendations on the Use of 7T MRI in Deep Brain Stimulation ======

**Middlebrooks EH et al.**  
''Mayo Clinic, Jacksonville; Amsterdam UMC; University of Minnesota, Minneapolis; Western University, London (ON)''  

Published in the [[Journal of Neurosurgery]]  
((Middlebrooks EH, Bot M, Patriat R, Lau JC, Grewal SS, Zhou X, Tao S, Straub S, Yacoub E, McGovern R, Harel N. Multi‑institutional recommendations on the use of 7T MRI in deep brain stimulation. J Neurosurg. 2025 Jul 4:1-11. doi:10.3171/2025.3.JNS243024. Epub ahead of print. PMID: 40614283.))

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A [[Consensus]]/Technique article presenting multi-institutional [[expert consensus]] on the clinical application and technical optimization of **7‑Tesla MRI** in [[deep brain stimulation]] (DBS) planning.

7T MRI enables **superior visualization** of DBS targets—[[subthalamic nucleus]], [[globus pallidus internus]] (GPi), and [[thalamus]]—due to increased spatial [[resolution]], enhanced contrast, and higher signal-to-noise ratio.

The paper outlines:
  * Standardized imaging sequences  
  * Distortion correction methods  
  * Artifact mitigation strategies  
  * Post‑processing workflows  

All recommendations are grounded in experience across **>1000 DBS cases**.

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===== 🔍 Critical Appraisal =====

**➕ Strengths**
  * Extensive real‑world experience from multiple high‑volume centers (>1 000 cases)
  * Provides reproducible and practical imaging protocols
  * Addresses technical pitfalls specific to ultrahigh‑field MRI (e.g., geometric distortion, susceptibility artifacts)
  * Multi‑institutional consensus improves external validity

**➖ Weaknesses**
  * No comparative clinical outcome data (7T vs. 1.5T/3T)
  * Potential [[selection bias]]—centers with 7T access may not reflect broader clinical reality
  * Sparse discussion on [[cost]], accessibility, and logistical constraints of 7T
  * No standardized safety reporting (e.g., implant interactions with 7T environment)

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===== ✅ Final Verdict =====

**Score**: '''7/10'''  
Technically rigorous and informative, yet limited by absence of clinical outcome validation and economic analysis.

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===== 🧠 Takeaway for the Practicing Neurosurgeon =====

If working within a center equipped with 7T MRI and multidisciplinary support, adopting these consensus protocols can sharpen anatomical targeting accuracy for DBS. However, **clinical superiority** over standard-field MRI remains to be definitively proven.

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===== 🧾 Bottom Line =====

A valuable, experience-based roadmap for integrating **7T MRI** into the DBS workflow—methodologically sound, but **awaiting evidence** of outcome benefit and cost-effectiveness.

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===== 🗂 Reference Metadata =====
  * **Title**: Multi‑institutional recommendations on the use of 7T MRI in deep brain stimulation  
  * **Authors**: Middlebrooks EH et al.  
  * **Journal**: ''Journal of Neurosurgery''  
  * **Date**: July 4, 2025 (Online ahead of print)  
  * **DOI**: [[https://doi.org/10.3171/2025.3.JNS243024|10.3171/2025.3.JNS243024]]  
  * **PMID**: 40614283

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