7 Tesla magnetic resonance imaging Indications

In a Consensus/Technique article Middlebrooks et al. from the Mayo Clinic, Jacksonville; Amsterdam UMC, Amsterdam; CMRR, University of Minnesota, Minneapolis; Western University, London (ON) published in the Journal of Neurosurgery to provide multi‑institutional expert consensus on the technical use and clinical applications of 7‑Tesla MRI for planning and targeting in deep brain stimulation (DBS) surgery. 7T MRI offers significantly improved visualization of DBS targets (subthalamic nucleus, GPi, thalamus) due to higher spatial resolution, contrast, and signal‑to‑noise. The authors outline standardized imaging sequences, distortion correction, artifact mitigation, and post‑processing strategies informed by experience spanning >1 000 DBS cases.

• Strengths

– Based on extensive real‑world experience from over 1 000 7T DBS cases across several leading centers.

  – Offers concrete, reproducible imaging protocols and pre/post‑processing workflows.  
  – Addresses key technical challenges—distortion, susceptibility artifacts—relevant to ultrahigh‑field MRI guidance.  
  – Multi‑institutional input improves generalizability beyond a single‑center bias.

• Weaknesses

– No quantitative outcome data—no randomized or controlled series comparing 7T vs. standard 1.5/3T for clinical endpoints.

  – Potential selection bias: centers with 7T access likely had advanced infrastructure and specialized workflow.  
  – Financial and logistical feasibility (cost, scanner availability, patient safety in 7T) only superficially discussed.  
  – Lacks standardized safety/adverse event reporting specific to 7T in DBS population (e.g., implant‑scanner interactions).

Score: 7/10 Provides a robust technical roadmap, but lack of corroborating clinical effectiveness data tempers its impact.

If you have access to a 7T MRI and multidisciplinary expertise, leveraging the recommended protocols can enhance anatomical targeting precision for DBS. But understand that clinical outcome superiority over standard MRI remains unproven to date.

Valuable consensus protocol on integrating 7T MRI into DBS workflows; rigorous, yet pending demonstration of outcome advantage and cost‑effectiveness.

~~~~ Title: Multi‑institutional recommendations on the use of 7T MRI in deep brain stimulation Citation: Middlebrooks EH et al. Multi‑institutional recommendations on the use of 7T MRI in deep brain stimulation. *J Neurosurg*. Published online July 4, 2025. doi:10.3171/2025.3.JNS243024

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• *Categories: Imaging protocols, Deep Brain Stimulation, 7T MRI, Consensus guidelines Tags**: 7T MRI, deep brain stimulation, DBS targeting, ultrahigh‑field MRI, surgical planning, artifact correction