Utilization of an ultra-low-field, portable magnetic resonance imaging for brain tumor assessment in lower middle-income countries

Abstract

Background: Access to neuroimaging is limited in low-middle-income countries (LMICs) due to financial and resource constraints. A new, ultra-low-field, low-cost, and portable magnetic resonance imaging (pMRI) device could potentially increase access to imaging in LMICs.

Case description: We have presented the first brain tumor case scanned using an Ultra-low-field pMRI at Aga Khan University Hospital in Karachi, Pakistan.

Conclusion: The imaging results suggest that the pMRI device can aid in neuroradiological diagnosis in resource-constrained settings. Further, research is needed to assess its compatibility for imaging other neurological disorders and compare its results with conventional MRI results.

Keywords: Brain tumors; Low-middle-income countries; Neuroimaging; Point-of-care; Portable magnetic resonance imaging; Ultra-low-field magnetic resonance imaging.

Figure 1:

Comparison of standard 1.5 T magnetic resonance imaging (MRI) and ultra-low-field portable MRI (ULF pMRI) Images of a brain tumor. The figure displays the preoperative MRI images of a patient with a brain tumor both obtained using a standard 1.5 T MRI and an ULF pMRI. Initial preoperative images on standard 1.5 T MRI localize a hyperintense lesion on T2 and fluid-attenuated inversion recovery sequences in the right centrum semiovale, involving deep and subcortical white matter with no surrounding edema. ULF pMRI reveals an isointense lesion with a non-specific hypointense rim (white arrow) on T1. The lesion was well-defined with no surrounding edema, or midline shift, nor any pressure effects. These findings were suggestive of low-grade glioma.

Figure 2:

The comparison highlights the capabilities of the portable, ultra-low-field magnetic resonance imaging in providing comparable imaging quality to its conventional counterpart. Radiofrequency (RF), Specific Absorption Rate (SAR), magnetic field gradient (dB/dt), magnitude of the static magnetic field (Max |B|), maximum value of the magnitude of the gradient of the magnetic field (Max |grad|B||), overall strength of the magnetic field used during an MRI scan (Max |B|.|grad|B||)