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Review
. 2024 Oct 9;6(5):fcae359.
doi: 10.1093/braincomms/fcae359. eCollection 2024.

The use of 7T MRI in multiple sclerosis: review and consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

Daniel M Harrison  1   2 , Pascal Sati  3 , Eric C Klawiter  4 , Sridar Narayanan  5   6 , Francesca Bagnato  7   8 , Erin S Beck  9 , Peter Barker  10 , Alberto Calvi  11 , Alessandro Cagol  12   13   14 , Maxime Donadieu  15 , Jeff Duyn  16 , Cristina Granziera  12   13   17 , Roland G Henry  18 , Susie Y Huang  19 , Michael N Hoff  20 , Caterina Mainero  19 , Daniel Ontaneda  21 , Daniel S Reich  15 , David A Rudko  5   22 , Seth A Smith  23   24 , Siegfried Trattnig  25 , Jonathan Zurawski  26 , Rohit Bakshi  26 , Susan Gauthier  27 , Cornelia Laule  28
Affiliations
Review

The use of 7T MRI in multiple sclerosis: review and consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

Daniel M Harrison et al. Brain Commun. .

Abstract

The use of ultra-high-field 7-Tesla (7T) MRI in multiple sclerosis (MS) research has grown significantly over the past two decades. With recent regulatory approvals of 7T scanners for clinical use in 2017 and 2020, the use of this technology for routine care is poised to continue to increase in the coming years. In this context, the North American Imaging in MS Cooperative (NAIMS) convened a workshop in February 2023 to review the previous and current use of 7T technology for MS research and potential future research and clinical applications. In this workshop, experts were tasked with reviewing the current literature and proposing a series of consensus statements, which were reviewed and approved by the NAIMS. In this review and consensus paper, we provide background on the use of 7T MRI in MS research, highlighting this technology's promise for identification and quantification of aspects of MS pathology that are more difficult to visualize with lower-field MRI, such as grey matter lesions, paramagnetic rim lesions, leptomeningeal enhancement and the central vein sign. We also review the promise of 7T MRI to study metabolic and functional changes to the brain in MS. The NAIMS provides a series of consensus statements regarding what is currently known about the use of 7T MRI in MS, and additional statements intended to provide guidance as to what work is necessary going forward to accelerate 7T MRI research in MS and translate this technology for use in clinical practice and clinical trials. This includes guidance on technical development, proposals for a universal acquisition protocol and suggestions for research geared towards assessing the utility of 7T MRI to improve MS diagnostics, prognostics and therapeutic efficacy monitoring. The NAIMS expects that this article will provide a roadmap for future use of 7T MRI in MS.

Keywords: 7 Tesla; magnetic resonance imaging; multiple sclerosis; ultra-high field.

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Conflict of interest statement

D.M.H. has received research funding from EMD-Serono and Roche-Genentech, consulting fees from Horizon Therapeutics, TG Therapeutics and EMD-Serono and royalties from Up To Date, Inc. F.B. has received speaker honoraria from EMD-Serono, Sanofi and Novartis and serves/ed as site PI of multi-centre studies sponsored by EMD-Serono and Novartis and on advisory boards for Sanofi, EMD-Serono and Biogen. S.N. has received research funding from Roche-Genentech and Immunotec, consulting fees from Sana Biotechnology and personal compensation from NeuroRx Research. S.G. has received research funding from Roche-Genentech. E.S.B. has received consulting fees from EMD-Serono. .J.Z. has received research support from Novartis, I-Mab Biopharma and the Race to Erase MS Foundation. R.B. has received speaking honoraria from EMD-Serono and research support from Bristol-Myers Squibb, EMD-Serono and Novartis. A.C. was supported by the ECTRIMS post-doctoral training fellowship (2022). A.C. has received speaker honoraria from Novartis. S.Y.H. has received research funding and consulting fees from Siemens Healthineers. The University Hospital Basel (USB), as the employer of C.G., has received the following fees which were used exclusively for research support: (i) advisory board and consultancy fees from Actelion, Genzyme-Sanofi, Novartis, GeNeuro and Roche; (ii) speaker fees from Genzyme-Sanofi, Novartis, GeNeuro and Roche; and (iii) research support from Siemens, GeNeuro and Roche. E.C.K. has received research funding from Abbvie, Biogen and Genentech and consulting fees from EMD-Serono, Genentech, INmune Bio, Myrobalan Therapeutics, OM1, Inc. and TG Therapeutics. C.M. has received research funding from Genentech-Roche. C.L., J.D., M.D., D.A.R. and P.B. have no disclosures to report.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
CVS and PRLs. 7T multi-echo 3D GRE (A), FLAIR (B), unwrapped phase (C) and QSM (D). Arrows in B indicate lesions with CVS visible on GRE. Arrows in C/D indicate PRL, seen as lesions with a hypointense rim on unwrapped phase and a hyperintense rim on QSM. 3T FLAIR (E), multi-echo GRE (F), unwrapped phase (G) and QSM (H) in the same person with MS. Although CVS and PRLs are visible, less detail can be seen on these images, leading to a reduced count of lesions marked as PRLs or having the CVS and less definitive and more subjective identification of both.
Figure 2
Figure 2
Cortical lesions. Two subpial lesions are well seen on a motion and B0-corrected, 3D 0.5-mm3 T2*w GRE image (A, total acquisition time ∼35 min. for three slabs covering the supratentorial brain) and on a median of 3 acquisitions of 0.5-mm3. MP2RAGE (B, ∼10 min/acquisition). Lesions are visible, but less well seen on a 0.7-mm3. MP2RAGE image (acquisition time ∼10 min). (D) and (E) A subpial lesion visualized on 0.7-mm3 MP2RAGE but less well seen on a 0.8-mm3 T2*w GRE image (acquisition time ∼8 min). (F) A subpial lesion visualized on a 2D T2*w GRE image (0.2 mm2 in-plane resolution, 1 mm slice thickness, ∼24 min acquisition time for three slabs covering the supratentorial brain). Images in red boxes are magnifications of the regions outlined in red on whole-brain images above. A comparison of 7T (G–I) and 3T (J–L) images in the same MS subject. Arrows indicate locations of CLs as seen on MP2RAGE (G, J), FLAIR (H, K) and T2*w GRE (I, L).
Figure 3
Figure 3
Thalamic lesions visualized on 7T MRI. Shown are MP2RAGE (A), FLAIR (B) and GRE (C). A thalamic body lesion is shown by the red arrow. Subependymal thalamic lesions are shown by the yellow arrows.
Figure 4
Figure 4
Leptomeningeal enhancement on 7T MRI. Shown is an example of LME (arrow). No enhancement seen in the same region on pre-Gd FLAIR (A), but a region of subarachnoid hyperintensity is seen on both Gd + FLAIR (B) and subtraction (Gd + minus Gd) (C).
Figure 5
Figure 5
7T MRSI. 7T MRSI in (A) a patient with multiple sclerosis, showing conventional MRI, mI, NAA and mI/NAA ratio images. Spectra from the T1-hypointense lesion in the right parietal white matter show decreased NAA and elevated tCho and mI. (B) mI/NAA and conventional MRI scans in two MS patients with cortical and sub-cortical lesions; mI/NAA maps depict these lesions clearly. Adapted with permission from Herckova et al. Radiology 2022;303(1):141–150.
Figure 6
Figure 6
Resting-state functional connectivity at 7T. The bilateral posterior cingulate cortices were seeded to map the default mode network from a resting-state functional connectivity acquisition at 7T in an individual with multiple sclerosis. Sagittal (left) and axial (right) views demonstrate improved spatial resolution and spatial specificity to the cortex compared to capabilities at lower field strengths (not pictured).
Figure 7
Figure 7
Quantitative maps from 7T MRI. Shown are a T1 map (A, derived from MP2RAGE), R2* map (B, derived from multi-echo GRE) and QSM (C, derived from multi-echo GRE). Each map is shown in colour scale below (D, E, F) with units of seconds for T1 maps and milliseconds for R2* and relative susceptibility (normalized to CSF) for QSM. Quantitation from these maps can be utilized for estimation of tissue myelin content, cell loss, etc.
See this image and copyright information in PMC

References

    1. Li TQ, van Gelderen P, Merkle H, Talagala L, Koretsky AP, Duyn J. Extensive heterogeneity in white matter intensity in high-resolution T2*-weighted MRI of the human brain at 7.0 T. Neuroimage. 2006;32:1032–1040. - PubMed
    1. Duyn JH, van Gelderen P, Li TQ, de Zwart JA, Koretsky AP, Fukunaga M. High-field MRI of brain cortical substructure based on signal phase. Proc Natl Acad Sci U S A. 2007;104:11796–11801. - PMC - PubMed
    1. Ge Y, Zohrabian VM, Grossman RI. Seven-Tesla magnetic resonance imaging: New vision of microvascular abnormalities in multiple sclerosis. Arch Neurol. 2008;65:812–816. - PMC - PubMed
    1. Hammond KE, Metcalf M, Carvajal L, et al. . Quantitative in vivo magnetic resonance imaging of multiple sclerosis at 7 Tesla with sensitivity to iron. Ann Neurol. 2008;64:707–713. - PubMed
    1. Tallantyre EC, Brookes MJ, Dixon JE, Morgan PS, Evangelou N, Morris PG. Demonstrating the perivascular distribution of MS lesions in vivo with 7-Tesla MRI. Neurology. 2008;70:2076–2078. - PubMed