Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2024; 16(7): 274-293
Published online Jul 28, 2024. doi: 10.4329/wjr.v16.i7.274
Evaluating the role of 7-Tesla magnetic resonance imaging in neurosurgery: Trends in literature since clinical approval
Arosh S Perera Molligoda Arachchige, Sarah Meuli, Francesca Romana Centini, Niccolò Stomeo, Federica Catapano, Letterio S Politi
Arosh S Perera Molligoda Arachchige, Sarah Meuli, Francesca Romana Centini, Faculty of Medicine, Humanitas University, Pieve Emanuele, Milan 20072, Italy
Niccolò Stomeo, Department of Anaesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan 20089, Italy
Niccolò Stomeo, Federica Catapano, Letterio S Politi, Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy
Federica Catapano, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
Letterio S Politi, Department of Neuroradiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan 20089, Italy
Author contributions: Perera Molligoda Arachchige AS conceived of the presented idea and performed the analysis; Catapano F and Politi LS verified the analytical methods. All authors discussed the results and contributed to writing the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Letterio S Politi, MD, Professor, Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan 20072, Italy.letterio.politi@hunimed.eu
Received: April 6, 2024
Revised: May 8, 2024
Accepted: June 17, 2024
Published online: July 28, 2024
Processing time: 108 Days and 13.4 Hours
Abstract
BACKGROUND

After approval for clinical use in 2017, early investigations of ultra-high-field abdominal magnetic resonance imaging (MRI) have demonstrated its feasibility as well as diagnostic capabilities in neuroimaging. However, there are no to few systematic reviews covering the entirety of its neurosurgical applications as well as the trends in the literature with regard to the aforementioned application.

AIM

To assess the impact of 7-Tesla MRI (7T MRI) on neurosurgery, focusing on its applications in diagnosis, treatment planning, and postoperative assessment, and to systematically analyze and identify patterns and trends in the existing literature related to the utilization of 7T MRI in neurosurgical contexts.

METHODS

A systematic search of PubMed was conducted for studies published between January 1, 2017, and December 31, 2023, using MeSH terms related to 7T MRI and neurosurgery. The inclusion criteria were: Studies involving patients of all ages, meta-analyses, systematic reviews, and original research. The exclusion criteria were: Pre-prints, studies with insufficient data (e.g., case reports and letters), non-English publications, and studies involving animal subjects. Data synthesis involved standardized extraction forms, and a narrative synthesis was performed.

RESULTS

We identified 219 records from PubMed within our defined period, with no duplicates or exclusions before screening. After screening, 125 articles were excluded for not meeting inclusion criteria, leaving 94 reports. Of these, 2 were irrelevant to neurosurgery and 7 were animal studies, resulting in 85 studies included in our systematic review. Data were categorized by neurosurgical procedures and diseases treated using 7T MRI. We also analyzed publications by country and the number of 7T MRI facilities per country was also presented. Experimental studies were classified into comparison and non-comparison studies based on whether 7T MRI was compared to lower field strengths.

CONCLUSION

7T MRI holds great potential in improving the characterization and understanding of various neurological and psychiatric conditions that may be neurosurgically treated. These include epilepsy, pituitary adenoma, Parkinson's disease, cerebrovascular diseases, trigeminal neuralgia, traumatic head injury, multiple sclerosis, glioma, and psychiatric disorders. Superiority of 7T MRI over lower field strengths was demonstrated in terms of image quality, lesion detection, and tissue characterization. Findings suggest the need for accelerated global distribution of 7T magnetic resonance systems and increased training for radiologists to ensure safe and effective integration into routine clinical practice.

Keywords: 7-Tesla; Magnetic resonance imaging; Neuroimaging; Neurosurgery; Pathologies; Procedures; Trends

Core Tip: Frequent neurosurgical procedures using 7-Tesla magnetic resonance imaging (7T MRI) include endoscopic neurosurgery, resective epilepsy surgery, and deep brain stimulation, addressing conditions like cerebrovascular diseases, epilepsy, pituitary adenoma, and gliomas. Leading in publications are the United States, Netherlands, South Korea, and Japan. 7T MRI enhances the understanding of neurological and psychiatric disorders, showing superiority in image quality, lesion detection, and tissue characterization, underscoring the need for global deployment and improved radiologist training.