First Demonstration of Post-Contrast Enhancement Using Conventional Gadolinium in Ultra-Low-Field MRI

Introduction: Magnetic resonance imaging (MRI) is considered the gold standard for diagnosing brain tumors, but access to MRI technology is limited in low- and middle-income countries (LMICs). Recently, portable ultra-low field (ULF) MRI scanners have emerged as a potential diagnostic tool for regions with limited MRI availability. One such system is the Swoop portable MR device (Hyperfine Inc., Guilford, CT) that operates at 0.064T. This work investigates the ability of the Swoop ULF-MRI scanner to generate post-contrast enhancement images using conventional gadolinium-based contrast agents. Successful implementation could expand the diagnostic capabilities of portable MRI in resource-limited settings.

Methods: A 54-year-old female patient with recurrent seizures underwent brain imaging including non-contrast Swoop ultra-low field (ULF) MRI identifying a suspicious clival mass. Further characterization was done with conventional 1.5T MRI with contrast administration. Thirty minutes after gadolinium contrast, post-contrast ULF-MRI was performed to assess enhancement dynamics.

Results: On T1-weighted post-contrast images from the ULF MRI, the clival mass exhibited significant enhancement concerning for a neoplastic process such as a brain tumor. A minimally invasive biopsy was subsequently performed, with histopathological examination confirming a diagnosis of clival meningioma. The ability to visualize real-time post-contrast enhancement dynamics using the portable ULF MRI scanner with conventional gadolinium-based contrast agents provided crucial information about lesion vascularity and characteristics. This aided in the differential diagnosis of this patient's intracranial pathology, distinguishing a clival meningioma from other potential etiologies. The findings demonstrate the feasibility of using widely available contrast agents to achieve post-contrast enhancement on ULF-MRI, expanding its diagnostic capabilities for brain tumor evaluation.

Conclusion : Our report highlights the potential of contrast-enhanced ULF-MRI in the diagnosis of brain tumors, particularly in settings where access to traditional MRI is limited. To our knowledge, this is the first report to describe the use of this technology for brain tumor imaging.
Further studies are needed to explore its diagnostic accuracy and clinical role, as well as the feasibility of gadolinium-based contrast use in ULF-MRI.