Office-based versus high-field strength MRI: diagnostic and technical considerations

Low-field office magnetic resonance scanners have been an exciting, innovative, and controversial development in medical imaging. These units boost cost efficiency, with ease of installation and no additional external radiofrequency shielding necessary. The open design enables imaging of those who are claustrophobic and overweight, and offer the potential of dynamic imaging for athletes. Experienced centers have reported that the diagnostic accuracy obtained with office-based systems is satisfactory and comparable with that of high-field systems. However, with the advantages afforded by these convenient units, some significant limitations owing primarily to decreased signal-to-noise ratio of low-field MR imaging and lower image quality compared with conventional high-field magnetic resonance scanners. In this article, we comprehensively reviewed the literature focusing on the diagnostic accuracy of low-field imaging with respect to individual joints and the major pathology that occur in these joints. According to most studies, there are still a number of patients in whom clinical treatment is affected owing to under or misdiagnosis by low-field MR imaging. For clinicians and radiologists who are an integral part of this office-based diagnostic system, it is important to be knowledgeable of the potential limitations of these low-field scanners compared with conventional systems. Specialized training and expertize is required to optimize imaging parameters, and provide quality control and accurate interpretation.