The issues and tentative solutions for contrast-enhanced magnetic resonance imaging at ultra-high field strength

Magnetic resonance imaging (MRI) performed at ultra-high field strengths beyond 3 Tesla (T) has become increasingly prevalent in research and preclinical applications. As such, the inevitable clinical implementation of such systems lies on the horizon. The major benefit of ultra-high field MRI is the markedly increased signal-to-noise ratios achievable, enabling acquisition of MR images with simultaneously greater spatial and temporal resolution. However, at field strengths higher than 3 T, the efficacy of Gd(III)-based contrast agents is diminished due to decreased r1 relaxivity, somewhat limiting imaging of the vasculature and contrast-enhanced imaging of tumors. There have been extensive efforts to design new contrast agents with high r1 relaxivities based on macromolecular compounds or nanoparticles; however, the efficacy of these agents at ultra-high field strengths has not yet been proven. The aim of this review article is to provide an overview of the basic principles of MR contrast enhancement processes and to highlight the main factors influencing relaxivity. In addition, challenges and opportunities for contrast-enhanced MRI at ultra-high field strengths will be explored. Various approaches for the development of effective contrast agent molecules that are suitable for a broad spectrum of applied field strengths will be discussed in the context of the current literature.