Pediatric 7 Tesla MRI: Current Applications and Future Opportunities

Utilization of ultra-high-field (UHF) MRI in humans has rapidly increased over the past decade, following regulatory approval of the first clinical 7 Tesla (7T) platforms in 2017 for brain and knee imaging. Currently, there are approximately 140 MRI scanners worldwide operating at or above 7T [1]. While the majority of 7T scanners are dedicated to research and development, select hospitals have successfully implemented 7T MRI for clinical care. Key advantages of 7T over lower-field systems include higher spatial and contrast resolution for anatomic and microstructural detail, susceptibility effects for functional and vascular imaging, and spectral resolution for metabolic evaluation. However, safety considerations-particularly specific absorption rate thresholds-have historically constrained utility to patients with weights of 30 kg and above. Additional considerations, including operating costs, longer imaging times, increased artifacts, and greater bioeffects, have limited widespread adoption, especially in pediatric patients. In this article, we discuss emerging technology advances and clinical applications for 7T MRI imaging of children. Major technical considerations are scanner hardware, coils, safety, sedation, and monitoring. Important clinical applications include neurodevelopmental, epilepsy, demyelinating, vascular, genetic, neoplastic, and traumatic disorders. Major research areas involve artificial intelligence, extracranial imaging, and field strengths exceeding 10T. Real-life imaging examples are provided for children and young adults to highlight the advantages and pitfalls of 7T in this population.