Gadolinium-Enhanced Portable Ultra-Low-Field MRI for Evaluating Various Intracranial Pathologies

Portable ultra-low-field (pULF) MRI scanners, operating at magnetic fields below 100 mT, are broadening MRI accessibility. Despite the widespread use of contrast agents in clinical imaging, the efficacy of pULF-MRI in providing valid diagnostic information remains largely unexplored. This study evaluated the ability of pULF-MRI to detect diagnostically useful contrast-enhancement patterns compared with 3T MRI. We studied 5 cases representing a range of neurologic conditions: meningiomas in a patient with neurofibromatosis type 2, an incidental meningioma, a CNS mycobacterial infection, an oligodendroglioma repeat resection, and a chronic subdural hematoma. Imaging was performed following administration of gadoteridol, gadobutrol, or gadopiclenol, and enhancement patterns were qualitatively compared across matched slices. Postcontrast enhancement was visible on pULF-MR images in all cases and corresponded to 3T findings, though there were limitations in enhancement of calcified, small, or heterogeneously enhancing tissues due to several factors such as partial volume effects, SNR, image resolution, or some combination thereof. Our findings demonstrate that pULF-MRI can depict diagnostically meaningful gadolinium enhancement across multiple pathologies, establishing the feasibility and potential clinical utility of contrast-based neuroimaging at pULF. Further selection and validation of appropriate use cases can improve neurologic health outcomes in settings in which access to standard MRI is limited or contraindicated.