- Design
- Prospective two-cohort comparison of field strengths
- Population
- 348 patients and 31 healthy volunteers having upper abdominal MRI
- Primary outcome
- Signal-to-noise, image quality and diagnostic confidence at 5.0 T, 3.0 T and 1.5 T
- Effect
- Signal-to-noise 5.0 T > 3.0 T > 1.5 T (p<0.001); highest diagnostic confidence at 5.0 T in patients
A prospective study compared 5.0 T with 1.5 T and 3.0 T in 348 consecutive patients having upper abdominal MRI and 31 healthy volunteers scanned on all three systems. Two radiologists scored image quality and diagnostic confidence on a 5-point scale and measured signal-to-noise and contrast-to-noise ratios.
Objective measures followed a gradient of 5.0 T above 3.0 T above 1.5 T (all p<0.001). Subjectively, 5.0 T scored higher for anatomical detail, overall quality and, in patients, diagnostic confidence. It scored lowest for cardiac motion artefact and liver signal uniformity on T2-weighted imaging, with more distortion and ghosting on diffusion-weighted imaging.
The authors consider it clinically feasible for liver imaging, with artefacts needing optimisation. The study measured image quality and reader confidence, not whether diagnoses changed, and 5.0 T systems are rare, so for most departments this is an early signal rather than a purchasing argument.
- Signal-to-noise and contrast-to-noise rose with field strength in patients and volunteers.
- Expect more cardiac motion and signal inhomogeneity on T2 at 5.0 T.
- Diffusion imaging at 5.0 T showed more distortion and ghosting.
- Diagnostic accuracy was not measured, so confidence is not evidence of correct diagnosis.
Why it matters
It shows what higher field strength buys, and what it costs in artefact, before the technology reaches routine departments.
Don't overread it
Image quality and confidence were measured; diagnostic accuracy and patient outcomes were not.
The statistics, in plain English
A significant gradient in signal-to-noise tells you the image is cleaner, not that the diagnosis is better. Reader confidence is a subjective score and can rise without any change in accuracy.
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