Donald Paty Lecture: Adventures at the Poles: Ultra-Low and Ultra-High-Field MRI for MS

In this talk, the speaker compares what MRI can and cannot show in multiple sclerosis at the two ends of the field-strength spectrum: portable ultra-low-field MRI (e.g., 64 millitesla) and ultra-high-field MRI (e.g., 7 tesla). The presentation discusses how field strength affects image quality and lesion visibility, what is gained and what is sacrificed as field strength increases or decreases, and how to select the most appropriate approach for a given clinical question. The speaker highlights examples in which 7T MRI provides additional biological insight, such as susceptibility-based lesion features and the tendency of lesions to develop around veins in both white matter and gray matter. The talk also examines how low-field systems expand access to MRI and enable point-of-care imaging.