A Systematic Review evaluating the role of the 7 T MRI in Neurosurgery: Unveiling Trends in the Literature during the First Four Years after Clinical Approval in 2017.

Aims(1) To assess the impact of 7-Tesla Magnetic Resonance Imaging (7T MRI) on neurosurgery, focusing on its applications in diagnosis, treatment planning, and post-operative assessment. (2) To systematically analyze and identify patterns and trends in the existing literature related to the utilization of 7T MRI in neurosurgical contexts. MethodsSystematic search of PubMed for studies published between January 1, 2017, and December 31, 2021, using MeSH terms related to 7T MRI and neurosurgery. Inclusion criteria: Studies involving patients of all ages, meta-analyses, systematic reviews, and original research. Exclusion criteria: Pre-prints, studies with insufficient data eg: case reports, letters, etc., non-English publications, and studies involving animal subjects. Data synthesis involved standardized extraction forms, and a narrative synthesis was performed. ResultsIdentified 83 records from PubMed, screened for inclusion criteria, resulting in 48 studies included in the systematic review. Most common neurosurgical procedures using 7T MRI: endoscopic neurosurgery, resective epilepsy surgery, and deep brain stimulation surgery. Commonly treated pathologies: cerebrovascular diseases, epilepsy, pituitary adenoma, and gliomas. USA, Netherlands, and Germany had the highest absolute number of publications, but the Netherlands showed the highest research productivity per 7T MRI available. A decline in research output in 2018 followed by an increase in subsequent years. Could not conduct a meta-analysis due to insufficient studies for each pathology. Conclusions7T MRI holds great potential in improving the characterization and understanding of various neurological and psychiatric conditions. Superiority of 7T MRI over lower field strengths demonstrated in terms of image quality, lesion detection, and tissue characterization. Applications in epilepsy, pituitary adenoma, Parkinsons disease, cerebrovascular diseases, trigeminal neuralgia, traumatic head injury, multiple sclerosis, glioma, and psychiatric disorders. Limitations include database selection, research productivity metrics, and study inclusion criteria. Findings suggest the need for accelerated global distribution of 7T MR systems and increased training for radiologists to ensure safe and effective integration into routine clinical practice.