Kim Annink

247 7.0T MRI in neonates 7.0T has comparable SNR as at 3.0T, but with the advantage of less overlap between metabolite peaks. Nevertheless, 7.0T MRS enabled more accurate detection of N-acetylaspartylglutamate, taurine and glycine; and possibly other metabolites such as glutamate, GABA and myo-inositol, as has been described in adults (5,6). This could be helpful for the diagnosis of metabolic diseases and neuronal injury, but can also provide information about the biochemical development of the neonatal brain. In the future, 7.0T might be particularly helpful to answer specific questions about diagnosis or outcome in for example infants with small (perforator) strokes, the diagnosis of metabolic diseases or patients with unexplained neurological symptoms i.e. seizures. The clinical implications and additional value of 7.0T in infants, should be investigated in larger 7.0T MRI studies. We did not scan preterm neonates, so safety and feasibility of 7.0T MRI in preterm infants should also be investigated in the future. CONCLUSIONS In conclusion, this pilot study shows for the first time that 7.0T ultra-high field MRI is feasible in infants. Good quality images could be obtained, with some sequences providing additional details compared to 3.0T. Positioning of the infant in the isocenter of the coil is important for SAR safety. ACKNOWLEDGMENTS We thank Patrick Stroosnijder for helping with the audiology tests and the physician assistants of the neonatal intensive care unit for their help and supervision during the MRI scans. FUNDING The study is funded by the Dr. C.J. Vaillant Foundation. The PhD position of the first author Kim Annink is supported by the the European Union’s Horizon 2020 research and innovation program (grant agreement No 667224, ALBINO). COMPETING INTERESTS Floris Groenendaal, one of the authors of the manuscript, declares that he is an expert witness in cases of perinatal asphyxia. Fredy Visser works in the ultra-high field MRI team of the department of Radiology in the UMC Utrecht, but is also an employee of Philips Healthcare, Best, The Netherlands. The other authors have no conflict of interest to declare. 11