Clinical translation of whole-body 5 Tesla MRI: An evolving paradigm in high-field imaging

The development of 5 Tesla (T) magnetic resonance imaging (MRI) bridges the gap between 3 T and 7 T systems. Recently, it has transitioned from a research tool to a clinical modality. This review summarizes technical advances in 5 T MRI, evaluates its organ-specific applications, and discusses its clinical benefits. Recent advances include the redesign of coils, artificial intelligence-assisted compressed sensing, and deep learning-based reconstruction techniques, that enable faster and higher-quality imaging. In addition, imaging safety studies have paved the way for clinical applications. Clinically, 5 T MRI demonstrates broad applicability across cardiovascular, cerebrovascular, peripheral vascular, abdominal, pelvic, musculoskeletal, and neurological imaging. Clinical benefits of 5 T MRI have been demonstrated. First, diagnostic confidence was enhanced via improved spatial resolution (e.g., elevated calcium detection sensitivity by coronary magnetic resonance angiography, superior visualization of Moyamoya collaterals, foot vessel, improved detection of pancreatic cystic lesions, sharp capsular definition by prostate imaging, etc.). Second, quantitative metrics at 5 T demonstrated reproducibility and consistency with those at 3 T (e.g. myocardial T1 mapping and abdominal apparent diffusion coefficient highly correlated with 3 T MRI, test-retest repeatability of glutamate chemical exchange saturation transfer in brain tumors, etc.). Third, 5 T MRI enabled improved imaging efficiency and reduced dosage of the contrast agent (e.g., a higher acceleration factor for peripheral vascular imaging, reduced scan time for oral cavity imaging, half-dose gadolinium for brain tumor imaging, etc.). In conclusion, 5 T MRI has served as a balanced platform that successfully merges ultra-high-field capabilities with practical clinical use, extending its application to whole-body imaging.