Navigated intraoperative ultrasound in pediatric brain tumors.

PURPOSE: The aim of this study was to evaluate the diagnostic value and accuracy of navigated intraoperative ultrasound (iUS) in pediatric oncological neurosurgery as compared to intraoperative magnetic resonance imaging (iMRI). METHODS: A total of 24 pediatric patients undergoing tumor debulking surgery with iUS, iMRI, and neuronavigation were included in this study. Prospective acquisition of iUS images was done at two time points during the surgical procedure: (1) before resection for tumor visualization and (2) after resection for residual tumor assessment. Dice similarity coefficients (DSC), Hausdorff distances 95th percentiles (HD95) and volume differences, sensitivity, and specificity were calculated for iUS segmentations as compared to iMRI. RESULTS: A high correlation (R = 0.99) was found for volume estimation as measured on iUS and iMRI before resection. A good spatial accuracy was demonstrated with a median DSC of 0.72 (IQR 0.14) and a median HD95 percentile of 4.98 mm (IQR 2.22 mm). The assessment after resection demonstrated a sensitivity of 100% and a specificity of 84.6% for residual tumor detection with navigated iUS. A moderate accuracy was observed with a median DSC of 0.58 (IQR 0.27) and a median HD95 of 5.84 mm (IQR 4.04 mm) for residual tumor volumes. CONCLUSION: We found that iUS measurements of tumor volume before resection correlate well with those obtained from preoperative MRI. The accuracy of residual tumor detection was reliable as compared to iMRI, indicating the suitability of iUS for directing the surgeon's attention to areas suspect for residual tumor. Therefore, iUS is considered as a valuable addition to the neurosurgical armamentarium. TRIAL REGISTRATION NUMBER AND DATE: PMCLAB2023.476, February 12th 2024.

Flexible metasurface for improving brain imaging at 7T.

PURPOSE: Ultra-high field MRI offers unprecedented detail for noninvasive visualization of the human brain. However, brain imaging is challenging at 7T due to the B 1 + $$ {}_1^{+} $$ field inhomogeneity, which results in signal intensity drops in temporal lobes and a bright region in the brain center. This study aims to evaluate using a metasurface to improve brain imaging at 7T and simplify the investigative workflow. METHODS: Two flexible metasurfaces comprising a periodic structure of copper strips and parallel-plate capacitive elements printed on an ultra-thin substrate were optimized for brain imaging and implemented via PCB. We considered two setups: (1) two metasurfaces located near the temporal lobes and (2) one metasurface placed near the occipital lobe. The effect of metasurface placement on the transmit efficiency and specific absorption rate was evaluated via electromagnetic simulation studies with voxelized models. In addition, their impact on signal-to-noise ratio (SNR) and diagnostic image quality was assessed in vivo for two male and one female volunteers. RESULTS: Placement of metasurfaces near the regions of interest led to an increase in homogeneity of the transmit field by 5% and 10.5% in the right temporal lobe and occipital lobe for a male subject, respectively. SAR efficiency values changed insignificantly, dropping by less than 8% for all investigated setups. In vivo studies also confirmed the numerically predicted improvement in field distribution and receive sensitivity in the desired ROI. CONCLUSION: Optimized metasurfaces enable homogenizing transmit field distribution in the brain at 7T. The proposed lightweight and flexible structure can potentially provide MR examination with higher diagnostic value images.

The Development and External Validation of Artificial Intelligence-Driven MRI-Based Models to Improve Prediction of Lesion-Specific Extraprostatic Extension in Patients with Prostate Cancer.

Adequate detection of the histopathological extraprostatic extension (EPE) of prostate cancer (PCa) remains a challenge using conventional radiomics on 3 Tesla multiparametric magnetic resonance imaging (3T mpMRI). This study focuses on the assessment of artificial intelligence (AI)-driven models with innovative MRI radiomics in predicting EPE of prostate cancer (PCa) at a lesion-specific level. With a dataset encompassing 994 lesions from 794 PCa patients who underwent robot-assisted radical prostatectomy (RARP) at two Dutch hospitals, the study establishes and validates three classification models. The models were validated on an internal validation cohort of 162 lesions and an external validation cohort of 189 lesions in terms of discrimination, calibration, net benefit, and comparison to radiology reporting. Notably, the achieved AUCs ranged from 0.86 to 0.91 at the lesion-specific level, demonstrating the superior accuracy of the random forest model over conventional radiological reporting. At the external test cohort, the random forest model was the best-calibrated model and demonstrated a significantly higher accuracy compared to radiological reporting (83% vs. 67%, p = 0.02). In conclusion, an AI-powered model that includes both existing and novel MRI radiomics improves the detection of lesion-specific EPE in prostate cancer.

Deep learning for automated contouring of neurovascular structures on magnetic resonance imaging for prostate cancer patients.

Background and purpose: Manual contouring of neurovascular structures on prostate magnetic resonance imaging (MRI) is labor-intensive and prone to considerable interrater disagreement. Our aim is to contour neurovascular structures automatically on prostate MRI by deep learning (DL) to improve workflow and interrater agreement. Materials and methods: Segmentation of neurovascular structures was performed on pre-treatment 3.0 T MRI data of 131 prostate cancer patients (training [n = 105] and testing [n = 26]). The neurovascular structures include the penile bulb (PB), corpora cavernosa (CCs), internal pudendal arteries (IPAs), and neurovascular bundles (NVBs). Two DL networks, nnU-Net and DeepMedic, were trained for auto-contouring on prostate MRI and evaluated using volumetric Dice similarity coefficient (DSC), mean surface distances (MSD), Hausdorff distances, and surface DSC. Three radiation oncologists evaluated the DL-generated contours and performed corrections when necessary. Interrater agreement was assessed and the time required for manual correction was recorded. Results: nnU-Net achieved a median DSC of 0.92 (IQR: 0.90-0.93) for the PB, 0.90 (IQR: 0.86-0.92) for the CCs, 0.79 (IQR: 0.77-0.83) for the IPAs, and 0.77 (IQR: 0.72-0.81) for the NVBs, which outperformed DeepMedic for each structure (p < 0.03). nnU-Net showed a median MSD of 0.24 mm for the IPAs and 0.71 mm for the NVBs. The median interrater DSC ranged from 0.93 to 1.00, with the majority of cases (68.9%) requiring manual correction times under two minutes. Conclusions: DL enables reliable auto-contouring of neurovascular structures on pre-treatment MRI data, easing the clinical workflow in neurovascular-sparing MR-guided radiotherapy.

Radiofrequency safety of high permittivity pads in MRI-Impact of insulation material.

PURPOSE: High permittivity dielectric pads are known to be effective for tailoring the RF field and improving image quality in high field MRI. Despite a number of studies reporting benign specific absorption rate (SAR) effects, their "universal" safety remains an open concern. In this work, we evaluate the impact of the insulation material in between the pad and the body, using both RF simulations as well as phantom experiments. METHODS: A 3T configuration with high permittivity material was simulated and characterized experimentally in terms of B1 + fields and RF power absorption, both with and without electrical insulation in between the high permittivity material and the sample. Different insulation conditions were compared, and electromagnetic analyses on the induced current density were performed to elucidate the effect. RESULTS: Increases in RF heating of up to 49% were observed experimentally in a tissue-mimicking phantom after removing the material insulation. The B1 + magnitude and RF transceive phase were not affected. Simulations indicated that an insulation thickness of 0.5-2 mm should be accounted for in numerical models in order to ensure reliable results. CONCLUSION: A reliable RF safety assessment of high permittivity dielectric pads requires accounting for the insulating properties of the plastic encasing. Ignoring the electrical insulation can lead to erroneous results with substantial increases in local SAR at the interface. Conversely, the material insulation does not need to be modeled to predict the B1 + effects during the design of the pad geometry.

Personalized local SAR prediction for parallel transmit neuroimaging at 7T from a single T1-weighted dataset.

PURPOSE: Parallel RF transmission (PTx) is one of the key technologies enabling high quality imaging at ultra-high fields (≥7T). Compliance with regulatory limits on the local specific absorption rate (SAR) typically involves over-conservative safety margins to account for intersubject variability, which negatively affect the utilization of ultra-high field MR. In this work, we present a method to generate a subject-specific body model from a single T1-weighted dataset for personalized local SAR prediction in PTx neuroimaging at 7T. METHODS: Multi-contrast data were acquired at 7T (N = 10) to establish ground truth segmentations in eight tissue types. A 2.5D convolutional neural network was trained using the T1-weighted data as input in a leave-one-out cross-validation study. The segmentation accuracy was evaluated through local SAR simulations in a quadrature birdcage as well as a PTx coil model. RESULTS: The network-generated segmentations reached Dice coefficients of 86.7% ± 6.7% (mean ± SD) and showed to successfully address the severe intensity bias and contrast variations typical to 7T. Errors in peak local SAR obtained were below 3.0% in the quadrature birdcage. Results obtained in the PTx configuration indicated that a safety margin of 6.3% ensures conservative local SAR estimates in 95% of the random RF shims, compared to an average overestimation of 34% in the generic "one-size-fits-all" approach. CONCLUSION: A subject-specific body model can be automatically generated from a single T1-weighted dataset by means of deep learning, providing the necessary inputs for accurate and personalized local SAR predictions in PTx neuroimaging at 7T.

Design and evaluation of a modular multimodality imaging phantom to simulate heterogeneous uptake and enhancement patterns for radiomic quantification in hybrid imaging: A feasibility study.

BACKGROUND: Accuracy and precision assessment in radiomic features is important for the determination of their potential to characterize cancer lesions. In this regard, simulation of different imaging conditions using specialized phantoms is increasingly being investigated. In this study, the design and evaluation of a modular multimodality imaging phantom to simulate heterogeneous uptake and enhancement patterns for radiomics quantification in hybrid imaging is presented. METHODS: A modular multimodality imaging phantom was constructed that could simulate different patterns of heterogeneous uptake and enhancement patterns in positron emission tomography (PET), single-photon emission computed tomography (SPECT), computed tomography (CT), and magnetic resonance (MR) imaging. The phantom was designed to be used as an insert in the standard NEMA-NU2 IEC body phantom casing. The entire phantom insert is composed of three segments, each containing three separately fillable compartments. The fillable compartments between segments had different sizes in order to simulate heterogeneous patterns at different spatial scales. The compartments were separately filled with different ratios of 99m Tc-pertechnetate, 18 F-fluorodeoxyglucose ([18 F]FDG), iodine- and gadolinium-based contrast agents for SPECT, PET, CT, and T1 -weighted MR imaging respectively. Image acquisition was performed using standard oncological protocols on all modalities and repeated five times for repeatability assessment. A total of 93 radiomic features were calculated. Variability was assessed by determining the coefficient of quartile variation (CQV) of the features. Comparison of feature repeatability at different modalities and spatial scales was performed using Kruskal-Wallis-, Mann-Whitney U-, one-way ANOVA- and independent t-tests. RESULTS: Heterogeneous uptake and enhancement could be simulated on all four imaging modalities. Radiomic features in SPECT were significantly less stable than in all other modalities. Features in PET were significantly less stable than in MR and CT. A total of 20 features, particularly in the gray-level co-occurrence matrix (GLCM) and gray-level run-length matrix (GLRLM) class, were found to be relatively stable in all four modalities for all three spatial scales of heterogeneous patterns (with CQV < 10%). CONCLUSION: The phantom was suitable for simulating heterogeneous uptake and enhancement patterns in [18 F]FDG-PET, 99m Tc-SPECT, CT, and T1 -weighted MR images. The results of this work indicate that the phantom might be useful for the further development and optimization of imaging protocols for radiomic quantification in hybrid imaging modalities.

Optimal sequences and sequence parameters for GBCA-enhanced MRI of the glymphatic system: a systematic literature review.

BACKGROUND: The glymphatic system (GS) is a recently discovered waste clearance system in the brain. PURPOSE: To evaluate the most promising magnetic resonance imaging (MRI) sequence(s) and the most optimal sequence parameters for glymphatic MRI (gMRI) 4-24 h after administration of gadolinium-based contrast agent (GBCA). MATERIAL AND METHODS: Multiple literature databases were systematically searched for articles regarding gMRI or MRI of the perilymph in the inner ear until 11 May 2020. All relevant MRI sequence parameters were tabulated for qualitative analysis. Their potential was assessed based on detection of low dose GBCA, primarily measured as signal intensity (SI) ratio. RESULTS: Thirty articles were included in the analysis. Three-dimensional fluid attenuated inversion recovery (3D-FLAIR), 3D Real Inversion Recovery (3D-Real IR), and multiple 3D T1-weighted gradient echo sequences were used. In perilymph, 3D-FLAIR with a TE of at least 400 ms yielded the highest SIRs. In the qualitative analysis of inner ear studies using 3D-FLAIR, TR was in the range of 4400-10,000 ms, TI 1500-2600 ms, refocusing flip angle (rFA) (range 120°-180°), and echo train length (ETL) 23-173. In the gMRI studies, quantitative analysis was not possible. In the qualitative analysis, 3D-FLAIR was used in the majority (8/12) of the studies, usually with TR 4800-9000 ms, TI 1650-2500 ms, TE 311-561 ms, rFA 90°-120°, and ETL 167-278. CONCLUSION: Long TE 3D-FLAIR is the most promising sequence for detection of low-dose GBCA in the GS. Clinical and/or phantom studies on other MRI parameters are needed for further optimization of gMRI.

Accelerating implant RF safety assessment using a low-rank inverse update method.

PURPOSE: Patients who have medical metallic implants, e.g. orthopaedic implants and pacemakers, often cannot undergo an MRI exam. One of the largest risks is tissue heating due to the radio frequency (RF) fields. The RF safety assessment of implants is computationally demanding. This is due to the large dimensions of the transmit coil compared to the very detailed geometry of an implant. METHODS: In this work, we explore a faster computational method for the RF safety assessment of implants that exploits the small geometry. The method requires the RF field without an implant as a basis and calculates the perturbation that the implant induces. The inputs for this method are the incident fields and a library matrix that contains the RF field response of every edge an implant can occupy. Through a low-rank inverse update, using the Sherman-Woodbury-Morrison matrix identity, the EM response of arbitrary implants can be computed within seconds. We compare the solution from full-wave simulations with the results from the presented method, for two implant geometries. RESULTS: From the comparison, we found that the resulting electric and magnetic fields are numerically equivalent (maximum error of 1.35%). However, the computation was between 171 to 2478 times faster than the corresponding GPU accelerated full-wave simulation. CONCLUSIONS: The presented method enables for rapid and efficient evaluation of the RF fields near implants and might enable situation-specific scanning conditions.

3-D Contrast Source Inversion-Electrical Properties Tomography.

Contrast source inversion-electrical properties tomography (CSI-EPT) is an iterative reconstruction method to retrieve the electrical properties (EPs) of tissues from magnetic resonance data. The method is based on integral representations of the electromagnetic field and has been shown to allow EP reconstructions of small structures as well as tissue boundaries with compelling accuracy. However, to date, the CSI-EPT has been implemented for 2-D configurations only, which limits its applicability. In this paper, a full 3-D extension of the CSI-EPT method is presented, to enable CSI-EPT to be applied to realistic 3-D scenarios. Here, we demonstrate a proof-of-principle of 3-D CSI-EPT and present the reconstructions of a 3-D abdominal body section and a 3-D head model using different settings of the transmit coil. Numerical results show that the full 3-D approach yields accurate reconstructions of the EPs, even at tissue boundaries and is most accurate in regions where the absolute value of the electric field is highest.

A simple head-sized phantom for realistic static and radiofrequency characterization at high fields.

PURPOSE: To demonstrate a simple head-sized phantom for realistic static and RF field characterization in high field systems. METHODS: The head-sized phantom was composed of an ellipsoidal compartment and a spherical cavity to mimic the nasal cavity. The phantom was filled with an aqueous solution of polyvinylpyrrolidone (PVP), to mimic the average dielectric properties of brain tissue. The static and RF field distributions were characterized on a 7T MRI system and compared to in vivo measurements and simulations. MR thermometry was performed, and the results were compared to thermal simulations for RF validation purposes. RESULTS: Accurate reproduction of both static and RF fields patterns observed in vivo was confirmed experimentally and was shown to be strongly affected by the inclusion of the spherical cavity. MR thermometry and transmit efficiency ( B1+) measurements were obtained in close agreement with simulations (peak values agreeing within 0.3 °C and 0.02 µT/√W) as well as fiber optic thermal probes (RMSE < 0.18 °C). CONCLUSIONS: A simple head-sized phantom has been presented that produces B0 and B1+ nonuniformities similar to those encountered in the human head and allows for accurate MR thermometry measurements, making this a suitable reference phantom for RF validation and methodological development in high field MRI.

Passive radiofrequency shimming in the thighs at 3 Tesla using high permittivity materials and body coil receive uniformity correction.

PURPOSE: To explore the effects of high permittivity dielectric pads on the transmit and receive characteristics of a 3 Tesla body coil centered at the thighs, and their implications on image uniformity in receive array applications. THEORY AND METHODS: Transmit and receive profiles of the body coil with and without dielectric pads were simulated and measured in healthy volunteers. Parallel imaging was performed using sensitivity encoding (SENSE) with and without pads. An intensity correction filter was constructed from the measured receive profile of the body coil. RESULTS: Measured and simulated data show that the dielectric pads improve the transmit homogeneity of the body coil in the thighs, but decrease its receive homogeneity, which propagates into reconstruction algorithms in which the body coil is used as a reference. However, by correcting for the body coil reception profile this effect can be mitigated. CONCLUSION: Combining high permittivity dielectric pads with an appropriate body coil receive sensitivity filter improves the image uniformity substantially compared with the situation without pads. Magn Reson Med 76:1951-1956, 2016. © 2015 International Society for Magnetic Resonance in Medicine.

Diffusion-prepared neurography of the brachial plexus with a large field-of-view at 3T.

PURPOSE: To study diffusion-prepared neurography optimized for a large field-of-view (FOV) to include the neck and both shoulders. In a large FOV poor homogeneity of the magnetic field (B0 ) often leads to poor image quality and possibly to poor diagnostic accuracy. The aim was therefore to find an optimal (combination of) shimming method(s) for diffusion-prepared neurography in a large FOV. MATERIALS AND METHODS: A 3D diffusion-prepared sequence with a large FOV was tested with and without the use of a susceptibility-matched pillow combined with image-based (IB) or standard shimming in six healthy volunteers on a 3T system. B0 , B1 , signal to noise ratio (SNR), and contrast to noise ratio (CNR) were compared between all protocols. Additionally, nerve visibility, fat suppression, artifacts, and overall image quality were ordinally (5-point scale) assessed by two readers. Furthermore, correlations between B0 and B1 (offset and variation) and SNR, CNR, and image quality were explored. RESULTS: The use of the susceptibility-matched pillow led to a 43% reduction of B0 variation over the brachial plexus compared to the situation without a pillow (P < 0.05). The combination of the pillow with IB-shimming and the optimized diffusion-prepared sequence resulted in good nerve visibility, good fat suppression, no artifacts that would hinder clinical diagnosis, and a good overall quality (median scores ≥4). Reducing B0 variation was associated with SNR, CNR, and the above-mentioned scored features (P < 0.05). CONCLUSION: The use of a susceptibility-matched pillow in combination with IB-shimming enables robust and high-quality neurography of the complete brachial plexus.

A theoretical approach based on electromagnetic scattering for analysing dielectric shimming in high-field MRI.

PURPOSE: In this study, we analyzed dielectric shimming by formulating it as an electromagnetic scattering problem using integral equations. METHODS: Three-dimensional simulations of the radiofrequency field in two configurations using different materials were analyzed in terms of induced currents and secondary fields. A two-dimensional integral equation method with different backgrounds was used to identify the underlying physical mechanisms. This framework was then used to develop an inversion method for the design of dielectric pads. RESULTS: The effects of a dielectric pad can be attributed to the interference of a secondary field that is produced by the currents induced in the dielectric pad, radiating in an inhomogeneous background. The integral equation method with inhomogeneous background reduces the complexity of the forward and inverse problem significantly and can be used to optimize the permittivity distribution for a desired B1+ field. Agreement with experimental B1+ maps was obtained in a cylindrical phantom, demonstrating the validity of the method. CONCLUSIONS: The integral equation method with inhomogeneous background yields an efficient numerical framework for the analysis and inverse design of dielectric shimming materials.

The effect of high-permittivity pads on specific absorption rate in radiofrequency-shimmed dual-transmit cardiovascular magnetic resonance at 3T.

BACKGROUND: Dual-channel transmit technology improves the image quality in cardiovascular magnetic resonance (CMR) at 3 T by reducing the degree of radiofrequency (RF) shading over the heart by using RF shimming. Further improvements in image quality have been shown on a dual-transmit system using high permittivity pads. The aim of this study is to investigate the transmit field (B 1 (+)) homogeneity and the specific absorption rate (SAR) using high permittivity pads as a function of the complete range of possible RF-shim settings in order to gauge the efficacy and safety of this approach. METHODS: Electromagnetic (EM) simulations were performed in five different body models using a dual-transmit RF coil, with and without high permittivity pads. The RF shimming behaviour in terms of B 1 (+) homogeneity and local SAR were determined as a function of different RF-shim settings. Comparative experimental data were obtained in healthy volunteers (n = 33) on either a standard-bore (60 cm diameter) or wide-bore (70 cm diameter) 3 T CMR system. RESULTS: EM simulations and experimental data showed higher (B 1 (+)) homogeneity and lower SAR for optimized RF-shim settings when using the high permittivity pads. The power distribution between the two channels was also much closer to being equal using the pads. EM simulations showed that for all five body models studied, optimized RF-shim settings corresponded to reduced local SAR using high permittivity pads. However, there are also specific, non-optimal RF-shim settings for which the actual SAR using the pads would be higher (up to ~20 %) than that calculated by the CMR system. CONCLUSIONS: The combination of active (dual transmit) and passive (high permittivity pads) RF shimming shows great promise for increasing image quality for cardiac imaging at 3 T. Optimized RF-shim settings result in increased B 1 (+) homogeneity and reduced SAR with the high permittivity pads: however, there are non-optimal cases in which SAR might be underestimated, and these merit further investigation.

Clinical applications of dual-channel transmit MRI: A review.

This article reviews the principle of dual-channel transmit MRI and highlights current clinical applications which are performed primarily at 3 Tesla. The main benefits of dual-channel transmit compared with single-transmit systems are the increased image contrast homogeneity and the decreased scanning time due to the more accurate local specific absorption ratio estimation, meaning that less conservative safety limits are needed. The dual-transmit approach has been particularly beneficial in body imaging applications, and is also promising in terms of cardiac, spine, and fetal imaging. Future advances in transmit SENSE, the combination of dual-channel transmit with high permittivity pads, as well as the potential increase in the number of transmit channels are also discussed.

Ventricular B1 (+) perturbation at 7 T - real effect or measurement artifact?

The objective of this work was to explore the origin of local B1 (+) perturbations in the ventricles measured at 7 T. The B1 (+) field in the human brain was mapped using four different MRI techniques: dual refocusing echo acquisition mode (DREAM), actual flip-angle imaging (AFI), saturated double-angle method (SDAM) and Bloch-Siegert shift (BSS). Electromagnetic field simulations of B1 (+) were performed in male and female subject models to assess the dependence of the B1 (+) distribution on the dielectric properties of cerebrospinal fluid and subject anatomy. All four B1 (+) mapping techniques, based on different B1 (+) encoding mechanisms, show 'residual' structure of the ventricles, with a slightly enhanced B1 (+) field in the ventricles. Electromagnetic field simulations indicate that this effect is real and arises from the strong contrast in electrical conductivity between cerebrospinal fluid and brain tissue. The simulated results were in good agreement with those obtained in three volunteers. Measured local B1 (+) perturbations in the ventricles at 7 T can be partially explained by the high contrast in electrical conductivity between cerebrospinal fluid and white matter, in addition to effects related to the particular B1 (+) measurement technique used.

High permittivity dielectric pads improve high spatial resolution magnetic resonance imaging of the inner ear at 7 T.

OBJECTIVES: The objective of this study was to evaluate the use of dielectric pads for improving high spatial resolution imaging of the inner ear at 7 T. MATERIALS AND METHODS: Two sets of dielectric pads were designed using electromagnetic simulations and implemented using a deuterated suspension of barium titanate. Their effect on transmit efficiency, contrast homogeneity, and diagnostic image quality was evaluated in vivo (N = 10). In addition, their effect on the specific absorption rate was evaluated numerically. RESULTS: Statistically significant improvements (P < 0.001) in several measures of the image quality were obtained by using dielectric pads. The dielectric pads lead to an increase in the transmit efficiency and uniformity at the location of the inner ear, which is reflected in both an increased contrast homogeneity and an increased diagnostic value. Simulations show that the dielectric pads do not increase the peak local specific absorption rate. CONCLUSIONS: Using geometrically tailored dielectric pads enables high spatial resolution magnetic resonance imaging of the human inner ear at 7 T. The high spatial resolution improves the depiction of the fine inner ear structures, showing the benefit of magnetic resonance imaging at ultrahigh fields.