Ultra-low-field MRI yields volumetric measurements comparable to conventional methods in ECMO patientsUltra-low-field MRI scans work safely for brain volume measurements in patients on ECMO support

medRxiv Published April 15, 2026 Study authors: Stockbridge, M. D.; Faria, A. V.; Neal, V.; Diaz-Carr, I.; Soule, Z.; Ahmad, Y. B.; Khanduja, S.; Wh… DOI ↗ Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain

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Key Takeaway

Consider ultra-low-field MRI for neuroimaging in ECMO patients as it yields volumetric measurements comparable to conventional methods.

This retrospective analysis of prospectively collected observational data examined thirty patients receiving extracorporeal membrane oxygenation (ECMO) at Johns Hopkins Hospital. The primary objective was to determine the feasibility of deriving volumetric analyses from ultra-low-field 64mT MR images in the presence of ECMO circuitry. The comparator group consisted of measurements obtained using conventional field and ultra-low-field MRI in the absence of ECMO instrumentation.

The study found that segmented brain volumes in patients undergoing ECMO were comparable to measurements obtained using conventional field and ultra-low-field MRI in the absence of ECMO instrumentation. Subgroup analysis revealed subtle volumetric differences between patients supported with venoarterial ECMO and those receiving venovenous ECMO, though specific statistical values were not reported in the source data.

Safety data indicated that the SAFE MRI ECMO study established the safety of ultra-low-field 64mT MRI in patients receiving ECMO. No specific adverse events or discontinuations were detailed in the provided text. The study limitations include the small sample size of thirty patients and the observational nature of the data, which precludes causal conclusions.

Practice relevance suggests that ultra-low-field MRI provides volumetric measurements comparable to conventional field-strength MRI, even in the presence of ECMO circuitry. This supports its feasibility for neuroimaging in critically ill patients, offering a potential alternative when conventional MRI is not feasible.

This research looked at whether ultra-low-field MRI could be used to measure brain volumes in critically ill patients using ECMO. The team analyzed data from thirty patients at Johns Hopkins Hospital who were on life support. They compared images taken with ultra-low-field scanners to those taken with conventional scanners when no ECMO equipment was present.

The main finding was that the brain volume measurements from the ultra-low-field scans were comparable to the standard ones. While there were subtle differences between patients on venoarterial ECMO and those on venovenous ECMO, the overall ability to get clear measurements remained strong. The study confirmed that using these scanners is safe for patients on ECMO.

Readers should understand that this is a small, retrospective analysis of observational data. Because the study involved only thirty patients, these results may not apply to all patients or all hospital settings. However, the findings support the potential use of this technology for neuroimaging in critical care.

What this means for you:

Ultra-low-field MRI offers comparable brain volume measurements to conventional MRI in patients on ECMO support.

Study Details

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

The SAFE MRI ECMO (NCT05469139) study established the safety of ultra-low-field 64mT MRI in patients receiving extracorporeal membrane oxygenation (ECMO) in the setting of intensive care and demonstrated that these images were highly sensitive in detecting acquired brain injuries. This retrospective analysis of prospectively collected observational data sought to expand on these findings in light of the crucial need for neurological monitoring while patients receive ECMO by evaluating the feasibility of volumetric analyses derived from ultra-low-field MR images. T2-weighted scans from thirty patients who received ultra-low-field MRI while undergoing ECMO at Johns Hopkins Hospital were analyzed using a volumetric pipeline to determine whole brain volume and volumes of total grey matter, total white matter, subcortical grey matter, ventricles, left hemisphere, right hemisphere, telencephalon, left and right lateral ventricles, the total intracranial volume, and the cerebellum. Segmented brain volumes in patients undergoing ECMO were comparable to measurements obtained using conventional field and ultra-low-field MRI in the absence of ECMO instrumentation. The subgroup analysis demonstrated subtle volumetric differences between patients supported with venoarterial ECMO and those receiving venovenous ECMO. These data provide the first evidence that ultra-low-field MRI provides volumetric measurements comparable to conventional field-strength MRI, even in the presence of ECMO circuitry, supporting its feasibility for neuroimaging in critically ill patients.

Ultra-low-field MRI yields volumetric measurements comparable to conventional methods in ECMO patientsUltra-low-field MRI scans work safely for brain volume measurements in patients on ECMO support

Study Details

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Ultra-low-field MRI yields volumetric measurements comparable to conventional methods in ECMO patientsUltra-low-field MRI scans work safely for brain volume measurements in patients on ECMO support

Study Details

Intravenous tenecteplase improves functional outcomes but increases hemorrhage risk in non-large vessel occlusion acute ischemic stroke

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Clinical research that matters. Delivered to your inbox.

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