ECR 2026’s second-day session on going towards high and low fields treated field strength as a practical variable rather than a safety shortcut. The speakers linked safety performance to repeatable processes, clear roles and disciplined risk assessment across referral, screening, scanning and post-scan workflow. High and ultrahigh-field systems raised specific operational constraints, while low-field and portable MRI were presented as an access and bedside opportunity with defined technical trade-offs. The discussions on cardiac devices and physical agents tied both ends together: safe access depends on precise conditions, multidisciplinary teamwork and consistent risk assessment.
High And Ultrahigh Field: Rules That Do Not Change
Pia C Maly Sundgren opened with a message of continuity across field strengths, stating that “whatever MR Safety rules we are applying to the 1.5 or 3 also applies to really high MR, such as the 7 Tesla.” She positioned ultrahigh field as a reason to tighten discipline, not to reinvent the rulebook. Her focus stayed on preventable failure modes, especially the entry of unsuitable items into controlled areas, and on the need for continuous training that reaches beyond radiology to any staff group that might accompany patients.
Related Read: Low-Field and Portable MRI: From Niche to Clinical Option
Prof. Maly Sundgren described safety as a chain of controls distributed across the pathway. She referred to a multi-step screening process that begins at referral and booking, continues through questionnaires and repeated checks, and includes enforced clothing changes to reduce hidden risk from pockets and personal items. She presented ferromagnetic detection as an added barrier that supports, but does not replace, screening and documentation. She also highlighted an ultrahigh-field challenge that sits outside day-to-day workflow: device evidence at 7T. Prof. Maly Sundgren noted that “many devices are not tested” and linked safe adoption to local testing, structured documentation and shared learning between 7T sites. Operationally, she connected 7T practice to readiness for adverse events and to staffing requirements, including the rule that “you are never allowed to be alone in the MR Facility.”
Low Field MRI: Access, Bedside Use and Technical Trade-Offs
Beatrice Lena framed low-field MRI as a practical response to access limits and the risks of moving unstable patients, with a particular emphasis on emergency and resource-limited settings. She placed the technology in a broader equity narrative, describing MRI as “an incredible technology… it’s also rich people technology.” She linked the access gap to global infrastructure and to research representation, stating that “only 1% of the published MR papers come from low- and middle-income countries,” and presented low-field systems as one route towards wider availability.
Dr. Lena defined the low-field range used in her talk as below 0.1T and described how permanent magnets and portable designs change the safety footprint of the scanner environment. She contrasted conventional suite constraints with low-field systems where the 5 Gauss line can sit close to the magnet, reducing some projectile risk and easing certain environmental restrictions. She tied portability directly to patient safety and operations in acute care, highlighting transport delays and coordination burdens in intensive care and emergency pathways, then describing a different model where the scanner comes to the patient. Her claim was that this shift can reduce exposure to transport-related hazards for unstable patients while accelerating decision-making.
She balanced that promise with technical realism. Lower field means lower SNR and different contrast behaviour, which places greater weight on protocol design and on the purpose of the scan. Her caution was that teams should not transplant high-field sequences unchanged, warning, “What we shouldn’t do is just to take sequences that have been developed for high-field strength and just bring us as they are to low-field.” She described protocol adaptation as the route to maintaining diagnostic confidence within lower-field constraints, while also recognising emerging approaches that aim to improve perceived image quality.
Implant Safety and Physical Agents: Risk, Conditions and Teamwork
Giles Hannibal Roditi addressed cardiac implanted electronic devices by arguing for equitable access and for service models that make safe scanning routine rather than exceptional. He described himself as “a strong advocate for ensuring that patients with cardiac implanted electronic devices have the same access to MRI scanning as everyone else.” His approach framed MRI planning as structured risk management built on device type, scan conditions, monitoring and escalation readiness. Benefit was positioned as inseparable from risk, with decisions guided by agreed conditions rather than blanket exclusion. He also highlighted the operational friction that still blocks access, including workflow burden and leadership choices, and he challenged the persistence of default denial in a setting where pathways exist.
Luisa Altabella extended the conversation beyond implants to the broader category of physical agents in the MRI environment: static magnetic fields, gradient fields and radiofrequency energy. She stressed that field strength changes the exposure profile, but not the responsibility to manage it. A central warning was complacency at the low-field end, which she described as a “risk of fostering a false sense of security.” Her emphasis was on conditions and transferability. She stated that safety levels “are not transferable,” underscoring that device conditionality, risk controls and operational practices must match the stated conditions for a specific field strength and environment. She reinforced a governance mindset that treats safety as multidisciplinary, with training, monitoring and regulatory awareness protecting both patients and staff.
Across high, ultrahigh and low-field MRI, the session kept returning to the same operational logic: safety is engineered through process, evidence and accountability rather than field strength alone. High and ultrahigh-field practice was presented as an intensification of established rules, with additional constraints around device testing, staffing and documentation. Low-field and portable MRI were framed as an access and bedside opportunity, provided protocols are adapted to the physics and limitations rather than transplanted from high field. For cardiac devices and exposure management, the message was that conditionality and risk must be handled with precision and that safe access depends on multidisciplinary teamwork, clear leadership and consistent adherence to defined conditions.
Source & Image Credit: ECR 2026
