# Case-based review of low-field MRI in resource-constrained settings: a clinical perspective from Malawi

## TL;DR

This paper explores how low-field MRI can be used in Malawi to improve diagnostic access in resource-limited healthcare settings.

## Contribution

The paper proposes a framework for integrating low-field MRI into clinical practice in LMICs through real-world case reviews and hypothetical models.

## Key findings

- Three clinical scenarios demonstrate potential uses of low-field MRI in different healthcare settings in Malawi.
- The 0.064 T Hyperfine Swoop MRI was reviewed in 31 cases over 32 months, offering practical insights.
- The study emphasizes the need for innovation, local production, and training to support low-field MRI in LMICs.

## Abstract

Low-field MRI (LF-MRI) is in the spotlight as multidisciplinary experts consider it to be one solution to expanding MRI access worldwide. The clinical scenarios and case-mix in which LF-MRI could play an especially important role in the patient diagnostic algorithm are different in High and Low- and Middle-Income Countries (LMIC). The aim of this article is to suggest a robust structure within which to envision clinical use and advancement of LF-MRI technology in LMICs. This article presents three discrete clinical scenarios—a tertiary care facility with an LF-MRI only, a tertiary care facility with an LF-MRI and an HF-MRI and a peripheral healthcare facility with an LF-MRI only—derived from a combination of the authors’ observed practice and hypothetical models in an LMIC and 31 consecutive case reviews within a 32-month timeframe of our experience with the 0.064 T Hyperfine Swoop in Malawi. The authors recognize the important of a holistic approach to the ongoing multifaceted efforts at LMIC-appropriate advancement of LF-MRI technology. This ranges from continued innovation relating to deep learning methods for improved diagnostic accuracy and workflow efficiency, empowerment towards building LF-MRIs in-situ in the LMIC and multidisciplinary capacity building initiatives in LMICs.