Evaluating analytic strategies to obtain high-resolution, vertex-level measures of cortical neuroanatomy in children in low- and middle-income countries

High-field magnetic resonance imaging to explore brain structure and function remains limited to high-resource settings. Novel, low-field (<0.1 T) imaging offers a more cost-effective/accessible alternative. However, the validity of low-field data at spatial resolutions relevant to research and clinic (vertex-level) remains unclear. Hence, we examine paired high-field (reference) and low-field (single/multi-orientation scans processed through established/novel pipelines) data (12 children [10-12 yrs] in a low- and middle-income country [LMIC]). We assess high-field/low-field correspondence between vertex-level measures of cortical volume, surface area, and cortical thickness; and compare analytic strategies. High/low-field images show weak-to-moderate global correspondence (cortical volume, surface area: Pearson’s r ≤ 0.6, cortical thickness r ≤ 0.3), and weak-to-very strong local correspondence (r ≤ 0.99). Greatest correspondence is achieved with multi-orientation images and a pipeline adjusted for low-resolution images (recon-all-clinical); or image enhancement (SynthSR) plus standard processing (FastSurfer); but agreement varies across brain based on input, analytic strategy, and neuroanatomical feature. We provide an application to interactively explore our results. Thus, low-field imaging can provide reliable, high-resolution estimates of cortical volume and surface area, but not cortical thickness; and analytic approaches should be selected based on multiple considerations. Once validated, this research may help deploy low-field imaging to aid research/evidence-based clinical work in high- and low-resource settings, including LMIC.

Pretzsch, C. M., Váša, F., Brammer, M., Brink, L., Potter, M., Mackay, W., Smit, P., Du Plessis, C., Wagner, M., Jonker, D., Donald, K. A., Scheffler, F., Pham, C., Hollestein, V., Loth, E., Murphy, D. G., Odendaal, H. J., Sowell, E. R., Springer, P. E., … Ecker, C. (2025). Evaluating analytic strategies to obtain high-resolution, vertex-level measures of cortical neuroanatomy in children in low- and middle-income countries. Communications Biology, 8(1). https://doi.org/10.1038/s42003-025-08322-2

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