Processing strategies for improving cortical thickness correspondence between low-field and high-field MRI in young people

Portable low-field MRI systems are a promising complement to conventional high-field systems, enabling broader access to MRI. However, correspondence in cortical thickness estimates between low- and high-field MRI in young people remains limited despite its importance for neurodevelopment and psychopathology. To evaluate how multiple low-field image processing approaches improve cortical thickness correspondence with high-field MRI in a large sample of young individuals, we collected ultra-low-field (64mT) and high-field (3T) MRI data from a community sample of young people. We applied deep learning–based image processing approaches (SynthSR v1.0, SynthSR v2.0, recon-all-clinical, and recon-any) to low-field data acquired across multiple sequences (T1- and T2-weighted) and orientations (axial, coronal, sagittal, and multi-orientation), with and without resampling and/or co-registration. We assessed global, lobar, and regional cortical thickness correspondence with 3T MRI measures using Pearson and intraclass correlations. We compared pipelines using Steiger’s Z-tests and Fisher’s Z-tests. A total of 150 individuals (mean age, 18.63±5.07; 80 female) were included. We observed the highest global correspondence with recon-all-clinical applied to coronal T1-weighted images ( r =0.40, p _FDR =2.6e-05). At the lobar and regional levels, multi-orientation T2-weighted images processed with recon-all-clinical showed the highest correspondence across the greatest number of regions (4/12 lobes; 13/68 regions). The highest correspondence and largest improvements were in frontal, cingulate, and temporal regions, including the right pars triangularis ( r =0.52, p _FDR =4.78e-11; Z =4.78, p _FDR =4.25e-06), right caudal anterior cingulate ( r =0.47, p _FDR =3.83e-09; Z =5.46, p _FDR =1.32e-07), and left parahippocampal ( r =0.58, p _FDR =2.98e-14; Z =5.17, p _FDR =6.01e-07). We observed significantly improved cortical thickness correspondence in low-field MRI in young people. The recon-all-clinical pipeline yielded moderate correspondence, particularly in frontal, cingulate, and temporal regions. Our results highlight the potential of low-field MRI as an affordable and scalable approach for assessing cortical thickness in young people.