Clinical applications of 5 T whole‑body MRI

The introduction of 5 Tesla (T) whole-body magnetic resonance imaging (MRI) systems offers a pragmatic balance between the superior SNR of 7 T and the broader clinical availability of 3 T. This review summarizes current evidence on 5 T MRI across the central nervous system, abdomen and pelvis, cardiovascular system, musculoskeletal system, and peripheral vasculature. The increased signal-to-noise ratio (SNR) at 5 T translates into tangible clinical benefits: improved visualization of distal small vessels, potential feasibility of reduced contrast agent dose in liver imaging, reduced contrast agent dose in liver imaging, superior diagnostic performance for cartilage defects and coronary artery stenosis, and non-invasive metabolic imaging via chemical exchange saturation transfer and deuterium magnetic resonance spectroscopy (MRS). Quantitative techniques including T1/T2 mapping, T1ρ, and diffusion-weighted imaging have been successfully implemented at 5 T, with preliminary normative reference values established in single-center cohorts. However, challenges remain, including B1 inhomogeneity, specific absorption rate constraints, prolonged T1 relaxation times, and implant safety concerns requiring updated guidelines. AI-assisted acceleration and reconstruction techniques are transforming 5 T MRI into an intelligent platform that balances image quality, scan time, and diagnostic accuracy. With continued technical advancements and larger validation studies, 5 T MRI is positioned as a compelling middle ground for routine clinical use and specialized research applications.