Implementation and Clinical Utility of Ultra-Low-Field Portable Magnetic Resonance Imaging for Postprocedural Neurological Evaluation in Ambulatory Neurosurgery: Illustrative Cases

Authors

• Devan Patel, University at Buffalo
• Vinay Jaikumar, University at Buffalo
• Taysia P. T. Morioka, Gates Vascular Institute at Kaleida Health
• Laz Rifkin, Middlebury College
• Kenneth S. Jacoby, University at Buffalo
• Jaims Lim, University at Buffalo
• Anais Andrade, University at Buffalo
• Aimee C. DeGaetano, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Pui Man Rosalind Lai, University at Buffalo
• Elad I. Levy, University at Buffalo

ORCID

0009-0002-7772-9505 (DeGaetano)

Document Type

Article

Publication Date

2026

DOI

10.3171/CASE26245

Publication Title

Journal of Neurosurgery: Case Lessons

Volume

12

Issue

3

Pages

CASE26245

Abstract

BACKGROUND

Elective endovascular neurosurgical procedures are increasingly performed in ambulatory neurosurgery centers, enabled by advances in catheter technology, safety of conscious sedation, and refined patient selection. Although complication rates are low, rapid evaluation of postprocedural neurological deficits remains critical. Conventional MRI is often impractical in outpatient or procedural settings, whereas ultra-low-field portable MRI (ULF-pMRI) systems (such as Swoop) allow bedside imaging with favorable diagnostic performance.

OBSERVATIONS

Two women in their 60s developed acute neurological deficits at an ambulatory neurosurgery center (ANSC) after diagnostic cerebral angiography in one case and elective internal carotid artery flow diversion in the other. In both cases, repeat angiography showed patent vessels. Bedside ULF-pMRI with diffusion-weighted and fluid-attenuated inversion recovery sequences demonstrated no acute infarction or hemorrhage. Symptoms fully resolved with supportive management. The availability of rapid portable MRI helped both patients avoid hospital admission, allowing same-day discharge without recurrent neurological symptoms.

LESSONS

In these 2 cases, ULF-pMRI demonstrated timely, informative neuroimaging in an ANSC setting. When paired with clinical improvement, bedside MRI safely guided disposition decisions, helped avoid unnecessary transfers, and supported patient safety as outpatient neurointervention expands.

https://thejns.org/doi/10.3171/CASE26245.

Rights

© 2026 The authors.

Published under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.

Original Publication Citation

Patel, D., Jaikumar, V., Morioka, T. P. T., Rifkin, L., Jacoby, K. S., Lim, J., Andrade, A., DeGaetano, A. C., Lai, P. M. R., & Levy, E. I. (2026). Implementation and clinical utility of ultra-low-field portable magnetic resonance imaging for postprocedural neurological evaluation in ambulatory neurosurgery: Illustrative cases. Journal of Neurosurgery: Case Lessons, 12(3), Article CASE26245. https://doi.org/10.3171/case26245 

Repository Citation

Patel, D., Jaikumar, V., Morioka, T. P. T., Rifkin, L., Jacoby, K. S., Lim, J., Andrade, A., DeGaetano, A. C., Lai, P. M. R., & Levy, E. I. (2026). Implementation and clinical utility of ultra-low-field portable magnetic resonance imaging for postprocedural neurological evaluation in ambulatory neurosurgery: Illustrative cases. Journal of Neurosurgery: Case Lessons, 12(3), Article CASE26245. https://doi.org/10.3171/case26245