Ultrafast deep learning super-resolution single-shot T2-weighted imaging for robust edema visualization in cardiovascular magnetic resonance.
Authors
Affiliations (5)
Affiliations (5)
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany; Quantitative Imaging Laboratory Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- Philips GmbH Market DACH, Röntgenstraße 22, 22335 Hamburg, Germany.
- Philips MR Clinical Science, Veenpluis 6, 5684 PC Best, Netherlands.
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany; Quantitative Imaging Laboratory Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. Electronic address: [email protected].
Abstract
To compare the diagnostic quality of deep learning (DL) super-resolution reconstructed breath-hold (BH) and free-breathing (FB) single-shot (SSH) black-blood T2-weighted short tau inversion recovery (STIR) imaging with standard BH T2-STIR in cardiovascular magnetic resonance (CMR). In this prospective study, short-axis BH and FB SSH T2-STIR were added to a standard cardiomyopathy CMR protocol at 1.5T, and DL super-resolution reconstruction were performed. Two readers evaluated diagnostic quality and certainty using a five-point Likert scale. Presence of focal edema was assessed on T2-weighted sequences including standard T2-STIR and T2 mapping (both used for reference clinical assessment) as well as SSH T2 STIR and DL-SSH T2-STIR. Friedman test and one-way ANOVA were performed. 81 participants (mean age: 54 ± 20 years; 50 men) were included. No difference was found in edema detection between reference assessment and DL-SSH T2-STIR (both 21/81 participants [26%]). Scan time was reduced by 63% for BH and 86% for FB DL-SSH T2-STIR compared to standard T2-STIR (90±6sec vs. 35±3sec vs. 243±16sec; p<.0001). BH and FB DL-SSH T2-STIR achieved lower artifact burden (5 [IQR, 4-5] vs. 4 [IQR, 4-5] vs. 4 [IQR, 3-5]; p<.0001), superior image contrast and sharpness compared to standard T2-STIR, especially in non-cooperative or arrhythmic participants. BH and FB DL-SSH T2-STIR imaging provided higher diagnostic certainty than standard T2-STIR (5 [IQR, 5-5] vs. 5 [IQR, 5-5] vs. 4 [IQR, 4-5]; p<.0001). Edema visibility was superior in BH DL-SSH compared to BH-SSH and standard T2-STIR (5 [IQR, 4.8-5] vs. 4 [IQR, 3.3-5] vs. 4 [IQR, 3-4.8]; p<.0001). Inter-rater agreement was substantial to excellent in the rating of edema visibility (BH DL-SSH T2-STIR, κ: 0.73 [95% CI: 0.44-1.0]; BH SSH T2-STIR, κ: 0.79 [95% CI: 0.66-0.97]; standard T2-STIR, κ: 0.86 [95% CI: 0.71-1.0]). Slice level-analysis showed that BH DL-SSH T2-STIR consistently provided superior image quality in apical slices compared to BH SSH and standard T2-STIR (4 [IQR, 4-5] vs. 4 [IQR, 4-4] vs. 4 [IQR, 3-4]; p<.0001). DL-SSH imaging enabled ultrafast T2-STIR acquisition and robust edema assessment in routine clinical CMR.