Clinical Implementation of Deep Learning MR reconstruction for TSE Sequences: Reduction of Acquisition Time and Maintenance

Author(s):  
Judith Herrmann ◽  
Sebastian Gassenmaier ◽  
Thomas Kuestner ◽  
Matthias Kuendel ◽  
Dominik Nickel ◽  
...  

Abstract Background: The application of Deep Learning (DL) in MR image reconstruction is increasingly gaining attention due to its potential of increasing image quality and reducing acquisition time. However, the technology hasn’t been yet implemented in clinical routine. The aim of this study was therefore to describe the implementation of this novel DL image reconstruction for turbo spin echo (TSE) sequences in clinical workflow including a thorough explanation of the required steps and an evaluation of the obtainable image quality compared to conventional TSE.Methods: DL image reconstruction using a variational network was clinically implemented to enable acquisition of accelerated TSE sequences. After internal review board’s approval and informed consent, 30 examinations for knee, shoulder, and lumbar spine in 15 volunteers at 3 T were included in this prospective study. Conventional TSE sequences (TSE) and TSE with deep learning reconstruction (TSEDL) were compared regarding overall image quality, noise, sharpness, and subjective signal-to-noise-ratio (SNR), as well diagnostic confidence and image impression. Comparative analyses were conducted to assess the differences between the sequences. A survey on technologists’ acceptance was performed for DL image reconstruction. Results: DL image reconstruction was successfully implemented in a clinical workflow and TSEDL allowed a remarkable time saving of more than 50%. Overall image quality, diagnostic confidence and image impression for TSEDL were rated as excellent (median 4, IQR 4-4) and comparable to TSE (image quality: p=0.059, diagnostic confidence: p=0.157, image impression: p=0.102). Noise, sharpness, artifacts, and subjective SNR for TSEDL reached significantly superior levels to TSE (noise: p<0.001, sharpness: p=0.001, artifacts: p=0.014, subjective SNR: p<0.001). Technologists reported high levels of acceptance for DL image reconstruction. Required time for the reconstruction process was rated moderate and longer than standard sequences (median 2, IQR 2-3). Required time and effort for the implementation in daily workflow was rated as low effort (median 4, IQR 3-4). General applicability of DL reconstruction as well as acceptance of DL sequences in clinical routine were rated excellent (median 4, IQR 3-4). Conclusion: DL image reconstruction for TSE sequences can be implemented in clinical workflow and enables a remarkable time saving (>50%) in image acquisition while maintaining excellent image quality.Trial registration: Your clinical trial is officially registered at the German DRKS with the registration number: DRKS00023278.

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1484
Author(s):  
Judith Herrmann ◽  
Gregor Koerzdoerfer ◽  
Dominik Nickel ◽  
Mahmoud Mostapha ◽  
Mariappan Nadar ◽  
...  

Magnetic Resonance Imaging (MRI) of the musculoskeletal system is one of the most common examinations in clinical routine. The application of Deep Learning (DL) reconstruction for MRI is increasingly gaining attention due to its potential to improve the image quality and reduce the acquisition time simultaneously. However, the technology has not yet been implemented in clinical routine for turbo spin echo (TSE) sequences in musculoskeletal imaging. The aim of this study was therefore to assess the technical feasibility and evaluate the image quality. Sixty examinations of knee, hip, ankle, shoulder, hand, and lumbar spine in healthy volunteers at 3 T were included in this prospective, internal-review-board-approved study. Conventional (TSES) and DL-based TSE sequences (TSEDL) were compared regarding image quality, anatomical structures, and diagnostic confidence. Overall image quality was rated to be excellent, with a significant improvement in edge sharpness and reduced noise compared to TSES (p < 0.001). No difference was found concerning the extent of artifacts, the delineation of anatomical structures, and the diagnostic confidence comparing TSES and TSEDL (p > 0.05). Therefore, DL image reconstruction for TSE sequences in MSK imaging is feasible, enabling a remarkable time saving (up to 75%), whilst maintaining excellent image quality and diagnostic confidence.


Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3593
Author(s):  
Sebastian Gassenmaier ◽  
Saif Afat ◽  
Marcel Dominik Nickel ◽  
Mahmoud Mostapha ◽  
Judith Herrmann ◽  
...  

Multiparametric MRI (mpMRI) of the prostate has become the standard of care in prostate cancer evaluation. Recently, deep learning image reconstruction (DLR) methods have been introduced with promising results regarding scan acceleration. Therefore, the aim of this study was to investigate the impact of deep learning image reconstruction (DLR) in a shortened acquisition process of T2-weighted TSE imaging, regarding the image quality and diagnostic confidence, as well as PI-RADS and T2 scoring, as compared to standard T2 TSE imaging. Sixty patients undergoing 3T mpMRI for the evaluation of prostate cancer were prospectively enrolled in this institutional review board-approved study between October 2020 and March 2021. After the acquisition of standard T2 TSE imaging (T2S), the novel T2 TSE sequence with DLR (T2DLR) was applied in three planes. Overall, the acquisition time for T2S resulted in 10:21 min versus 3:50 min for T2DLR. The image evaluation was performed by two radiologists independently using a Likert scale ranging from 1–4 (4 best) applying the following criteria: noise levels, artifacts, overall image quality, diagnostic confidence, and lesion conspicuity. Additionally, T2 and PI-RADS scoring were performed. The mean patient age was 69 ± 9 years (range, 49–85 years). The noise levels and the extent of the artifacts were evaluated to be significantly improved in T2DLR versus T2S by both readers (p < 0.05). Overall image quality was also evaluated to be superior in T2DLR versus T2S in all three acquisition planes (p = 0.005–<0.001). Both readers evaluated the item lesion conspicuity to be superior in T2DLR with a median of 4 versus a median of 3 in T2S (p = 0.001 and <0.001, respectively). T2-weighted TSE imaging of the prostate in three planes with an acquisition time reduction of more than 60% including DLR is feasible with a significant improvement of image quality.


Author(s):  
Jihang Sun ◽  
Haoyan Li ◽  
Haiyun Li ◽  
Michelle Li ◽  
Yingzi Gao ◽  
...  

BACKGROUND: The inflammatory indexes of children with Takayasu arteritis (TAK) usually tend to be normal immediately after treatment, therefore, CT angiography (CTA) has become an important method to evaluate the status of TAK and sometime is even more sensitive than laboratory test results. OBJECTIVE: To evaluate image quality improvement in CTA of children diagnosed with TAK using a deep learning image reconstruction (DLIR) in comparison to other image reconstruction algorithms. METHODS: hirty-two TAK patients (9.14±4.51 years old) underwent neck, chest and abdominal CTA using 100 kVp were enrolled. Images were reconstructed at 0.625 mm slice thickness using Filtered Back-Projection (FBP), 50%adaptive statistical iterative reconstruction-V (ASIR-V), 100%ASIR-V and DLIR with high setting (DLIR-H). CT number and standard deviation (SD) of the descending aorta and back muscle were measured and contrast-to-noise ratio (CNR) for aorta was calculated. The vessel visualization, overall image noise and diagnostic confidence were evaluated using a 5-point scale (5, excellent; 3, acceptable) by 2 observers. RESULTS: There was no significant difference in CT number across images reconstructed using different algorithms. Image noise values (in HU) were 31.36±6.01, 24.96±4.69, 18.46±3.91 and 15.58±3.65, and CNR values for aorta were 11.93±2.12, 15.66±2.37, 22.54±3.34 and 24.02±4.55 using FBP, 50%ASIR-V, 100%ASIR-V and DLIR-H, respectively. The 100%ASIR-V and DLIR-H images had similar noise and CNR (all P >  0.05), and both had lower noise and higher CNR than FBP and 50%ASIR-V images (all P <  0.05). The subjective evaluation suggested that all images were diagnostic for large arteries, however, only 50%ASIR-V and DLIR-H met the diagnostic requirement for small arteries (3.03±0.18 and 3.53±0.51). CONCLUSION: DLIR-H improves CTA image quality and diagnostic confidence for TAK patients compared with 50%ASIR-V, and best balances image noise and spatial resolution compared with 100%ASIR-V.


2021 ◽  
Author(s):  
Jihang Sun ◽  
Haoyan Li ◽  
Jianying Li ◽  
Haiyun Li ◽  
Michelle Li ◽  
...  

Abstract purpose: To evaluate the image quality improvement in CTA of children with Takayasu arteritis (TAK) using a Deep learning image reconstruction (DLIR) in comparison to other reconstruction algorithms.Methods: 32 patients (9.14±4.51 years old) with TAK underwent neck, chest and abdominal CTA with 100kVp were enrolled. Images were reconstructed at 0.625mm slice thickness using Filtered Back-Projection (FBP), 50% adaptive statistical iterative reconstruction-V (ASIR-V), 100%ASIR-V and DLIR with high setting (DLIR-H). The CT number and standard deviation (SD) of the descending aorta and back muscle were measured and contrast-to-noise ratio (CNR) for aorta was calculated. The vessel visualization, overall image noise and diagnostic confidence were evaluated using a 5-point scale (5, excellent; 3, acceptable) by 2 observers.Results: There was no significant difference in CT number across all reconstructions. The image noise values (in HU) were 31.36±6.01, 24.96±4.69, 18.46±3.91 and 15.58±3.65, and CNR values for aorta were 11.93±2.12, 15.66±2.37, 22.54±3.34 and 24.02±4.55 with FBP, 50%ASIR-V, 100%ASIR-V and DLIR-H, respectively. The 100%ASIR-V and DLIR-H images had similar noise and CNR (all P>0.05), and both had lower noise and higher CNR than FBP and 50%ASIR-V images (all P<0.05). The subjective evaluation suggested that all images were diagnostic for large arteries, but only 50%ASIR-V and DLIR-H met the diagnostic requirement for small arteries (3.03±0.18 and 3.53±0.51). Conclusions: DLIR-H improves the CTA image quality and diagnostic confidence for TAK patients compared with 50%ASIR-V, and best balances image noise and spatial resolution compared with 100%ASIR-V.


2021 ◽  
Vol 137 ◽  
pp. 109600
Author(s):  
Sebastian Gassenmaier ◽  
Saif Afat ◽  
Dominik Nickel ◽  
Mahmoud Mostapha ◽  
Judith Herrmann ◽  
...  

2021 ◽  
Vol 94 (1121) ◽  
pp. 20201329
Author(s):  
Yoshifumi Noda ◽  
Tetsuro Kaga ◽  
Nobuyuki Kawai ◽  
Toshiharu Miyoshi ◽  
Hiroshi Kawada ◽  
...  

Objectives: To evaluate image quality and lesion detection capabilities of low-dose (LD) portal venous phase whole-body computed tomography (CT) using deep learning image reconstruction (DLIR). Methods: The study cohort of 59 consecutive patients (mean age, 67.2 years) who underwent whole-body LD CT and a prior standard-dose (SD) CT reconstructed with hybrid iterative reconstruction (SD-IR) within one year for surveillance of malignancy were assessed. The LD CT images were reconstructed with hybrid iterative reconstruction of 40% (LD-IR) and DLIR (LD-DLIR). The radiologists independently evaluated image quality (5-point scale) and lesion detection. Attenuation values in Hounsfield units (HU) of the liver, pancreas, spleen, abdominal aorta, and portal vein; the background noise and signal-to-noise ratio (SNR) of the liver, pancreas, and spleen were calculated. Qualitative and quantitative parameters were compared between the SD-IR, LD-IR, and LD-DLIR images. The CT dose-index volumes (CTDIvol) and dose-length product (DLP) were compared between SD and LD scans. Results: The image quality and lesion detection rate of the LD-DLIR was comparable to the SD-IR. The image quality was significantly better in SD-IR than in LD-IR (p < 0.017). The attenuation values of all anatomical structures were comparable between the SD-IR and LD-DLIR (p = 0.28–0.96). However, background noise was significantly lower in the LD-DLIR (p < 0.001) and resulted in improved SNRs (p < 0.001) compared to the SD-IR and LD-IR images. The mean CTDIvol and DLP were significantly lower in the LD (2.9 mGy and 216.2 mGy•cm) than in the SD (13.5 mGy and 1011.6 mGy•cm) (p < 0.0001). Conclusion: LD CT images reconstructed with DLIR enable radiation dose reduction of >75% while maintaining image quality and lesion detection rate and superior SNR in comparison to SD-IR. Advances in knowledge: Deep learning image reconstruction algorithm enables around 80% reduction in radiation dose while maintaining the image quality and lesion detection compared to standard-dose whole-body CT.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hyunkwang Lee ◽  
Chao Huang ◽  
Sehyo Yune ◽  
Shahein H. Tajmir ◽  
Myeongchan Kim ◽  
...  

Abstract Recent advancements in deep learning for automated image processing and classification have accelerated many new applications for medical image analysis. However, most deep learning algorithms have been developed using reconstructed, human-interpretable medical images. While image reconstruction from raw sensor data is required for the creation of medical images, the reconstruction process only uses a partial representation of all the data acquired. Here, we report the development of a system to directly process raw computed tomography (CT) data in sinogram-space, bypassing the intermediary step of image reconstruction. Two classification tasks were evaluated for their feasibility of sinogram-space machine learning: body region identification and intracranial hemorrhage (ICH) detection. Our proposed SinoNet, a convolutional neural network optimized for interpreting sinograms, performed favorably compared to conventional reconstructed image-space-based systems for both tasks, regardless of scanning geometries in terms of projections or detectors. Further, SinoNet performed significantly better when using sparsely sampled sinograms than conventional networks operating in image-space. As a result, sinogram-space algorithms could be used in field settings for triage (presence of ICH), especially where low radiation dose is desired. These findings also demonstrate another strength of deep learning where it can analyze and interpret sinograms that are virtually impossible for human experts.


2020 ◽  
Author(s):  
Alexandre Chicheportiche ◽  
Elinor Goshen ◽  
Jeremy Godefroy ◽  
Simona Grozinsky-Glasberg ◽  
Kira Oleinikov ◽  
...  

Abstract Background: Image quality and quantitative accuracy of Positron Emission Tomography (PET) depend on several factors such as uptake time, scanner characteristics and image reconstruction methods. Ordered subset expectation maximization (OSEM) is considered the gold standard for image reconstruction. Penalized-likelihood estimation (PL) algorithms have been recently developed for PET reconstruction to improve quantitation accuracy while maintaining or even improving image quality. In PL algorithms a regularization parameter β controls the penalization of relative differences between neighboring pixels and determines image characteristics. In the present study, we aim to compare the performance of Q.Clear (PL algorithm, GE Healthcare) and OSEM (3 iterations, 8 subsets, 6 mm post-processing filter) for 68Ga-DOTATATE (68Ga-DOTA) PET studies, both visually and quantitatively.Thirty consecutive whole-body 68Ga-DOTA studies were included. The data were acquired in list mode and were reconstructed using 3D OSEM and Q.Clear with various values of β, and various acquisition times per bed position (bp), thus generating images with reduced injected dose (1.5 min/bp: β=300-1100; 1.0 min/bp: β=600-1400 and 0.5 min/bp: β=800-2200). An additional analysis adding β values up to 1500, 1700 and 300 for 1.5, 1.0 and 0.5 min/bp, respectively, was performed for a random sample of 8 studies. Evaluation was performed using a phantom and clinical data. Two experienced nuclear medicine physicians blinded to the variables assessed the image quality visually.Results: Clinical images reconstructed with Q.Clear, set at 1.5, 1.0 min/bp and 0.5 min/bp using β = 1100, 1300, 3000 respectively, resulted in images with noise equivalence to 3D OSEM (1.5 min/bp) with a mean increase in SUVmax of 14%, 13% and 4%, an increase in SNR of 30%, 24% and 10%, and in SBR of 13%, 13% and 2%, respectively. Visual assessment yielded similar results for β values of 1300-1500 and 1500-1700 for 1.5 and 1.0 min/bp, respectively although for 0.5 min/bp there was no significant improvement compared to OSEM. Conclusion: 68Ga-DOTA reconstructions with Q.Clear, 1.5 and 1.0 min/bp resulted in increased tumor SUVmax and in improved SNR and SBR at a similar level of noise compared to 3D OSEM. Q.Clear with β =1500-1700 enables one-third reduction of acquisition time or injected dose, with similar image quality compared to 3D OSEM.


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