Sonoko Oshima1, Yasutaka Fushimi1, Satoshi Nakajima1, Akihiko Sakata1, Takuya Hinoda1, Sayo Otani1, Krishna Pandu Wicaksono1, Hiroshi Tagawa1, Yang Wang1, Yuichiro Sano2, Rimika Imai2, Masahito Nambu2, Koji Fujimoto3, Hitomi Numamoto4, Kanae Kawai Miyake4, Tsuneo Saga4, and Yuji Nakamoto1
1Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 2Canon Medical Systems Corporation, Otawara, Japan, 3Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 4Department of Advanced Medical Imaging Research, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Synopsis
We
applied four patterns of deep learning reconstruction (DLR) denoising methods to
1 NEX neuromelanin-sensitive MR images. DLR with denoising intensity
coefficient of 1.0 and edge enhancement off provided the best image quality among
the four types of DLR, and it was significantly better than or as good as 5 NEX
images. ROC analyses using images with all DLR patterns showed good AUCs for
diagnosis of Parkinson’s disease. This DLR denoising method can improve image
quality of neuromelanin-sensitive MRI with good diagnostic ability to
differentiate patients with Parkinson’s disease from healthy controls.
Introduction
Neuromelanin-sensitive
MR imaging (NM-MRI) has been developed to visualize the substantia nigra (SN)
and locus coeruleus (LC). Previous studies have proven that this imaging can help
diagnose Parkinson’s disease (PD) by showing
decreased contrast ratios of the SN or LC.1-6 However, it usually
requires relatively long scan time. Recently, deep learning reconstruction
(DLR) method for image noise reduction has been developed, which can reduce
acquisition time without spoiling image quality.7 The aims of this
study were: 1) to compare the image quality of 1 number of excitation (NEX) NM-MRI
without DLR and with four patterns of DLR, and 5 NEX NM-MRI; and 2) to evaluate
diagnostic ability for PD using 1 NEX NM-MRI with DLR.Methods
Subjects
This
prospective study was approved by the institutional review board. We enrolled 10
healthy volunteers (1 male and 9 females; age, 35.3 ±
9.4 years) and 15 patients with PD (7 males and 8 females; age, 67.4 ± 10.4 years).
MR image acquisition and denoising
with DLR
MR
imaging was performed at a 3T MR scanner (Vantage Galan 3T / ZGO, Canon Medical
Systems, Otawara, Japan) with a 32-channel head coil. We acquired NM-MR images (2D
gradient echo pulse sequence with MTC preparation) with 1 NEX.
Scan with 5 NEX was also performed for healthy volunteers. The
parameters were as follows: TR/TE, 460/2.7 ms; 15 slices; slice thickness/gap,
3/0 mm; in-plane resolution, 0.55×0.55 mm2; matrix, 416×416; FOV,
230×230 mm2; flip angle, 40°; bandwidth, 244.1 Hz/pixel; MTC pulses,
300°, 1.2 kHz off resonance; and acquisition time, 3 minutes 12 seconds for 1 NEX
and 15 minutes 58 seconds for 5 NEX.
Denoising
was applied to 1 NEX images using DLR algorithm (Advanced Intelligent Clear-IQ
Engine [AiCE], Canon Medical Systems).7 The four patterns of DLR used
in this study are provided in Table 1.
Image analysis and statistical
analysis
All
the images were analyzed using ImageJ (National Institutes of Health,
Bethesda, MD). ROIs of the SN, superior cerebellar peduncle (SCP), LC and pons
were manually placed on the slices where the SN or LC was most clearly
delineated (Figure 1). The shape and
size of ROIs were the same in all the images. The SCP and pons were used as
background areas for the SN and LC, respectively.
1.
Image quality
We
evaluated image quality using images of healthy volunteers by calculating SNRSCP, SNRpons, CNRSN
and CNRLC. They were defined as follows: SNRSCP = mean SISCP
/ SD of SISCP, SNRpons = mean SIpons / SD of
SIpons, CNRSN = (mean SISN – mean SISCP)
/ SD of SISCP, and CNRLC = (mean SILC – mean SIpons)
/ SD of SIpons, where SI is signal intensity and SD is standard deviation.
SNRs
and CNRs were compared among 1 NEX without DLR, 1 NEX with DLR-a to DLR-d, and
5 NEX images using ANOVA with Bonferroni correction. P < 0.05 was considered statistically significant.
2.
Diagnostic ability
We
calculated contrast ratios (CRs) as follows: CRSN = mean SISN
/ mean SISCP and CRLC = mean SILC / mean SIpons.
We compared CRs between healthy control (HC) and PD groups using the
Mann-Whitney U test, and performed receiver operating characteristic (ROC)
analyses for differentiating patients with PD from HCs using images of 1 NEX
without DLR and with DLR-a to DLR-d.Results
1.
Image quality
Images of the SN and LC with 1 NEX without DLR, 1 NEX with DLR, and 5 NEX of a healthy volunteer are shown in Figure 2. The results of SNRs and CNRs are shown in Table 2 and Figure 3. DLR-c
achieved the highest values among the four DLR patterns. SNRs and CNRs of DLR-c
were significantly higher than those of 1 NEX without DLR. SNRSCP of
DLR-c was significantly higher than that of 5 NEX. There was no significant
difference in SNRpons, CNRSN and CNRLC between
DLR-c and 5 NEX.
2.
Diagnostic ability
Figure 4 represents 1NEX images without DLR and with DLR-c of a
HC and a patient with PD. The
patient with PD shows decreased contrast of the SN and LC compared to the HC. The CRs of HCs were significantly higher than those of
patients with PD for in all types of images (Table 3). All the images
demonstrated good areas under the curve (AUCs) of ROC analyses (Table 4).Discussion
We compared NM-MR images using DLR noise reduction with various
parameters. Among the four patterns of DLR, DLR-c (denoising intensity
coefficient, 1.0; edge enhancement, off) showed the best image quality. The SNRs and CNRs of DLR-c were significantly higher than or as high as 5 NEX
images. The graphs in Figure 3 suggest that SNRs and CNRs become higher when
images are reconstructed with higher denoising intensity coefficient and without
edge enhancement. We also revealed that the images with all DLR patterns provided
good diagnostic ability for PD. Our results
suggest that this DLR technique enables scan time reduction of NM-MRI with good
image quality and diagnostic ability.Conclusion
Among our four patterns of DLR for NM-MRI, DLR-c provided
the best image quality. The reconstructed images showed good diagnostic ability
for differentiation between patients with PD and HCs.Acknowledgements
No acknowledgement found.References
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