Amaresha Shridhar Konar1, Jaemin Shin2, Ramesh Paudyal1, Abhay Dave3, Maggie Fung2, Suchandrima Banerjee4, Vaios Hatzoglou5, and Amita Shukla-Dave1,5
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY, United States, 2GE Healthcare, New York City, NY, United States, 3Touro College of Osteopathic Medicine, New York, NY, United States, 4GE Healthcare, Menlo Park, CA, United States, 5Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY, United States
Synopsis
Keywords: Machine Learning/Artificial Intelligence, Quantitative Imaging
MRI has excellent
extracranial soft-tissue contrast to detect tumors in the head and neck (HN)
region. Technical challenges arise due to MRI related artifacts. In routine radiological
practice, HN MR imaging protocols are optimized specifically to the subsites. We
aimed to evaluate the performance of the HN imaging protocol that include
qualitative T
1w, T
2w, and quantitative diffusion MRI powered by a novel deep
learning (DL) based reconstruction (recon) using the ACR and QIBA diffusion
phantoms. This phantom study showed that qualitative T
1w and T
2w
images and multiple b-value DWI data powered with DL recon substantially
improves the image quality.
Purpose:
In routine radiological
practice, HN MR imaging protocols are optimized specifically to the subsite,
such as the oral cavity, oropharynx, nasopharynx, nasal cavity, larynx, neck,
parotid, and thyroid. The qualitative high-resolution, multiplanar T1- and
T2-weighted (w) images are used to assess the location and extent of the HN tumors.
However, quantitative analysis of diffusion MRI, a technique to measure tumor
cellularity, can provide added value to the structural and anatomical
evaluation of HN tumors by prognostic prediction and assessment of treatment response1-4. A novel deep learning-based MRI
reconstruction pipeline was designed to address fundamental image quality
limitations of conventional reconstruction to provide high-resolution,
low-noise MR images5. This pipeline’s
unique aims were to convert truncation artifacts into improved image sharpness
while jointly denoising images to improve image quality5. This new approach,
now commercially available as AIR Recon DL (GE Healthcare, Waukesha, WI),
includes a deep convolutional neural network (CNN) to aid in the reconstruction
of raw data, ultimately producing clean, sharp images. In this study, we
evaluate the HN imaging protocol's performance, including qualitative T1w, T2w, and quantitative diffusion MRI powered by DL reconstruction, using the
ACR and QIBA diffusion phantoms.Methods:
MRI data acquisition:
HN
MRI protocol consisted of T1 and T2w imaging
followed by multi-b-value DWI on a 3 T MRI scanner (SIGNA Premier, GE
Healthcare) using a 21-channel HN unit and at 1.5 T (Signa, GE Healthcare)
using 19 channel HN unit. The medium-size ACR phantom was used for T1w
and T2w imaging, and the QIBA diffusion phantom was used for DW-MRI.
The acquisition parameters for T1w imaging were: FOV=25 cm, slice
thickness=5 mm, slice gap=5 mm, the number of slices=11, and TR/TE= 550/8.1 ms, and for T2w imaging: TR/TE=2228/102 ms. The multi b-value (b=0, 50,
500, 1000 s/mm2) DW images were acquired using a single shot spin echo planar imaging
(SS-SE-EPI) sequence with TR/TE=4000/77 (minimum) ms, the field of view
(FOV)=20 cm, slice thickness=5 mm, number of excitation (NEX)=1, 4 and
6 for b=50, 500,1000 s/mm2, respectively. Another set of multi-b-value DW-MRI
data was acquired using similar acquisition parameters by changing the NEX=1
for all the b-value. The qualitative and quantitative images were reconstructed using the standard and AIR Recon DL methods. The DL reconstruction was tested for
all three settings, i.e., low, medium, and high, available at the scanner.
MR image assessment: The
T1w and T2w images acquired using the medium-size ACR
phantom were reconstructed with and without DL recon and analyzed for the
following assessment: 1. High contrast spatial resolution, 2. Percent Integral Uniformity (PIU), 3. Low contrast
object detectability, 4. Gibbs (ringing) artifact. Similarly, the images
obtained from the QIBA (DWI) phantom were reconstructed for standard and reduced
NEX using the option of DL to measure the ADC values for the combinations
mentioned above. The coefficient of variation (CV in %) was calculated and
reported for all the combination measured ADC values. Results:
Based on the four assessments performed on the
ACR phantom study, the DL-based T1w and T2w images showed
superior overall image quality compared to the images reconstructed without the
DL method. The images acquired and reconstructed on 1.5T, and 3T with and
without DL passed the Percent Integral Uniformity (PIU) test and the low
contrast object detectability test. The high contrast spatial
resolution test and Gibbs or ringing artifacts test showed improved image
quality for DL-based images, as shown in Figure 1. A minimal difference was observed
between the three different settings (low, medium, and high) of DL-based image
reconstruction for both 3T and 1.5T scanners. Reduced ringing artifacts and
improved image quality were observed in DL-reconstructed images obtained from
the QIBA phantom for selected b-values, as shown in Figure 2. Diffusion images
reconstructed using DL for reduced NEX=1 showed comparable image quality to standard
NEX. The ADC maps obtained using the multi-b-value diffusion images
reconstructed with and without DL for both standard and reduced NEX are shown
in Figure 3. Figure 4 exhibits a bar
plot for all combinations' measured mean ADC values. We did not observe a significant difference in
measured ADC values between the images reconstructed with and without DL. The
mean ADC values obtained from reduced NEX were comparable to Standard NEX. CV
calculated for the measured ADC values are tabulated in Table 1, showing lower
CV for DL based method. Discussion and Conclusion:
The SNR improvement offered
by the DL Recon also provides opportunities for increasing spatial resolution.
The ACR phantom study showed significant improvement by reducing ringing artifacts and increasing image sharpness. The different settings (low, medium,
and high) available on the scanner to set the DL reconstruction did not show a significant
difference between them. We observed a better reduction in the noise for the high
setting than low or medium. The ADC values obtained from the QIBA diffusion
phantom study showed similarities between the methods. Reduced NEX=1 significantly
minimizes the image acquisition time, and the images reconstructed using the DL
method showed comparable image quality and similar ADC values to the standard
NEX. In conclusion, this phantom study showed that applying DL reconstruction
on qualitative T1w and T2w images and DWI data substantially
improves image quality. Acknowledgements
Funding support from National Institutes of
Health Grant: U01 CA211205 (ASD)References
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