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Erschienen in:
24.03.2022 | Musculoskeletal
Evaluation of deep learning reconstructed high-resolution 3D lumbar spine MRI
Erschienen in: European Radiology | Ausgabe 9/2022
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Objectives
To compare interobserver agreement and image quality of 3D T2-weighted fast spin echo (T2w-FSE) L-spine MRI images processed with a deep learning reconstruction (DLRecon) against standard-of-care (SOC) reconstruction, as well as against 2D T2w-FSE images. The hypothesis was that DLRecon 3D T2w-FSE would afford improved image quality and similar interobserver agreement compared to both SOC 3D and 2D T2w-FSE.
Methods
Under IRB approval, patients who underwent routine 3-T lumbar spine (L-spine) MRI from August 17 to September 17, 2020, with both isotropic 3D and 2D T2w-FSE sequences, were retrospectively included. A DLRecon algorithm, with denoising and sharpening properties was applied to SOC 3D k-space to generate 3D DLRecon images. Four musculoskeletal radiologists blinded to reconstruction status evaluated randomized images for motion artifact, image quality, central/foraminal stenosis, disc degeneration, annular fissure, disc herniation, and presence of facet joint cysts. Inter-rater agreement for each graded variable was evaluated using Conger’s kappa (κ).
Results
Thirty-five patients (mean age 58 ± 19, 26 female) were evaluated. 3D DLRecon demonstrated statistically significant higher median image quality score (2.0/2) when compared to SOC 3D (1.0/2, p < 0.001), 2D axial (1.0/2, p < 0.001), and 2D sagittal sequences (1.0/2, p value < 0.001). κ ranges (and 95% CI) for foraminal stenosis were 0.55–0.76 (0.32–0.86) for 3D DLRecon, 0.56–0.73 (0.35–0.84) for SOC 3D, and 0.58–0.71 (0.33–0.84) for 2D. Mean κ (and 95% CI) for central stenosis at L4-5 were 0.98 (0.96–0.99), 0.97 (0.95–0.99), and 0.98 (0.96–0.99) for 3D DLRecon, 3D SOC and 2D, respectively.
Conclusions
DLRecon 3D T2w-FSE L-spine MRI demonstrated higher image quality and similar interobserver agreement for graded variables of interest when compared to 3D SOC and 2D imaging.
Key Points
• 3D DLRecon T2w-FSE isotropic lumbar spine MRI provides improved image quality when compared to 2D MRI, with similar interobserver agreement for clinical evaluation of pathology.
• 3D DLRecon images demonstrated better image quality score (2.0/2) when compared to standard-of-care (SOC) 3D (1.0/2), p value < 0.001; 2D axial (1.0/2), p value < 0.001; and 2D sagittal sequences (1.0/2), p value < 0.001.
• Interobserver agreement for major variables of interest was similar among all sequences and reconstruction types. For foraminal stenosis, κ ranged from 0.55 to 0.76 (95% CI 0.32–0.86) for 3D DLRecon, 0.56–0.73 (95% CI 0.35–0.84) for standard-of-care (SOC) 3D, and 0.58–0.71 (95% CI 0.33–0.84) for 2D.