Image Quality and Diagnostic Performance of Accelerated Shoulder MRI With Deep Learning-Based Reconstruction.

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Abstract

Background: Shoulder MRI using standard multiplanar sequences requires long scan times. Accelerated sequences have tradeoffs in noise and resolution. Deep learning-based reconstruction (DLR) may allow reduced scan time with preserved image quality. Objectives: To compare standard shoulder MRI sequences and accelerated sequences without and with DLR in terms of image quality and diagnostic performance. Methods: This retrospective study included 105 patients (45 men, 60 women; mean age 57.6±10.9 years) who underwent a total of 110 3-T shoulder MRI examinations. Examinations included standard sequences (scan time, 9 minutes 23 seconds) and accelerated sequences (3 minutes 5 seconds; 67% reduction), both including fast spin echo sequences in three planes. Standard sequences were reconstructed using the conventional pipeline; accelerated sequences were reconstructed using both conventional pipeline and a commercially available DLR pipeline. Two radiologists independently assessed three image sets (standard, accelerated without DLR, accelerated with DLR) for subjective image quality and artifacts using 4-point scales (4=highest quality), and identified pathologies of subscapularis tendon, supraspinatus-infraspinatus tendon, biceps brachii long head tendon, and glenoid labrum. Interobserver and inter-image set agreement for the evaluated pathologies was assessed using weighted kappa statistics. In 27 patients who underwent arthroscopy, diagnostic performance was calculated using arthroscopic findings as reference. Results: Mean subjective image quality for readers 1 and 2 was 10.6±1.2 and 10.5±1.4 for standard, 8.1±1.3 and 7.2±1.1 for accelerated without DLR, and 10.7±1.2 and 10.5±1.6 for accelerated with DLR. Mean artifact score for readers 1 and 2 was 9.3±1.2 and 10.0±1.0 for standard, 7.3±1.3 and 9.1±0.8 for accelerated without DLR, and 9.4±1.2 and 9.8±0.8 for accelerated with DLR. Interobserver agreement ranged from kappa=0.813-0.951 except for accelerated without DLR for SST-IST (κ=0.673). Inter-image set agreement ranged from kappa=0.809-0.957 except for reader 1 for SST-IST (κ=0.663-0.700). Accuracy, sensitivity, and specificity for tears of the four structures was not different (p>.05) among image sets. Conclusions: Accelerated sequences with DLR provide 67% scan time reduction with similar subjective image quality, artifacts, and diagnostic performance as standard sequences. Clinical impact: Accelerated sequences with DLR may provide an alternative to standard sequences for clinical shoulder MRI.