Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Impact of Deep-Learning Based Reconstruction on Single-Breath-Hold, Single-Shot Fast Spin-Echo in MR Enterography for Crohn's Disease

크론병에서 자기공명영상 장운동기록의 단일호흡 단발 고속 스핀 에코기법: 딥러닝 기반 재구성의 영향

  • Eun Joo Park (Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital) ;
  • Yedaun Lee (Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital) ;
  • Joonsung Lee (GE Healthcare Korea)
  • 박언주 (인제대학교 의과대학 해운대백병원 영상의학과) ;
  • 이예다운 (인제대학교 의과대학 해운대백병원 영상의학과) ;
  • 이준성 (GE 헬스케어코리아)
  • Received : 2023.01.20
  • Accepted : 2023.05.06
  • Published : 2023.11.01
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Abstract

Purpose To assess the quality of four images obtained using single-breath-hold (SBH), single-shot fast spin-echo (SSFSE) and multiple-breath-hold (MBH) SSFSE with and without deep-learning based reconstruction (DLR) in patients with Crohn's disease. Materials and Methods This study included 61 patients who underwent MR enterography (MRE) for Crohn's disease. The following images were compared: SBH-SSFSE with (SBH-DLR) and without (SBH-conventional reconstruction [CR]) DLR and MBH-SSFSE with (MBH-DLR) and without (MBH-CR) DLR. Two radiologists independently reviewed the overall image quality, artifacts, sharpness, and motion-related signal loss using a 5-point scale. Three inflammatory parameters were evaluated in the ileum, the terminal ileum, and the colon. Moreover, the presence of a spatial misalignment was evaluated. Signal-to-noise ratio (SNR) was calculated at two locations for each sequence. Results DLR significantly improved the image quality, artifacts, and sharpness of the SBH images. No significant differences in scores between MBH-CR and SBH-DLR were detected. SBH-DLR had the highest SNR (p < 0.001). The inter-reader agreement for inflammatory parameters was good to excellent (κ = 0.76-0.95) and the inter-sequence agreement was nearly perfect (κ = 0.92-0.94). Misalignment artifacts were observed more frequently in the MBH images than in the SBH images (p < 0.001). Conclusion SBH-DLR demonstrated equivalent quality and performance compared to MBH-CR. Furthermore, it can be acquired in less than half the time, without multiple BHs and reduce slice misalignments.

목적 크론병 환자의 자기공명영상 장운동기록(MR enterography; 이하 MRE)에서 단발 고속 스핀 에코기법(single-shot fast spin-echo; 이하 SSFSE)을 이용한 단일호흡영상(singlebreath-hold; 이하 SBH)과 다호흡영상(multiple-breath-hold; 이하 MBH)을 딥러닝 기반 재구성(deep-learning based reconstruction; 이하 DLR)의 유무에 따라 네 개의 영상에서 품질을 비교했다. 대상과 방법 이 연구는 후향적 연구로서, 크론병으로 MRE를 시행한 61명의 환자가 포함되었다. SBH와 MBH SSFSE 영상에서 각각 DLR과 고식적 재구성(conventional reconstruction; 이하 CR)을 시행한 영상을 획득했다. 두 명의 영상의학과 전문의가 네 가지 영상을 분석하여 전반적인 영상의 품질, 인공물, 선명도와 움직임 관련 신호 손실에 대하여 각각 5점 척도를 이용해 점수를 부여했다. 회장과 말단 회장, 결장에서 염증을 시사하는 세 가지 소견을 평가했다. 각 영상에 대해서 공간적 불일치 여부를 확인했고, 네 가지 영상에서 각각 다른 두 위치에서 신호 대 잡음비(signal-to-noise ratio; 이하 SNR)를 계산했다. 결과 SBH SSFSE 영상에서 DLR을 적용한 경우 CR보다 영상의 품질, 인공물, 선명도가 통계학적으로 유의하게 개선되었다. 네 가지 영상 중 SBH-DLR 영상에서 SNR이 가장 높게 나타났다(p < 0.001). 염증 소견에 대한 판독자 간 일치율은 좋음에서 매우 좋음으로 나타났고(κ = 0.76-0.95) 시퀀스 간 일치율은 매우 좋음으로 측정되었다(κ = 0.92-0.94). 공간적 불일치는 SBH 영상보다 MBH 영상에서 통계학적으로 유의하게 빈도가 높았다(p < 0.001). 결론 SBH-DLR 영상은 MBH-CR 영상과 비교했을 때 동등한 영상 품질과 성능을 보여주었다. 또한, MBH 영상에 비해 절반 이하의 시간과 단일 호흡만으로 영상을 획득할 수 있으며 공간 불일치를 줄일 수 있는 대체제로 사용할 수 있다.

Keywords

References

  1. Grand DJ, Guglielmo FF, Al-Hawary MM. MR enterography in Crohn's disease: current consensus on optimal imaging technique and future advances from the SAR Crohn's disease-focused panel. Abdom Imaging 2015;40:953-964
  2. Rimola J, Ordas I, Rodriguez S, Garcia-Bosch O, Aceituno M, Llach J, et al. Magnetic resonance imaging for evaluation of Crohn's disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis 2011;17:1759-1768
  3. Rimola J, Rodriguez S, Garcia-Bosch O, Ordas I, Ayala E, Aceituno M, et al. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut 2009;58:1113-1120
  4. Ziech ML, Bipat S, Roelofs JJ, Nio CY, Mearadji B, van Doorn S, et al. Retrospective comparison of magnetic resonance imaging features and histopathology in Crohn's disease patients. Eur J Radiol 2011;80:e299-e305
  5. Siddiki HA, Fidler JL, Fletcher JG, Burton SS, Huprich JE, Hough DM, et al. Prospective comparison of stateof-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AJR Am J Roentgenol 2009;193:113-121
  6. Lee MG, Jeong YK, Kim JC, Kang EM, Kim PN, Auh YH, et al. Fast T2-weighted liver MR imaging: comparison among breath-hold turbo-spin-echo, HASTE, and inversion recovery (IR) HASTE sequences. Abdom Imaging 2000;25:93-99
  7. Nakayama Y, Yamashita Y, Matsuno Y, Tang Y, Namimoto T, Kadota M, et al. Fast breath-hold T2-weighted MRI of the kidney by means of half-Fourier single-shot turbo spin echo: comparison with high resolution turbo spin echo sequence. J Comput Assist Tomogr 2001;25:55-60
  8. Makowski MR, Wiethoff AJ, Jansen CH, Uribe S, Parish V, Schuster A, et al. Single breath-hold assessment of cardiac function using an accelerated 3D single breath-hold acquisition technique--comparison of an intravascular and extravascular contrast agent. J Cardiovasc Magn Reson 2012;14:53
  9. Sheng RF, Zheng LY, Jin KP, Sun W, Liao S, Zeng MS, et al. Single-breath-hold T2WI liver MRI with deep learning-based reconstruction: a clinical feasibility study in comparison to conventional multi-breath-hold T2WI liver MRI. Magn Reson Imaging 2021;81:75-81
  10. Loening AM, Saranathan M, Ruangwattanapaisarn N, Litwiller DV, Shimakawa A, Vasanawala SS. Increased speed and image quality in single-shot fast spin echo imaging via variable refocusing flip angles. J Magn Reson Imaging 2015;42:1747-1758
  11. Jabarkheel R, Tong E, Lee EH, Cullen TM, Yousaf U, Loening AM, et al. Variable refocusing flip angle singleshot imaging for sedation-free fast brain MRI. AJNR Am J Neuroradiol 2020;41:1256-1262
  12. Loening AM, Litwiller DV, Saranathan M, Vasanawala SS. Increased speed and image quality for pelvic single-shot fast spin-echo imaging with variable refocusing flip angles and full-Fourier acquisition. Radiology 2017;282:561-568
  13. Wang S, Xiao T, Liu Q, Zheng H. Deep learning for fast MR imaging: a review for learning reconstruction from incomplete k-space data. Biomed Signal Process Control 2021;68:102579
  14. Lebel RM. Performance characterization of a novel deep learning-based MR image reconstruction pipeline. arXiv [Preprint]. 2020 [cited 2022 June 17]. Available at: https://doi.org/10.48550/arXiv.2008.06559
  15. Kim J, Seo N, Bae H, Kang EA, Kim E, Chung YE, et al. Comparison of sensitivity encoding (SENSE) and compressed sensing-SENSE for contrast-enhanced T1-weighted imaging in patients with Crohn disease undergoing MR enterography. AJR Am J Roentgenol 2022;218:678-686
  16. Kaltenbach B, Bucher AM, Wichmann JL, Nickel D, Polkowski C, Hammerstingl R, et al. Dynamic liver magnetic resonance imaging in free-breathing: feasibility of a Cartesian T1-weighted acquisition technique with compressed sensing and additional self-navigation signal for hard-gated and motion-resolved reconstruction. Invest Radiol 2017;52:708-714
  17. Steward MJ, Punwani S, Proctor I, Adjei-Gyamfi Y, Chatterjee F, Bloom S, et al. Non-perforating small bowel Crohn's disease assessed by MRI enterography: derivation and histopathological validation of an MRbased activity index. Eur J Radiol 2012;81:2080-2088
  18. Pimpalkhute VA, Page R, Kothari A, Bhurchandi KM, Kamble VM. Digital image noise estimation using DWT coefficients. IEEE Trans Image Process 2021;30:1962-1972
  19. Dietrich O, Raya JG, Reeder SB, Reiser MF, Schoenberg SO. Measurement of signal-to-noise ratios in MR images: influence of multichannel coils, parallel imaging, and reconstruction filters. J Magn Reson Imaging 2007;26:375-385
  20. Mugler JP 3rd. Optimized three-dimensional fast-spin-echo MRI. J Magn Reson Imaging 2014;39:745-767
  21. Bernstein MA, Huston J 3rd, Ward HA. Imaging artifacts at 3.0T. J Magn Reson Imaging 2006;24:735-746
  22. Ruangwattanapaisarn N, Loening AM, Saranathan M, Litwiller DV, Vasanawala SS. Faster pediatric 3-T abdominal magnetic resonance imaging: comparison between conventional and variable refocusing flip-angle single-shot fast spin-echo sequences. Pediatr Radiol 2015;45:847-854
  23. Hicks RM, Loening AM, Ohliger MA, Vasanawala SS, Hope TA. Variable refocusing flip angle single-shot fast spin echo imaging of liver lesions: increased speed and lesion contrast. Abdom Radiol (NY) 2018;43:593-599