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Gohla G, Hauser TK, Bombach P, Feucht D, Estler A, Bornemann A, Zerweck L, Weinbrenner E, Ernemann U, Ruff C. Speeding Up and Improving Image Quality in Glioblastoma MRI Protocol by Deep Learning Image Reconstruction. Cancers (Basel) 2024; 16:1827. [PMID: 38791906 PMCID: PMC11119715 DOI: 10.3390/cancers16101827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
A fully diagnostic MRI glioma protocol is key to monitoring therapy assessment but is time-consuming and especially challenging in critically ill and uncooperative patients. Artificial intelligence demonstrated promise in reducing scan time and improving image quality simultaneously. The purpose of this study was to investigate the diagnostic performance, the impact on acquisition acceleration, and the image quality of a deep learning optimized glioma protocol of the brain. Thirty-three patients with histologically confirmed glioblastoma underwent standardized brain tumor imaging according to the glioma consensus recommendations on a 3-Tesla MRI scanner. Conventional and deep learning-reconstructed (DLR) fluid-attenuated inversion recovery, and T2- and T1-weighted contrast-enhanced Turbo spin echo images with an improved in-plane resolution, i.e., super-resolution, were acquired. Two experienced neuroradiologists independently evaluated the image datasets for subjective image quality, diagnostic confidence, tumor conspicuity, noise levels, artifacts, and sharpness. In addition, the tumor volume was measured in the image datasets according to Response Assessment in Neuro-Oncology (RANO) 2.0, as well as compared between both imaging techniques, and various clinical-pathological parameters were determined. The average time saving of DLR sequences was 30% per MRI sequence. Simultaneously, DLR sequences showed superior overall image quality (all p < 0.001), improved tumor conspicuity and image sharpness (all p < 0.001, respectively), and less image noise (all p < 0.001), while maintaining diagnostic confidence (all p > 0.05), compared to conventional images. Regarding RANO 2.0, the volume of non-enhancing non-target lesions (p = 0.963), enhancing target lesions (p = 0.993), and enhancing non-target lesions (p = 0.951) did not differ between reconstruction types. The feasibility of the deep learning-optimized glioma protocol was demonstrated with a 30% reduction in acquisition time on average and an increased in-plane resolution. The evaluated DLR sequences improved subjective image quality and maintained diagnostic accuracy in tumor detection and tumor classification according to RANO 2.0.
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Affiliation(s)
- Georg Gohla
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
| | - Till-Karsten Hauser
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
| | - Paula Bombach
- Department of Neurology and Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany;
- Hertie Institute for Clinical Brain Research, Eberhard Karls University Tübingen Center of Neuro-Oncology, Ottfried-Müller-Straße 27, 72076 Tübingen, Germany
- Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital of Tuebingen, Eberhard Karls University of Tübingen, Herrenberger Straße 23, 72070 Tübingen, Germany
| | - Daniel Feucht
- Department of Neurosurgery, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany;
| | - Arne Estler
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
| | - Antje Bornemann
- Department of Neuropathology, Institute of Pathology and Neuropathology, University Hospital Tübingen, Calwerstraße 3, 72076 Tübingen, Germany;
| | - Leonie Zerweck
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
| | - Eliane Weinbrenner
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
| | - Christer Ruff
- Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls-University Tübingen, 72076 Tübingen, Germany; (T.-K.H.); (A.E.); (L.Z.); (E.W.); (U.E.); (C.R.)
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