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Chen Y, Gao Y, Fu X, Chen Y, Wu J, Guo C, Li X. Automatic 3D reconstruction of vertebrae from orthogonal bi-planar radiographs. Sci Rep 2024; 14:16165. [PMID: 39003269 PMCID: PMC11246511 DOI: 10.1038/s41598-024-65795-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/24/2024] [Indexed: 07/15/2024] Open
Abstract
When conducting spine-related diagnosis and surgery, the three-dimensional (3D) upright posture of the spine under natural weight bearing is of significant clinical value for physicians to analyze the force on the spine. However, existing medical imaging technologies cannot meet current requirements of medical service. On the one hand, the mainstream 3D volumetric imaging modalities (e.g. CT and MRI) require patients to lie down during the imaging process. On the other hand, the imaging modalities conducted in an upright posture (e.g. radiograph) can only realize 2D projections, which lose the valid information of spinal anatomy and curvature. Developments of deep learning-based 3D reconstruction methods bring potential to overcome the limitations of the existing medical imaging technologies. To deal with the limitations of current medical imaging technologies as is described above, in this paper, we propose a novel deep learning framework, ReVerteR, which can realize automatic 3D Reconstruction of Vertebrae from orthogonal bi-planar Radiographs. With the utilization of self-attention mechanism and specially designed loss function combining Dice, Hausdorff, Focal, and MSE, ReVerteR can alleviate the sample-imbalance problem during the reconstruction process and realize the fusion of the centroid annotation and the focused vertebra. Furthermore, aiming at automatic and customized 3D spinal reconstruction in real-world scenarios, we extend ReVerteR to a clinical deployment-oriented framework, and develop an interactive interface with all functions in the framework integrated so as to enhance human-computer interaction during clinical decision-making. Extensive experiments and visualization conducted on our constructed datasets based on two benchmark datasets of spinal CT, VerSe 2019 and VerSe 2020, demonstrate the effectiveness of our proposed ReVerteR. In this paper, we propose an automatic 3D reconstruction method of vertebrae based on orthogonal bi-planar radiographs. With the 3D upright posture of the spine under natural weight bearing effectively constructed, our proposed method is expected to better support doctors make clinical decision during spine-related diagnosis and surgery.
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Affiliation(s)
- Yuepeng Chen
- School of Computer Science (National Pilot Software Engineering School), Beijing University of Posts and Telecommunications, Beijing, 100876, China
- Key Laboratory of Trustworthy Distributed Computing and Service (BUPT), Ministry of Education, Beijing, 100876, China
- Institute for Intelligent Healthcare, Tsinghua University, Beijing, 100084, China
| | - Yue Gao
- School of Computer Science (National Pilot Software Engineering School), Beijing University of Posts and Telecommunications, Beijing, 100876, China
- Key Laboratory of Trustworthy Distributed Computing and Service (BUPT), Ministry of Education, Beijing, 100876, China
| | - Xiangling Fu
- School of Computer Science (National Pilot Software Engineering School), Beijing University of Posts and Telecommunications, Beijing, 100876, China.
- Key Laboratory of Trustworthy Distributed Computing and Service (BUPT), Ministry of Education, Beijing, 100876, China.
| | - Yingyin Chen
- Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai, 519000, China
| | - Ji Wu
- Institute for Intelligent Healthcare, Tsinghua University, Beijing, 100084, China.
- Department of Electronic Engineering, Tsinghua University, Beijing, 100084, China.
- College of AI, Tsinghua University, Beijing, 100084, China.
| | - Chenyi Guo
- Institute for Intelligent Healthcare, Tsinghua University, Beijing, 100084, China.
- Department of Electronic Engineering, Tsinghua University, Beijing, 100084, China.
| | - Xiaodong Li
- Department of Spine and Osteology, Zhuhai People's Hospital, Zhuhai, 519000, China.
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Awan KM, Goncalves Filho ALM, Tabari A, Applewhite BP, Lang M, Lo WC, Sellers R, Kollasch P, Clifford B, Nickel D, Husseni J, Rapalino O, Schaefer P, Cauley S, Huang SY, Conklin J. Diagnostic evaluation of deep learning accelerated lumbar spine MRI. Neuroradiol J 2024; 37:323-331. [PMID: 38195418 PMCID: PMC11138337 DOI: 10.1177/19714009231224428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND AND PURPOSE Deep learning (DL) accelerated MR techniques have emerged as a promising approach to accelerate routine MR exams. While prior studies explored DL acceleration for specific lumbar MRI sequences, a gap remains in comprehending the impact of a fully DL-based MRI protocol on scan time and diagnostic quality for routine lumbar spine MRI. To address this, we assessed the image quality and diagnostic performance of a DL-accelerated lumbar spine MRI protocol in comparison to a conventional protocol. METHODS We prospectively evaluated 36 consecutive outpatients undergoing non-contrast enhanced lumbar spine MRIs. Both protocols included sagittal T1, T2, STIR, and axial T2-weighted images. Two blinded neuroradiologists independently reviewed images for foraminal stenosis, spinal canal stenosis, nerve root compression, and facet arthropathy. Grading comparison employed the Wilcoxon signed rank test. For the head-to-head comparison, a 5-point Likert scale to assess image quality, considering artifacts, signal-to-noise ratio (SNR), anatomical structure visualization, and overall diagnostic quality. We applied a 15% noninferiority margin to determine whether the DL-accelerated protocol was noninferior. RESULTS No significant differences existed between protocols when evaluating foraminal and spinal canal stenosis, nerve compression, or facet arthropathy (all p > .05). The DL-spine protocol was noninferior for overall diagnostic quality and visualization of the cord, CSF, intervertebral disc, and nerve roots. However, it exhibited reduced SNR and increased artifact perception. Interobserver reproducibility ranged from moderate to substantial (κ = 0.50-0.76). CONCLUSION Our study indicates that DL reconstruction in spine imaging effectively reduces acquisition times while maintaining comparable diagnostic quality to conventional MRI.
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Affiliation(s)
- Komal M Awan
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | | | - Azadeh Tabari
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | - Brooks P Applewhite
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | - Min Lang
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | | | | | | | | | | | - Jad Husseni
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | - Otto Rapalino
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | - Pamela Schaefer
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
| | | | - Susie Y Huang
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, USA
| | - John Conklin
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Harvard Medical School, USA
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Sneag DB, Queler SC, Campbell G, Colucci PG, Lin J, Lin Y, Wen Y, Li Q, Tan ET. Optimized 3D brachial plexus MR neurography using deep learning reconstruction. Skeletal Radiol 2024; 53:779-789. [PMID: 37914895 DOI: 10.1007/s00256-023-04484-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/12/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To evaluate whether 'fast,' unilateral, brachial plexus, 3D magnetic resonance neurography (MRN) acquisitions with deep learning reconstruction (DLR) provide similar image quality to longer, 'standard' scans without DLR. MATERIALS AND METHODS An IRB-approved prospective cohort of 30 subjects (13F; mean age = 50.3 ± 17.8y) underwent clinical brachial plexus 3.0 T MRN with 3D oblique-coronal STIR-T2-weighted-FSE. 'Standard' and 'fast' scans (time reduction = 23-48%, mean = 33%) were reconstructed without and with DLR. Evaluation of signal-to-noise ratio (SNR) and edge sharpness was performed for 4 image stacks: 'standard non-DLR,' 'standard DLR,' 'fast non-DLR,' and 'fast DLR.' Three raters qualitatively evaluated 'standard non-DLR' and 'fast DLR' for i) bulk motion (4-point scale), ii) nerve conspicuity of proximal and distal suprascapular and axillary nerves (5-point scale), and iii) nerve signal intensity, size, architecture, and presence of a mass (binary). ANOVA or Wilcoxon signed rank test compared differences. Gwet's agreement coefficient (AC2) assessed inter-rater agreement. RESULTS Quantitative SNR and edge sharpness were superior for DLR versus non-DLR (SNR by + 4.57 to + 6.56 [p < 0.001] for 'standard' and + 4.26 to + 4.37 [p < 0.001] for 'fast;' sharpness by + 0.23 to + 0.52/pixel for 'standard' [p < 0.018] and + 0.21 to + 0.25/pixel for 'fast' [p < 0.003]) and similar between 'standard non-DLR' and 'fast DLR' (SNR: p = 0.436-1, sharpness: p = 0.067-1). Qualitatively, 'standard non-DLR' and 'fast DLR' had similar motion artifact, as well as nerve conspicuity, signal intensity, size and morphology, with high inter-rater agreement (AC2: 'standard' = 0.70-0.98, 'fast DLR' = 0.69-0.97). CONCLUSION DLR applied to faster, 3D MRN acquisitions provides similar image quality to standard scans. A faster, DL-enabled protocol may replace currently optimized non-DL protocols.
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Affiliation(s)
- D B Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA.
- Weill Medical College of Cornell, New York, NY, USA.
| | - S C Queler
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
- College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - G Campbell
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
| | - P G Colucci
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
| | - J Lin
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
| | - Y Lin
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
| | - Y Wen
- GE Healthcare, Waukesha, WI, USA
| | - Q Li
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
| | - E T Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70Th St., New York, NY, 10021, USA
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Abel F, Tan ET, Lunenburg M, van Leeuwen C, van Hooren T, van Uden M, Arteaga C, Vincent J, Robb F, Sneag DB. Flexible array coil for cervical and extraspinal (FACE) MRI at 3.0 Tesla. Phys Med Biol 2023; 68:215011. [PMID: 37816375 DOI: 10.1088/1361-6560/ad0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/10/2023] [Indexed: 10/12/2023]
Abstract
Objective.High-resolution MRI of the cervical spine (c-spine) and extraspinal neck region requires close-fitting receiver coils to maximize the signal-to-noise ratio (SNR). Conventional, rigid C-spine receiver coils do not adequately contour to the neck to accommodate varying body shapes, resulting in suboptimal SNR. Recent innovations in flexible surface coil array designs may provide three-dimensional (3D) bendability and conformability to optimize SNR, while improving capabilities for higher acceleration factors.Approach.This work describes the design, implementation, and preliminaryin vivotesting of a novel, conformal 23-channel receive-only flexible array for cervical and extraspinal (FACE) MRI at 3-Tesla (T), with use of high-impedance elements to enhance the coil's flexibility. Coil performance was tested by assessing SNR and geometry factors (g-factors) in a phantom compared to a conventional 21-channel head-neck-unit (HNU).In vivoimaging was performed in healthy human volunteers and patients using high-resolution c-spine and neck MRI protocols at 3T, including MR neurography (MRN).Main results.Mean SNR with the FACE was 141%-161% higher at left, right, and posterior off-isocenter positions and 4% higher at the isocenter of the phantom compared to the HNU. Parallel imaging performance was comparable for an acceleration factor (R) = 2 × 2 between the two coils, but improved forR= 3 × 3 with meang-factors ranging from 1.46-2.15 with the FACE compared to 2.36-3.62 obtained with the HNU. Preliminary human volunteer and patient testing confirmed that equivalent or superior image quality could be obtained for evaluation of osseous and soft tissue structures of the cervical region with the FACE.Significance.A conformal and highly flexible cervical array with high-impedance coil elements can potentially enable higher-resolution imaging for cervical imaging.
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Affiliation(s)
- Frederik Abel
- Hospital for Special Surgery, 535 East 70th Street, NY 10021, United States of America
| | - Ek T Tan
- Hospital for Special Surgery, 535 East 70th Street, NY 10021, United States of America
| | - Martijn Lunenburg
- Tesla Dynamic Coils, Schimminck 12, 5301 Zaltbommel, The Netherlands
| | - Carel van Leeuwen
- Tesla Dynamic Coils, Schimminck 12, 5301 Zaltbommel, The Netherlands
| | - Thijs van Hooren
- Tesla Dynamic Coils, Schimminck 12, 5301 Zaltbommel, The Netherlands
| | - Mark van Uden
- Tesla Dynamic Coils, Schimminck 12, 5301 Zaltbommel, The Netherlands
| | - Catalina Arteaga
- Tesla Dynamic Coils, Schimminck 12, 5301 Zaltbommel, The Netherlands
| | - Jana Vincent
- GE HealthCare, 1515 Danner Dr, 44202 Aurora, OH, United States of America
| | - Fraser Robb
- GE HealthCare, 1515 Danner Dr, 44202 Aurora, OH, United States of America
| | - Darryl B Sneag
- Hospital for Special Surgery, 535 East 70th Street, NY 10021, United States of America
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Sahr ME, Miller TT. Pain After Hip Arthroplasty. Magn Reson Imaging Clin N Am 2023; 31:215-238. [PMID: 37019547 DOI: 10.1016/j.mric.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
MR imaging and ultrasound (US) have complementary roles for the comprehensive assessment of painful hip arthroplasty. Both modalities demonstrate synovitis, periarticular fluid collections, tendon tears and impingement, and neurovascular impingement, often with features indicating the causative etiology. MR imaging assessment requires technical modifications to reduce metal artifact, such as multispectral imaging, and optimization of image quality, and a high-performance 1.5-T system. US images periarticular structures at high-spatial resolution without interference of metal artifact, permitting real-time dynamic evaluation, and is useful for procedure guidance. Bone complications (periprosthetic fracture, stress reaction, osteolysis, and component loosening) are well depicted on MR imaging.
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Rapid lumbar MRI protocol using 3D imaging and deep learning reconstruction. Skeletal Radiol 2023; 52:1331-1338. [PMID: 36602576 DOI: 10.1007/s00256-022-04268-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Three-dimensional (3D) imaging of the spine, augmented with AI-enabled image enhancement and denoising, has the potential to reduce imaging times without compromising image quality or diagnostic performance. This work evaluates the time savings afforded by a novel, rapid lumbar spine MRI protocol as well as image quality and diagnostic differences stemming from the use of an AI-enhanced 3D T2 sequence combined with a single Dixon acquisition. MATERIALS AND METHODS Thirty-five subjects underwent MRI using standard 2D lumbar imaging in addition to a "rapid protocol" consisting of 3D imaging, enhanced and denoised using a prototype DL reconstruction algorithm as well as a two-point Dixon sequence. Images were graded by subspecialized radiologists and imaging times were collected. Comparison was made between 2D sagittal T1 and Dixon fat images for neural foraminal stenosis, intraosseous lesions, and fracture detection. RESULTS This study demonstrated a 54% reduction in total acquisition time of a 3D AI-enhanced imaging lumbar spine MRI rapid protocol combined with a sagittal 2D Dixon sequence, compared to a 2D standard-of-care protocol. The rapid protocol also demonstrated strong agreement with the standard-of-care protocol with respect to osseous lesions (κ = 0.88), fracture detection (κ = 0.96), and neural foraminal stenosis (ICC > 0.9 at all levels). CONCLUSION 3D imaging of the lumbar spine with AI-enhanced DL reconstruction and Dixon imaging demonstrated a significant reduction in imaging time with similar performance for common diagnostic metrics. Although previously limited by long postprocessing times, this technique has the potential to enhance patient throughput in busy radiology practices while providing similar or improved image quality.
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