Rationale and Objectives
Magnetic resonance imaging (MRI) of the hand and wrist is a routine MRI examination
and takes about 15-20 minutes, which can lead to problems resulting from the relatively
long scan time, such as decreased image quality due to motion artifacts and lower
patient throughput.
The objective of this study was to evaluate a deep learning (DL) reconstruction for
turbo spin echo (TSE) sequences of the hand and wrist regarding image quality, visualization
of anatomy, and diagnostic performance concerning common pathologies.
Materials and Methods
Twenty-one patients (mean age: 43 ± 19 [19-85] years, 10 men, 11 female) were prospectively
enrolled in this study between October 2020 and June 2021. Each participant underwent
two MRI protocols: first, standard fully sampled TSE sequences reconstructed with
a standard GRAPPA reconstruction (TSES) and second, prospectively undersampled TSE sequences using a conventional parallel
imaging undersampling pattern reconstructed with a DL reconstruction (TSEDL). Both protocols were acquired consecutively in one examination. Two experienced
MSK-imaging radiologists qualitatively evaluated the images concerning image quality,
noise, edge sharpness, artifacts, and diagnostic confidence, as well as the delineation
of anatomical structures (triangular fibrocartilage complex, tendon of the extensor
carpi ulnaris muscle, extrinsic and intrinsic ligaments, median nerve, cartilage)
using a five-point Likert scale and assessed common pathologies. Wilcoxon signed-rank
test and kappa statistics were performed to compare the sequences.
Results
Overall image quality, artifacts, delineation of anatomical structures, and diagnostic
confidence of TSEDL were rated to be comparable to TSES (p > 0.05). Additionally, TSEDL showed decreased image noise (4.90, median 5, IQR 5-5) compared to TSES (4.52, median 5, IQR 4-5, p < 0.05) and improved edge sharpness (TSEDL: 4.10, median 4, IQR 3.5-5; TSES: 3.57, median 4, IQR 3-4; p < 0.05). Inter- and intrareader agreement was substantial to almost perfect (κ = 0.632-1.000)
for the detection of common pathologies. Time of acquisition could be reduced by more
than 60% with the protocol using TSEDL.
Conclusion
Compared to TSES, TSEDL provided decreased noise and increased edge sharpness, equal image quality, delineation
of anatomical structures, detection of pathologies, and diagnostic confidence. Therefore,
TSEDL may be clinically relevant for hand and wrist imaging, as it reduces examination
time by more than 60%, thus increasing patient comfort and patient throughput.
Key Words
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Article info
Publication history
Published online: February 14, 2023
Accepted:
December 26,
2022
Received in revised form:
December 20,
2022
Received:
November 1,
2022
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: The authors declare no conflict of interest.
Funding: This research received no external funding.
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of The Association of University Radiologists.
