Accelerated MRI reconstructions via variational network and feature domain learning.

We introduce three architecture modifications to enhance the performance of the end-to-end (E2E) variational network (VarNet) for undersampled MRI reconstructions. We first implemented the Feature VarNet, which propagates information throughout the cascades of the network in an N-channel feature-space instead of a 2-channel feature-space. Then, we add an attention layer that utilizes the spatial locations of Cartesian undersampling artifacts to further improve performance. Lastly, we combined the Feature and E2E VarNets into the Feature-Image (FI) VarNet, to facilitate cross-domain learning and boost accuracy. Reconstructions were evaluated on the fastMRI dataset using standard metrics and clinical scoring by three neuroradiologists. Feature and FI VarNets outperformed the E2E VarNet for 4 × , 5 × and 8 × Cartesian undersampling in all studied metrics. FI VarNet secured second place in the public fastMRI leaderboard for 4 × Cartesian undersampling, outperforming all open-source models in the leaderboard. Radiologists rated FI VarNet brain reconstructions with higher quality and sharpness than the E2E VarNet reconstructions. FI VarNet excelled in preserving anatomical details, including blood vessels, whereas E2E VarNet discarded or blurred them in some cases. The proposed FI VarNet enhances the reconstruction quality of undersampled MRI and could enable clinically acceptable reconstructions at higher acceleration factors than currently possible.

FastMRI Prostate: A public, biparametric MRI dataset to advance machine learning for prostate cancer imaging.

Magnetic resonance imaging (MRI) has experienced remarkable advancements in the integration of artificial intelligence (AI) for image acquisition and reconstruction. The availability of raw k-space data is crucial for training AI models in such tasks, but public MRI datasets are mostly restricted to DICOM images only. To address this limitation, the fastMRI initiative released brain and knee k-space datasets, which have since seen vigorous use. In May 2023, fastMRI was expanded to include biparametric (T2- and diffusion-weighted) prostate MRI data from a clinical population. Biparametric MRI plays a vital role in the diagnosis and management of prostate cancer. Advances in imaging methods, such as reconstructing under-sampled data from accelerated acquisitions, can improve cost-effectiveness and accessibility of prostate MRI. Raw k-space data, reconstructed images and slice, volume and exam level annotations for likelihood of prostate cancer are provided in this dataset for 47468 slices corresponding to 1560 volumes from 312 patients. This dataset facilitates AI and algorithm development for prostate image reconstruction, with the ultimate goal of enhancing prostate cancer diagnosis.

FastMRI Prostate: A Publicly Available, Biparametric MRI Dataset to Advance Machine Learning for Prostate Cancer Imaging.

The fastMRI brain and knee dataset has enabled significant advances in exploring reconstruction methods for improving speed and image quality for Magnetic Resonance Imaging (MRI) via novel, clinically relevant reconstruction approaches. In this study, we describe the April 2023 expansion of the fastMRI dataset to include biparametric prostate MRI data acquired on a clinical population. The dataset consists of raw k-space and reconstructed images for T2-weighted and diffusion-weighted sequences along with slice-level labels that indicate the presence and grade of prostate cancer. As has been the case with fastMRI, increasing accessibility to raw prostate MRI data will further facilitate research in MR image reconstruction and evaluation with the larger goal of improving the utility of MRI for prostate cancer detection and evaluation. The dataset is available at https://fastmri.med.nyu.edu.

Deep Learning Reconstruction Enables Prospectively Accelerated Clinical Knee MRI.

Background MRI is a powerful diagnostic tool with a long acquisition time. Recently, deep learning (DL) methods have provided accelerated high-quality image reconstructions from undersampled data, but it is unclear if DL image reconstruction can be reliably translated to everyday clinical practice. Purpose To determine the diagnostic equivalence of prospectively accelerated DL-reconstructed knee MRI compared with conventional accelerated MRI for evaluating internal derangement of the knee in a clinical setting. Materials and Methods A DL reconstruction model was trained with images from 298 clinical 3-T knee examinations. In a prospective analysis, patients clinically referred for knee MRI underwent a conventional accelerated knee MRI protocol at 3 T followed by an accelerated DL protocol between January 2020 and February 2021. The equivalence of the DL reconstruction of the images relative to the conventional images for the detection of an abnormality was assessed in terms of interchangeability. Each examination was reviewed by six musculoskeletal radiologists. Analyses pertaining to the detection of meniscal or ligament tears and bone marrow or cartilage abnormalities were based on four-point ordinal scores for the likelihood of an abnormality. Additionally, the protocols were compared with use of four-point ordinal scores for each aspect of image quality: overall image quality, presence of artifacts, sharpness, and signal-to-noise ratio. Results A total of 170 participants (mean age ± SD, 45 years ± 16; 76 men) were evaluated. The DL-reconstructed images were determined to be of diagnostic equivalence with the conventional images for detection of abnormalities. The overall image quality score, averaged over six readers, was significantly better (P < .001) for the DL than for the conventional images. Conclusion In a clinical setting, deep learning reconstruction enabled a nearly twofold reduction in scan time for a knee MRI and was diagnostically equivalent with the conventional protocol. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Roemer in this issue.

New-Generation Low-Field Magnetic Resonance Imaging of Hip Arthroplasty Implants Using Slice Encoding for Metal Artifact Correction: First In Vitro Experience at 0.55 T and Comparison With 1.5 T.

OBJECTIVES: Despite significant progress, artifact-free visualization of the bone and soft tissues around hip arthroplasty implants remains an unmet clinical need. New-generation low-field magnetic resonance imaging (MRI) systems now include slice encoding for metal artifact correction (SEMAC), which may result in smaller metallic artifacts and better image quality than standard-of-care 1.5 T MRI. This study aims to assess the feasibility of SEMAC on a new-generation 0.55 T system, optimize the pulse protocol parameters, and compare the results with those of a standard-of-care 1.5 T MRI. MATERIALS AND METHODS: Titanium (Ti) and cobalt-chromium total hip arthroplasty implants embedded in a tissue-mimicking American Society for Testing and Materials gel phantom were evaluated using turbo spin echo, view angle tilting (VAT), and combined VAT and SEMAC (VAT + SEMAC) pulse sequences. To refine an MRI protocol at 0.55 T, the type of metal artifact reduction techniques and the effect of various pulse sequence parameters on metal artifacts were assessed through qualitative ranking of the images by 3 expert readers while taking measured spatial resolution, signal-to-noise ratios, and acquisition times into consideration. Signal-to-noise ratio efficiency and artifact size of the optimized 0.55 T protocols were compared with the 1.5 T standard and compressed-sensing SEMAC sequences. RESULTS: Overall, the VAT + SEMAC sequence with at least 6 SEMAC encoding steps for Ti and 9 for cobalt-chromium implants was ranked higher than other sequences for metal reduction ( P < 0.05). Additional SEMAC encoding partitions did not result in further metal artifact reductions. Permitting minimal residual artifacts, low magnetic susceptibility Ti constructs may be sufficiently imaged with optimized turbo spin echo sequences obviating the need for SEMAC. In cross-platform comparison, 0.55 T acquisitions using the optimized protocols are associated with 45% to 64% smaller artifacts than 1.5 T VAT + SEMAC and VAT + compressed-sensing/SEMAC protocols at the expense of a 17% to 28% reduction in signal-to-noise ratio efficiency. B 1 -related artifacts are invariably smaller at 0.55 T than 1.5 T; however, artifacts related to B 0 distortion, although frequently smaller, may appear as signal pileups at 0.55 T. CONCLUSIONS: Our results suggest that new-generation low-field SEMAC MRI reduces metal artifacts around hip arthroplasty implants to better advantage than current 1.5 T MRI standard of care. While the appearance of B 0 -related artifacts changes, reduction in B 1 -related artifacts plays a major role in the overall benefit of 0.55 T.

Deep Learning Reconstruction Enables Highly Accelerated Biparametric MR Imaging of the Prostate.

BACKGROUND: Early diagnosis and treatment of prostate cancer (PCa) can be curative; however, prostate-specific antigen is a suboptimal screening test for clinically significant PCa. While prostate magnetic resonance imaging (MRI) has demonstrated value for the diagnosis of PCa, the acquisition time is too long for a first-line screening modality. PURPOSE: To accelerate prostate MRI exams, utilizing a variational network (VN) for image reconstruction. STUDY TYPE: Retrospective. SUBJECTS: One hundred and thirteen subjects (train/val/test: 70/13/30) undergoing prostate MRI. FIELD STRENGTH/SEQUENCE: 3.0 T; a T2 turbo spin echo (TSE) T2-weighted image (T2WI) sequence in axial and coronal planes, and axial echo-planar diffusion-weighted imaging (DWI). ASSESSMENT: Four abdominal radiologists evaluated the image quality of VN reconstructions of retrospectively under-sampled biparametric MRIs (bp-MRI), and standard bp-MRI reconstructions for 20 test subjects (studies). The studies included axial and coronal T2WI, DWI B50 seconds/mm2 and B1000 seconds/mm (4-fold T2WI, 3-fold DWI), all of which were evaluated separately for image quality on a Likert scale (1: non-diagnostic to 5: excellent quality). In another 10 test subjects, three readers graded lesions on bp-MRI-which additionally included calculated B1500 seconds/mm2 , and apparent diffusion coefficient map-according to the Prostate Imaging Reporting and Data System (PI-RADS v2.1), for both VN and standard reconstructions. Accuracy of PI-RADS ≥3 for clinically significant cancer was computed. Projected scan time of the retrospectively under-sampled biparametric exam was also computed. STATISTICAL TESTS: One-sided Wilcoxon signed-rank test was used for comparison of image quality. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for lesion detection and grading. Generalized estimating equation with cluster effect was used to compare differences between standard and VN bp-MRI. A P-value of <0.05 was considered statistically significant. RESULTS: Three of four readers rated no significant difference for overall quality between the standard and VN axial T2WI (Reader 1: 4.00 ± 0.56 (Standard), 3.90 ± 0.64 (VN) P = 0.33; Reader 2: 4.35 ± 0.74 (Standard), 3.80 ± 0.89 (VN) P = 0.003; Reader 3: 4.60 ± 0.50 (Standard), 4.55 ± 0.60 (VN) P = 0.39; Reader 4: 3.65 ± 0.99 (Standard), 3.60 ± 1.00 (VN) P = 0.38). All four readers rated no significant difference for overall quality between standard and VN DWI B1000 seconds/mm2 (Reader 1: 2.25 ± 0.62 (Standard), 2.45 ± 0.75 (VN) P = 0.96; Reader 2: 3.60 ± 0.92 (Standard), 3.55 ± 0.82 (VN) P = 0.40; Reader 3: 3.85 ± 0.72 (Standard), 3.55 ± 0.89 (VN) P = 0.07; Reader 4: 4.70 ± 0.76 (Standard); 4.60 ± 0.73 (VN) P = 0.17) and three of four readers rated no significant difference for overall quality between standard and VN DWI B50 seconds/mm2 (Reader 1: 3.20 ± 0.70 (Standard), 3.40 ± 0.75 (VN) P = 0.98; Reader 2: 2.85 ± 0.81 (Standard), 3.00 ± 0.79 (VN) P = 0.93; Reader 3: 4.45 ± 0.72 (Standard), 4.05 ± 0.69 (VN) P = 0.02; Reader 4: 4.50 ± 0.69 (Standard), 4.45 ± 0.76 (VN) P = 0.50). In the lesion evaluation study, there was no significant difference in the number of PI-RADS ≥3 lesions identified on standard vs. VN bp-MRI (P = 0.92, 0.59, 0.87) with similar sensitivity and specificity for clinically significant cancer. The average scan time of the standard clinical biparametric exam was 11.8 minutes, and this was projected to be 3.2 minutes for the accelerated exam. DATA CONCLUSION: Diagnostic accelerated biparametric prostate MRI exams can be performed using deep learning methods in <4 minutes, potentially enabling rapid screening prostate MRI. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 5.

Artificial Intelligence for MR Image Reconstruction: An Overview for Clinicians.

Artificial intelligence (AI) shows tremendous promise in the field of medical imaging, with recent breakthroughs applying deep-learning models for data acquisition, classification problems, segmentation, image synthesis, and image reconstruction. With an eye towards clinical applications, we summarize the active field of deep-learning-based MR image reconstruction. We review the basic concepts of how deep-learning algorithms aid in the transformation of raw k-space data to image data, and specifically examine accelerated imaging and artifact suppression. Recent efforts in these areas show that deep-learning-based algorithms can match and, in some cases, eclipse conventional reconstruction methods in terms of image quality and computational efficiency across a host of clinical imaging applications, including musculoskeletal, abdominal, cardiac, and brain imaging. This article is an introductory overview aimed at clinical radiologists with no experience in deep-learning-based MR image reconstruction and should enable them to understand the basic concepts and current clinical applications of this rapidly growing area of research across multiple organ systems.

Rapid mono and biexponential 3D-T1ρ mapping of knee cartilage using variational networks.

In this study we use undersampled MRI acquisition methods to obtain accelerated 3D mono and biexponential spin-lattice relaxation time in the rotating frame (T1ρ) mapping of knee cartilage, reducing the usual long scan time. We compare the accelerated T1ρ maps obtained by deep learning-based variational network (VN) and compressed sensing (CS). Both methods were compared with spatial (S) and spatio-temporal (ST) filters. Complex-valued fitting was used for T1ρ parameters estimation. We tested with seven in vivo and six synthetic datasets, with acceleration factors (AF) from 2 to 10. Median normalized absolute deviation (MNAD), analysis of variance (ANOVA), and coefficient of variation (CV) were used for analysis. The methods CS-ST, VN-S, and VN-ST performed well for accelerating monoexponential T1ρ mapping, with MNAD around 5% for AF = 2, which increases almost linearly with the AF to an MNAD of 13% for AF = 8, with all methods. For biexponential mapping, the VN-ST was the best method starting with MNAD of 7.4% for AF = 2 and reaching MNAD of 13.1% for AF = 8. The VN was able to produce 3D-T1ρ mapping of knee cartilage with lower error than CS. The best results were obtained by VN-ST, improving CS-ST method by nearly 7.5%.

Improving the Speed of MRI with Artificial Intelligence.

Magnetic resonance imaging (MRI) is a leading image modality for the assessment of musculoskeletal (MSK) injuries and disorders. A significant drawback, however, is the lengthy data acquisition. This issue has motivated the development of methods to improve the speed of MRI. The field of artificial intelligence (AI) for accelerated MRI, although in its infancy, has seen tremendous progress over the past 3 years. Promising approaches include deep learning methods for reconstructing undersampled MRI data and generating high-resolution from low-resolution data. Preliminary studies show the promise of the variational network, a state-of-the-art technique, to generalize to many different anatomical regions and achieve comparable diagnostic accuracy as conventional methods. This article discusses the state-of-the-art methods, considerations for clinical applicability, followed by future perspectives for the field.

Conditional generative adversarial network for 3D rigid-body motion correction in MRI.

PURPOSE: Subject motion in MRI remains an unsolved problem; motion during image acquisition may cause blurring and artifacts that severely degrade image quality. In this work, we approach motion correction as an image-to-image translation problem, which refers to the approach of training a deep neural network to predict an image in 1 domain from an image in another domain. Specifically, the purpose of this work was to develop and train a conditional generative adversarial network to predict artifact-free brain images from motion-corrupted data. METHODS: An open source MRI data set comprising T2 *-weighted, FLASH magnitude, and phase brain images for 53 patients was used to generate complex image data for motion simulation. To simulate rigid motion, rotations and translations were applied to the image data based on randomly generated motion profiles. A conditional generative adversarial network, comprising a generator and discriminator networks, was trained using the motion-corrupted and corresponding ground truth (original) images as training pairs. RESULTS: The images predicted by the conditional generative adversarial network have improved image quality compared to the motion-corrupted images. The mean absolute error between the motion-corrupted and ground-truth images of the test set was 16.4% of the image mean value, whereas the mean absolute error between the conditional generative adversarial network-predicted and ground-truth images was 10.8% The network output also demonstrated improved peak SNR and structural similarity index for all test-set images. CONCLUSION: The images predicted by the conditional generative adversarial network have quantitatively and qualitatively improved image quality compared to the motion-corrupted images.

Retrospective 3D motion correction using spherical navigator echoes.

PURPOSE: To develop and evaluate a rapid spherical navigator echo (SNAV) motion correction technique, then apply it for retrospective correction of brain images. METHODS: The pre-rotated, template matching SNAV method (preRot-SNAV) was developed in combination with a novel hybrid baseline strategy, which includes acquired and interpolated templates. Specifically, the SNAV templates are only rotated around X- and Y-axis; for each rotated SNAV, simulated baseline templates that mimic object rotation about the Z-axis were interpolated. The new method was first evaluated with phantom experiments. Then, a customized SNAV-interleaved gradient echo sequence was used to image three volunteers performing directed head motion. The SNAV motion measurements were used to retrospectively correct the brain images. Experiments were performed using a 3.0T whole-body MRI scanner and both single and 8-channel head coils. RESULTS: Phantom rotations and translations measured using the hybrid baselines agreed to within 0.9° and 1mm compared to those measured with the original preRot-SNAV method. Retrospective motion correction of in vivo images using the hybrid preRot-SNAV effectively corrected for head rotation up to 4° and 4mm. CONCLUSIONS: The presented hybrid approach enables the acquisition of pre-rotated baseline templates in as little as 2.5s, and results in accurate measurement of rotations and translations. Retrospective 3D motion correction successfully reduced motion artifacts in vivo.

Design and evaluation of an MRI-compatible linear motion stage.

PURPOSE: To develop and evaluate a tool for accurate, reproducible, and programmable motion control of imaging phantoms for use in motion sensitive magnetic resonance imaging (MRI) appli cations. METHODS: In this paper, the authors introduce a compact linear motion stage that is made of nonmagnetic material and is actuated with an ultrasonic motor. The stage can be positioned at arbitrary positions and orientations inside the scanner bore to move, push, or pull arbitrary phantoms. Using optical trackers, measuring microscopes, and navigators, the accuracy of the stage in motion control was evaluated. Also, the effect of the stage on image signal-to-noise ratio (SNR), artifacts, and B0 field homogeneity was evaluated. RESULTS: The error of the stage in reaching fixed positions was 0.025 ± 0.021 mm. In execution of dynamic motion profiles, the worst-case normalized root mean squared error was below 7% (for frequencies below 0.33 Hz). Experiments demonstrated that the stage did not introduce artifacts nor did it degrade the image SNR. The effect of the stage on the B0 field was less than 2 ppm. CONCLUSIONS: The results of the experiments indicate that the proposed system is MRI-compatible and can create reliable and reproducible motion that may be used for validation and assessment of motion related MRI applications.

International profiles of dental hygiene 1987 to 2006: a 21-nation comparative study.

This international longitudinal study examines trends and changes in dental hygiene. Information was collected from national dental hygienists' associations through a series of five surveys conducted between 1987 and 2006; sample sizes increased from thirteen to twenty-five countries. As dental hygiene has evolved, it has remained remarkably consistent globally, in particular its scope of clinical practice. Regarding historical development, predominant work setting, and professional organisation, the profession was more similar than dissimilar. Greater variation existed regarding the supply, education, regulation, workforce behaviour and remuneration of dental hygienists. Over the 19-year period, there was a marked increase in supply accompanied by improved dental hygienist-to-population and to-dentist ratios, continuing high workforce participation rates, shift to and increase in the number of baccalaureate-level education programmes, and increase in scope of practice and professional autonomy including, for many countries, a decline in mandatory work supervision and slight increase in independent practice. By 2006, the profiles reflected the vast majority of the world's population of dental hygienists. While the rate of change varied, its nature was consistent overall, resulting in a continuing homogeneity in the profession worldwide. Observed trends and persisting issues have implications for service accessibility and technical efficiency and should continue to be monitored.

International profiles of dental hygiene 1987 to 2001: a 19-nation comparative study.

AIM: The purpose of this international longitudinal study is to examine patterns and monitor trends and changes in dental hygiene. METHOD: Information was collected from national dental hygienists' associations through surveys conducted in 1987, 1992, 1998 and 2001. Sample size increased from 13 countries in 1987 to 22 by 2001--of which 19 were included in the analysis. RESULTS: Overall, characteristics of the profession were remarkably similar; most noteworthy was the scope of dental hygiene clinical practice. Regarding historical development, educational programmes and professional organisation, the profession was more similar than dissimilar. Greater variation was evident regarding numbers, distribution, regulation, workforce behaviour, predominant work setting, and remuneration. Over the relatively short 14-year period, several observations were of particular interest: marked increase in the supply of dental hygienists, accompanied by a decline in their ratio to populations and to dentists and a high workforce participation rate; increase in baccalaureate dental hygiene programmes, with a gradual shift from the diploma as the entry-level qualification; and increase in scope of practice and professional autonomy, including for Europe and North America in particular, a decline in mandated level of work supervision and a slight but gradual increase in independent practice. CONCLUSION: By 2001, the profiles reflected the vast majority of the world's population of dental hygienists. Rate of change varied across the countries examined; however, the nature of the change overall was consistent, resulting in a continuing homogeneity in the profession worldwide. Observed trends, changes and persistent issues have implications for service accessibility and technical efficiency and should continue to be monitored.