Feasibility study of fast T2-weighted imaging with deep-learning reconstruction in volunteers and emergency patients with acute abdomen.

PURPOSE: To evaluate the image quality and clinical utility of DLR-enhanced single-shot fast spin-echo (SSFSE) T2-weighted imaging (T2WI) for diagnosing acute abdominal conditions, compared to standard SSFSE and Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) T2WI sequences.

METHODS

This prospective single-institutional study enrolled 70 participants (35 healthy volunteers and 35 patients with acute abdominal pain). Abdominopelvic MRI were performed, including SSFSE and PROPELLER sequences. SSFSE images were reconstructed with and without deep-learning algorithm. Three radiologists independently evaluated image quality and target organ conditions. The Friedman test was used to compare image quality across sequences. The diagnostic performance for identifying disorders (e.g., cholecystitis, appendicitis, etc.) was assessed using the area under receiver operating characteristic curves (AUCs) and compared using the Delong method. Three pregnant women and one elderly patient who underwent SSFSE protocols only were also analyzed.

RESULTS

SSFSE-DLR demonstrated significantly higher image quality and lower noise than SSFSE and PROPELLER across all imaging planes (p < 0.05). It exhibited fewer motion artifacts and superior clarity of the appendix, gallbladder, and common bile duct compared to PROPELLER (p < 0.05). SSFSE-DLR achieved higher diagnostic accuracy for common acute abdominopelvic disorders (AUCs: 0.977-1.0), compared to SSFSE and PROPELLER (AUCs: 0.887-1.00 and 0.585-0.953, respectively, p < 0.05). In vulnerable patients with fast protocol, SSFSE-DLR identified one appendicitis missed by ultrasound, enabling timely surgery.

CONCLUSION

SSFSE-DLR significantly improves image quality and diagnostic accuracy in healthy volunteers and patients with acute abdomen.