Deep Learning-Accelerated Non-Contrast Abbreviated Liver MRI for Detecting Malignant Focal Hepatic Lesions: Dual-Center Validation.

OBJECTIVE

To compare a deep learning (DL)-accelerated non-enhanced abbreviated MRI (AMRIDL) protocol with standard AMRI (AMRISTD) of the liver in terms of image quality and malignant focal lesion detection.

MATERIALS AND

METHODS

This retrospective study included 155 consecutive patients (110 male; mean age 62.4 ± 11 years) from two sites who underwent standard liver MRI and additional AMRIDL sequences, specifically DL-accelerated single-shot fast-spin echo (SSFSEDL) and DL-accelerated diffusion-weighted imaging (DWIDL). Additional MRI phantom experiments assessed signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) values. Three reviewers evaluated AMRIDL and AMRISTD protocols for image quality using a five-point Likert scale and identified malignant hepatic lesions. Image quality scores and per-lesion sensitivities were compared between AMRIDL and AMRISTD using the Wilcoxon signed-rank test and logistic regression with generalized estimating equations, respectively.

RESULTS

Phantom experiments demonstrated comparable SNR and higher CNR for SSFSEDL compared to SSFSESTD, with similar ADC values for DWIDL and DWISTD. Among the 155 patients, 130 (83.9%) had chronic liver disease or a history of intra- or extrahepatic malignancy. Of 104 malignant focal lesions in 64 patients, 58 (55.8%) were hepatocellular carcinomas (HCCs), 38 (36.5%) were metastases, four (3.8%) were cholangiocarcinomas, and four (3.8%) were lymphomas. The pooled per-lesion sensitivity across three readers was 97.6% for AMRIDL, comparable to 97.6% for AMRISTD. Compared with AMRISTD, AMRIDL demonstrated superior image quality regarding structural sharpness, artifacts, and noise (all P < 0.001) and reduced the average scan time by approximately 50% (2 min 29 sec vs. 4 min 11 sec). In patients with chronic liver disease, AMRIDL achieved a 96.6% per-lesion sensitivity for HCC detection, similar to 96.5% for AMRISTD (P > 0.05).

CONCLUSION

The AMRIDL protocol offers comparable sensitivity for detecting malignant focal lesions, including HCC while significantly enhancing image quality and reducing scan time by approximately 50% compared to AMRISTD.