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Performance of PROPELLER relative to standard FSE T2-weighted imaging in pediatric brain MRI
A Talia Vertinsky1, Erika Rubesova, Michael V Krasnokutsky
1Department of Radiology, Vancouver General Hospital, Vancouver, Canada V5Z 1M9. talia.vertinsky@vch.ca
Background:
T2-weighted fast spin-echo imaging (T2-W FSE) is frequently degraded by motion in pediatric patients. MR imaging with periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) employs alternate sampling of k-space to achieve motion reduction.
Objective:
To compare T2-W PROPELLER FSE (T2-W PROP) with conventional T2-W FSE for: (1) image quality; (2) presence of artefacts; and (3) ability to detect lesions.
Materials And Methods:
Ninety-five pediatric patients undergoing brain MRI (1.5 T) were evaluated with T2-W FSE and T2-W PROP. Three independent radiologists rated T2-W FSE and T2-W PROP, assessing image quality, presence of artefacts, and diagnostic confidence. Chi-square analysis and Wilcoxon signed rank test were used to assess the radiologists' responses.
Results:
Compared with T2-W FSE, T2-W PROP demonstrated better image quality and reduced motion artefacts, with the greatest benefit in children younger than 6 months. Although detection rates were comparable for the two sequences, blood products were more conspicuous on T2-W FSE. Diagnostic confidence was higher using T2-W PROP in children younger than 6 months. Average inter-rater agreement was 87%.
Conclusion:
T2-W PROP showed reduced motion artefacts and improved diagnostic confidence in children younger than 6 months. Thus, use of T2-W PROP rather than T2-W FSE should be considered in routine imaging of this age group, with caution required in identifying blood products.
Insights
T2-weighted PROPELLER FSE (T2-W PROP) significantly reduces motion artifacts in pediatric brain MRI compared to conventional T2-weighted FSE (T2-W FSE). This technique improves image quality and diagnostic confidence, especially in infants under 6 months.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric Neurology
Background:
- Pediatric brain MRI often suffers from motion-related artifacts with T2-weighted fast spin-echo imaging (T2-W FSE).
- Periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) is a technique designed to mitigate motion artifacts in MRI.
Purpose of the Study:
- To compare the image quality, artifact presence, and lesion detection capabilities of T2-W PROPELLER FSE (T2-W PROP) against conventional T2-W FSE.
- To evaluate the diagnostic confidence provided by each imaging sequence in pediatric patients.
Main Methods:
- Ninety-five pediatric patients underwent 1.5 T brain MRI using both T2-W FSE and T2-W PROP sequences.
- Three independent radiologists assessed image quality, artifacts, and diagnostic confidence for both sequences.
- Statistical analysis included chi-square and Wilcoxon signed rank tests.
Main Results:
- T2-W PROP demonstrated superior image quality and reduced motion artifacts compared to T2-W FSE, particularly in infants younger than 6 months.
- Lesion detection rates were similar between the two sequences, though blood products were more visible on T2-W FSE.
- Diagnostic confidence was higher with T2-W PROP in the youngest patient group.
Conclusions:
- T2-W PROP is recommended for routine pediatric brain imaging, especially for children under 6 months, due to reduced motion artifacts and improved diagnostic confidence.
- Caution is advised when identifying blood products with T2-W PROP, as they are more conspicuous on T2-W FSE.
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