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Deep learning-enhanced zero echo time silent brain magnetic resonance imaging in infants without sedation
Chanyoung Rhee1,2, Jae-Yeon Hwang1,2, Jae Won Choi1,2
1Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Background:
Reducing acoustic noise is essential in infant brain magnetic resonance imaging (MRI) to minimize the need for sedation. Deep learning (DL)-based MRI reconstruction may enhance the image quality of the zero echo time (ZTE) silent sequence.
Objective:
To evaluate the effect of DL-based reconstruction on the image quality of ZTE infant brain MRI using the feed-and-wrap technique, compared to conventional MRI with sedation.
Materials And Methods:
This retrospective study included 78 infants (postmenstrual age ≤16 months) who underwent brain MRI between January 2022 and December 2024. The control group underwent sedated 3-dimensional T1-weighted magnetization-prepared rapid gradient-echo (MPRAGE) imaging. The experimental group underwent unsedated inversion recovery-prepared ZTE imaging with and without DL-based reconstruction (ZTE-DL and ZTE, respectively), using the feed-and-wrap technique. Three radiologists independently rated five image quality metrics using a 5-point Likert scale. Signal uniformity was assessed by the coefficient of variation across eight brain regions. Differences among sequences were analyzed using the Mann-Whitney U test with Bonferroni correction. Interrater agreement was assessed using Cohen's kappa coefficient.
Results:
ZTE-DL had the highest scores for noisiness, gray-white matter differentiation, artifacts, and overall image quality. ZTE-DL showed no significant differences from MPRAGE except for reduced noisiness, while significantly outperforming ZTE across all metrics (all P<0.017). Lesion conspicuity did not differ significantly among the groups. Interrater agreement was substantial (κ>0.6) for most metrics. Signal uniformity was greatest in ZTE-DL for gray and white matter (all P<0.001); no difference was observed between ZTE-DL and ZTE for cerebrospinal fluid (P=0.721).
Conclusion:
DL-based MRI reconstruction improved ZTE image quality and provided comparable image quality to MPRAGE, potentially reducing the need for sedation in infant brain MRI.
