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Clinical Feasibility of Deep Learning Contrast Synthesis From MR Fingerprinting in Knee Osteoarthritis
Mika T Nevalainen1,2, Olli Nykänen1,3, Jyri Järvinen1,2
1Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
Background:
Magnetic Resonance Fingerprinting (MRF) enables rapid quantitative parameter mapping from which synthetic clinical contrast images can be derived using deep learning (DL).
Purpose:
This study evaluates the reliability and interchangeability of MRF-derived synthetic knee MRI relative to conventional MRI in patients with osteoarthritis.
Study Type:
Prospective single-center comparative study.
Subjects:
Between March 2022 and 2023, 78 participants (54 females, mean age 57.2, range 33-78 years) with knee osteoarthritis.
Field Strength/Sequence:
3.0 T; proton density weighted (PDw) imaging, T2-weighted fat-saturated (T2w fs) imaging, and MRF.
Assessment:
U-Nets were trained to produce synthetic contrasts from MRF data. Three musculoskeletal radiologists performed MRI OsteoArthritis Knee Score (MOAKS) assessments and image quality evaluation using a Likert scale (1-5).
Statistical Tests:
The inter-rater and inter-method reliability were evaluated using prevalence-and-bias-adjusted kappa (PABAK), and percentages of exact matches. Image quality scores were compared using the Wilcoxon test. The limit of statistical significance was set at p < 0.05 and no multiple comparisons corrections were applied.
Results:
The inter-rater reliability for synthetic MR images varied between 0.980-0.994 (CI 0.975-0.997; exact matches 77.%-89.2%) and for conventional MR images between 0.979 and 0.994 (CI 0.973-0.997; exact matches 75.3%-89.5%). Inter-method reliability between synthetic and conventional MR images was near-perfect: mean PABAK-values and exact matches were 0.927 and 77.9% for cartilage, 0.915 and 89.7% for bone marrow lesions, 0.922 and 65.2% for osteophytes, 0.950 and 72.9% for meniscus pathology, 0.934 and 66.6% for effusion, and 0.857 and 92.5% for Baker's cyst. Average Likert scores were significantly better for conventional than synthetic images: 4.5 vs. 3.9 for PDw and 4.1 vs. 3.2 for T2w fs.
Data Conclusion:
MRF-derived DL-based synthetic clinical contrasts provide excellent inter-rater reliability and interchangeability against conventional MR sequences in knee OA; however, image quality needs further development.
Evidence Level:
2.
Stage Of Technical Efficacy:
2.
