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Deep Learning Assisted Double Inversion Recovery improves Focal Lesion Detection in Optic Neuropathy
Dandan Zhang1, Qichao Cheng1, Ziyao Liu1
1From the Department of Radiology (D.Z., Q.C., Z.L., B.S., Y.Z., X.B., Q.L., A.L.), Ophthalmology (Y.Q.), Neurology (S.W., L.C.), Qilu Hospital of Shandong University, Jinan, Shandong, China; Department of Radiology (D.Z.), The People's Hospital of Qihe, Dezhou, Shandong, China and Department of Radiology (Q.L.), The People's Hospital of XueCheng, ZaoZhuang, Shandong, China.
Objectives:
To compare the acquisition time, image quality, and diagnostic confidence of DL-accelerated DIR (DIR-DL) with conventional MRI in patients undergoing imaging for suspected optic neuropathy.
Materials And Methods:
This prospective, study enrolled 75 consecutive patients (mean age, 37 ± 20 years; 47 female) with suspected optic neuropathy who were clinically referred for optic nerve MRI between April and September 2024. Each participant underwent both conventional MRI (including STIR, T2-FS, T1WI, and Cube T1-FS sequences) and DL-accelerated protocol (with DIR sequence in addition). Three radiologists independently assessed lesion extent, overall image quality, perceived SNR, sharpness, artifacts, and diagnostic confidence using a 4-point Likert scale (1 = poor; 4 = excellent). Lesion lengths were normalized to optic nerve length and expressed as percentages. Because of zero inflation, a two-stage approach (logistic regression for detection, linear mixed model for lesion extent) was applied. Inter-method agreement between sequence pairs was assessed using weighted Cohen's κ (quadratic weights) for segmental, total lesion length percentages and image quality scores. Interchangeability between sequences was tested using the individual equivalence index (IEI, margin 5%). Paired t-tests compared signal-to-noise ratios, and all P values were FDR-adjusted.
Results:
DL reconstruction reduced total acquisition time by 43.57% (from 22 min 55 s to 12 min 56 s). DIR-DL presented a higher proportion of excellent overall image quality than conventional sequences (87.56% excellent readings vs. 82.89%). DIR and DIR-DL detected significantly longer lesion lengths than STIR (Beta = 7.59% and 7.40%, both Padj<0.001). STIR vs STIR-DL and DIR vs DIR-DL were interchangeable (IEI = 0.02 and 0.04, 90% CI within ±0.05), with almost perfect/excellent agreement (κ = 0.95 and 0.85). DIR and DIR-DL had higher specificity than STIR and STIR-DL.
Conclusion:
In a clinical setting, DIR-DL reduced scan time while providing superior image quality and comparable diagnostic confidence to standard STIR MRI for optic nerve evaluation.