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Deep learning reconstruction-applied PROPELLER diffusion-weighted imaging in uterine malignancies: a comparison study
Takuro Gonda1, Ryoya Ochiai2, Hiroto Yunaga2
1Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, 36-1, Nishi-Cho, Yonago, Tottori, 683-8504, Japan. tgonda@tottori-u.ac.jp.
Purpose:
To compare the image quality of diffusion-weighted imaging (DWI) between deep learning reconstruction (DLR)-applied Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) and MUltiplexed Sensitivity Encoding (MUSE) sequences in MRI of uterine malignancies.
Materials And Methods:
This retrospective study included 66 MRI examinations of 48 patients. The cohort consisted of cases with uterine malignancies (cervical cancer (n = 50), endometrial cancer (n = 15) and endometrial stromal sarcoma (n = 1)) at different clinical settings (initial staging, post-treatment, or recurrence). DWI was performed using both DLR-applied PROPELLER and MUSE sequences using b-values of 0 and 800 s/mm2. Two independent reviewers evaluated overall image quality, artifacts, sharpness, and lesion conspicuity using a 5-point Likert scale. Apparent diffusion coefficient (ADC), apparent signal-to-noise ratio (aSNR), and apparent contrast-to-noise ratio (aCNR) were quantitatively measured in both sequences.
Results:
In the qualitative assessment, DLR-applied PROPELLER-DWI showed significantly fewer artifacts and better lesion conspicuity than MUSE-DWI. No significant difference was found in overall image quality or sharpness. Inter-reader agreement was slight to moderate, except for strong agreement on DLR-applied PROPELLER-DWI lesion conspicuity (κ = 0.696, good). Quantitatively, the mean ADC values were significantly higher with DLR-applied PROPELLER-DWI compared to MUSE-DWI for both readers (p < 0.001). Furthermore, both aSNR and aCNR were significantly higher with DLR-applied PROPELLER-DWI compared to MUSE-DWI.
Conclusions:
DLR-applied PROPELLER-DWI demonstrated fewer artifacts and better lesion conspicuity than MUSE-DWI, with higher measured aSNR and aCNR. However, DLR-applied PROPELLER-DWI yielded significantly higher mean ADC values.
Insights
Deep learning reconstruction (DLR)-applied PROPELLER diffusion-weighted imaging (DWI) offers superior image quality in uterine malignancies compared to MUSE-DWI, showing fewer artifacts and better lesion conspicuity. However, it results in higher apparent diffusion coefficient (ADC) values.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Diffusion-weighted imaging (DWI) is crucial for diagnosing and monitoring uterine malignancies.
- Traditional DWI techniques like MUltiplexed Sensitivity Encoding (MUSE) can be limited by artifacts and conspicuity.
- Deep learning reconstruction (DLR) techniques offer potential improvements in MRI image quality.
Purpose of the Study:
- To compare the image quality of DWI between DLR-applied Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) and MUSE sequences.
- To evaluate qualitative and quantitative differences in MRI of uterine malignancies using these two DWI techniques.
Main Methods:
- Retrospective analysis of 66 MRI examinations from 48 patients with uterine malignancies (cervical cancer, endometrial cancer, endometrial stromal sarcoma).
- DWI performed using both DLR-applied PROPELLER and MUSE sequences at b-values of 0 and 800 s/mm².
- Qualitative assessment by two reviewers (image quality, artifacts, sharpness, lesion conspicuity) and quantitative measurements (ADC, aSNR, aCNR).
Main Results:
- DLR-applied PROPELLER-DWI demonstrated significantly fewer artifacts and better lesion conspicuity compared to MUSE-DWI.
- No significant difference in overall image quality or sharpness between the two sequences.
- Quantitative analysis revealed significantly higher apparent signal-to-noise ratio (aSNR) and apparent contrast-to-noise ratio (aCNR) with DLR-applied PROPELLER-DWI.
- Mean apparent diffusion coefficient (ADC) values were significantly higher with DLR-applied PROPELLER-DWI.
Conclusions:
- DLR-applied PROPELLER-DWI provides superior image quality in uterine malignancies due to reduced artifacts and enhanced lesion conspicuity.
- Higher aSNR and aCNR values further support the improved performance of DLR-applied PROPELLER-DWI.
- The significant difference in ADC values warrants consideration in clinical interpretation.
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