Synthetic MRI for Clinical Neuroimaging: Results of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial
Synthetic MRI for Clinical Neuroimaging: Results of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial
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DOI：
10.3174/ajnr.a5227
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发表时间：
2017-06-01
影响因子：
3.5
通讯作者：
Field, A. S.
中科院分区：
文献类型：
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作者：
Tanenbaum, L. N.;Tsiouris, A. J.;Field, A. S.
作者进行了一项前瞻性多读者、多病例非劣效性试验，由 7 名盲法神经放射科医生读取了 1526 张图像，并前瞻性地从 109 名具有神经影像学指征的受试者中获取了合成和传统脑部 MR 成像病例对照对。每个病例包括传统的 T1 和 T2 加权、T1 和 T2 FLAIR、STIR 和/或质子密度以及多动态多回波成像的合成重建。图像被随机化并独立评估。总体合成 MR 成像质量与神经系统疾病中的传统质子密度、STIR 以及 T1 和 T2 加权对比视图相似。伪影在合成 T2 FLAIR 中更为常见，但很容易识别，并且不模仿病理学。 背景和目的：合成 MR 成像能够通过 1 次扫描重建各种图像对比度，减少扫描时间并可能提供新颖的信息。这项研究是常规神经影像学中合成与传统 MR 成像的首次大型前瞻性比较。 材料和方法：一项前瞻性多读片、多病例非劣效性试验，由 7 名盲法神经放射科医生读取了 1526 张图像，并使用来自 109 名受试者（平均年龄 53.0±18.5 岁；范围：19-89 岁）的前瞻性合成和传统脑部 MR 成像病例对照对进行了研究。年龄）并具有神经影像学指征。每个病例包括传统的 T1 和 T2 加权、T1 和 T2 FLAIR、STIR 和/或质子密度以及多动态多回波成像的合成重建。图像被随机化并独立评估诊断质量、形态易读性、诊断的放射学结果和伪影。结果：临床 MR 成像研究显示 46 例健康病例和 63 例病理病例。合成 MR 图像的总体诊断质量在 5 级李克特量表上并不劣于传统成像（P < .001；平均合成-常规，-0.335 +/- 0.352；= 0.5；95% CI 的下限，-0.402）。合成形态和常规形态的清晰度一致 >95%，但内囊后肢的 T1、T1 FLAIR 和质子密度视图除外（全部 >80%）。合成 T2 FLAIR 具有更明显的伪影，包括 +24.1% 的血流伪影病例和 +17.6% 的白噪声伪影病例。结论：总体合成 MR 成像质量与神经系统条件下的传统质子密度、STIR 以及 T1 和 T2 加权对比视图相似。虽然伪影在合成 T2 FLAIR 中更常见，但这些伪影很容易识别，并且不模仿病理学，但可能需要额外的常规 T2 FLAIR 来确认诊断。
The authors performed a prospective multireader, multicasenoninferiority trial of 1526 images read by 7 blinded neuroradiologists with prospectively acquired synthetic and conventional brain MR imaging case-control pairs from 109 subjects with neuroimaging indications. Each case included conventional T1- and T2-weighted, T1 and T2 FLAIR, and STIR and/or proton density and synthetic reconstructions from multiple-dynamic multiple-echo imaging. Images were randomized and independently assessed. Overall synthetic MR imaging quality was similar to that of conventional proton-density, STIR, and T1- and T2-weighted contrast views across neurologic conditions. Artifacts were more common in synthetic T2 FLAIR, but were readily recognizable and did not mimic pathology.BACKGROUND AND PURPOSE: Synthetic MR imaging enables reconstruction of various image contrasts from 1 scan, reducing scan times and potentially providing novel information. This study is the first large, prospective comparison of synthetic-versus-conventional MR imaging for routine neuroimaging.MATERIALS AND METHODS: A prospective multireader, multicase noninferiority trial of 1526 images read by 7 blinded neuroradiologists was performed with prospectively acquired synthetic and conventional brain MR imaging case-control pairs from 109 subjects (mean, 53.0 18.5 years of age; range, 19-89 years of age) with neuroimaging indications. Each case included conventional T1- and T2-weighted, T1 and T2 FLAIR, and STIR and/or proton density and synthetic reconstructions from multiple-dynamic multiple-echo imaging. Images were randomized and independently assessed for diagnostic quality, morphologic legibility, radiologic findings indicative of diagnosis, and artifacts.RESULTS: Clinical MR imaging studies revealed 46 healthy and 63 pathologic cases. Overall diagnostic quality of synthetic MR images was noninferior to conventional imaging on a 5-level Likert scale (P < .001; mean synthetic-conventional, -0.335 +/- 0.352; = 0.5; lower limit of the 95% CI, -0.402). Legibility of synthetic and conventional morphology agreed in >95%, except in the posterior limb of the internal capsule for T1, T1 FLAIR, and proton-density views (all, >80%). Synthetic T2 FLAIR had more pronounced artifacts, including +24.1% of cases with flow artifacts and +17.6% cases with white noise artifacts.CONCLUSIONS: Overall synthetic MR imaging quality was similar to that of conventional proton-density, STIR, and T1- and T2-weighted contrast views across neurologic conditions. While artifacts were more common in synthetic T2 FLAIR, these were readily recognizable and did not mimic pathology but could necessitate additional conventional T2 FLAIR to confirm the diagnosis.