Cited by 351Advanced MRI Techniques and ApplicationsArtificial Intelligence in Healthcare and EducationLanthanide and Transition Metal Complexes

Deep learning enables reduced gadolinium dose for contrast-enhanced brain MRI

Gong, Enhao, Pauly, John M., Wintermark, Max, Zaharchuk, Greg·2018·Journal of Magnetic Resonance Imaging

Abstract

BACKGROUND: There are concerns over gadolinium deposition from gadolinium-based contrast agents (GBCA) administration. PURPOSE: To reduce gadolinium dose in contrast-enhanced brain MRI using a deep learning method. STUDY TYPE: Retrospective, crossover. POPULATION: Sixty patients receiving clinically indicated contrast-enhanced brain MRI. SEQUENCE: -weighted inversion-recovery prepped fast-spoiled-gradient-echo (IR-FSPGR) imaging was acquired at both 1.5T and 3T. In 60 brain MRI exams, the IR-FSPGR sequence was obtained under three conditions: precontrast, postcontrast images with 10% low-dose (0.01mmol/kg) and 100% full-dose (0.1 mmol/kg) of gadobenate dimeglumine. We trained a deep learning model using the first 10 cases (with mixed indications) to approximate full-dose images from the precontrast and low-dose images. Synthesized full-dose images were created using the trained model in two test sets: 20 patients with mixed indications and 30 patients with glioma. ASSESSMENT: For both test sets, low-dose, true full-dose, and the synthesized full-dose postcontrast image sets were compared quantitatively using peak-signal-to-noise-ratios (PSNR) and structural-similarity-index (SSIM). For the test set comprised of 20 patients with mixed indications, two neuroradiologists scored blindly and independently for the three postcontrast image sets, evaluating image quality, motion-artifact suppression, and contrast enhancement compared with precontrast images. STATISTICAL ANALYSIS: Results were assessed using paired t-tests and noninferiority tests. RESULTS: The proposed deep learning method yielded significant (n = 50, P < 0.001) improvements over the low-dose images (>5 dB PSNR gains and >11.0% SSIM). Ratings on image quality (n = 20, P = 0.003) and contrast enhancement (n = 20, P < 0.001) were significantly increased. Compared to true full-dose images, the synthesized full-dose images have a slight but not significant reduction in image quality (n = 20, P = 0.083) and contrast enhancement (n = 20, P = 0.068). Slightly better (n = 20, P = 0.039) motion-artifact suppression was noted in the synthesized images. The noninferiority test rejects the inferiority of the synthesized to true full-dose images for image quality (95% CI: -14-9%), artifacts suppression (95% CI: -5-20%), and contrast enhancement (95% CI: -13-6%). DATA CONCLUSION: With the proposed deep learning method, gadolinium dose can be reduced 10-fold while preserving contrast information and avoiding significant image quality degradation. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 5 J. MAGN. RESON. IMAGING 2018;48:330-340.

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Crossref · 10.1002/jmri.25970

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Research works printed but not linked: 2

  1. Esses SJ, 2017, Automated image quality evaluation of T2‐weighted liver MRI utilizing deep learning architecture, J Magn Reson Imaging
  2. Çiçek Ö, 2016, International Conference on Medical Image Computing and Computer‐Assisted Intervention, 424

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Authors
Gong, E., Pauly, J. M., Wintermark, M., & Zaharchuk, G.
Affiliations
  • Stanford Medicine (US)
  • Stanford University (US)
Corresponding author
Gong, Enhao
Venue
Journal of Magnetic Resonance Imaging
Publisher
Wiley
Published
2018-02-13
Volume
48
Issue
2
Pages
330-340
ISSN
  • 1053-1807 (ISSN-L)
  • 1522-2586
OpenAlex
W2789565832
Cited by
351
References
37
Citations by year
2026: 27 · 2025: 42 · 2024: 52 · 2023: 42 · 2022: 53 · 2021: 53 · 2020: 47 · 2019: 26 · 2018: 9
FWCI
23.32
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Magnetic Resonance Imaging (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Materials Science › Materials Chemistry › Lanthanide and Transition Metal Complexes
Keywords
gadolinium-based contrast agents, gadobenate dimeglumine, deep learning image synthesis, gadolinium deposition, glioma, image quality assessment, motion artifact reduction, non-inferiority
MeSH terms
Machine Learning, Deep Learning, Adult, Aged, Brain, Brain Neoplasms, Contrast Media, Female, Gadolinium, Glioma, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Motion, Artifacts

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