Abstract：
OBJECTIVE: To evaluate deep learning reconstruction (DLR)-based accelerated rectal magnetic resonance imaging (MRI) compared with standard MRI.
METHODS: Patients with biopsy-confirmed rectal adenocarcinoma between November/2022 and May/2023 in a single centre were prospectively enrolled for an intra-individual comparison between standard fast spin-echo (FSEstandard) and DLR-based FSE (FSEDL) sequences. Quantitative and qualitative image quality metrics of the pre-therapeutic MRIs were evaluated in all patients; diagnostic performance and evaluating time for T-staging, N-staging, extramural vascular invasion (EMVI), and mesorectal fascia (MRF) status was further analysed in patients undergoing curative surgery, with histopathologic results as the diagnostic gold standard.
RESULTS: A total of 117 patients were enrolled, with 60 patients undergoing curative surgery. FSEDL reduced the acquisition time by 65% than FSEstandard. FSEDL exhibited higher signal-to-noise ratios, contrast-to-noise ratio, and subjective scores (noise, tumour margin clarity, visualisation of bowel wall layering and MRF, overall image quality, and diagnostic confidence) than FSEstandard (p < 0.001). Reduced artefacts were observed in FSEDL for patients without spasmolytics (p < 0.05). FSEDL provided higher T-staging accuracy by junior readers than FSEstandard (reader 1, 58.33% vs 70.00%, p = 0.016; reader 3, 60.00% vs 76.67%, p = 0.021), with similar N-staging, EMVI, and MRF performance. No significant difference was observed for senior readers. FSEDL exhibited shorter diagnostic time in all readers\' T-staging and overall evaluation, and junior readers\' EMVI and MRF (p < 0.05).
CONCLUSIONS: FSEDL provided improved image quality, reading time, and junior radiologists\' T-staging accuracy than FSEstandard, while reducing the acquisition time by 65%.
CONCLUSIONS: DLR is clinically applicable for rectal MRI, providing improved image quality with shorter scanning time, which may ease the examination burden. It is beneficial for diagnostic optimisation in improving junior radiologists\' T-staging accuracy and reading time.
CONCLUSIONS: The rising incidence of rectal cancer has demanded enhanced efficiency and quality in imaging examinations. FSEDL demonstrated superior image quality and had a 65% reduced acquisition time. FSEDL can improve the diagnostic accuracy of T-staging and reduce the reading time for assessing rectal cancer.
METHODS: Patients with biopsy-confirmed rectal adenocarcinoma between November/2022 and May/2023 in a single centre were prospectively enrolled for an intra-individual comparison between standard fast spin-echo (FSEstandard) and DLR-based FSE (FSEDL) sequences. Quantitative and qualitative image quality metrics of the pre-therapeutic MRIs were evaluated in all patients; diagnostic performance and evaluating time for T-staging, N-staging, extramural vascular invasion (EMVI), and mesorectal fascia (MRF) status was further analysed in patients undergoing curative surgery, with histopathologic results as the diagnostic gold standard.
RESULTS: A total of 117 patients were enrolled, with 60 patients undergoing curative surgery. FSEDL reduced the acquisition time by 65% than FSEstandard. FSEDL exhibited higher signal-to-noise ratios, contrast-to-noise ratio, and subjective scores (noise, tumour margin clarity, visualisation of bowel wall layering and MRF, overall image quality, and diagnostic confidence) than FSEstandard (p < 0.001). Reduced artefacts were observed in FSEDL for patients without spasmolytics (p < 0.05). FSEDL provided higher T-staging accuracy by junior readers than FSEstandard (reader 1, 58.33% vs 70.00%, p = 0.016; reader 3, 60.00% vs 76.67%, p = 0.021), with similar N-staging, EMVI, and MRF performance. No significant difference was observed for senior readers. FSEDL exhibited shorter diagnostic time in all readers\' T-staging and overall evaluation, and junior readers\' EMVI and MRF (p < 0.05).
CONCLUSIONS: FSEDL provided improved image quality, reading time, and junior radiologists\' T-staging accuracy than FSEstandard, while reducing the acquisition time by 65%.
CONCLUSIONS: DLR is clinically applicable for rectal MRI, providing improved image quality with shorter scanning time, which may ease the examination burden. It is beneficial for diagnostic optimisation in improving junior radiologists\' T-staging accuracy and reading time.
CONCLUSIONS: The rising incidence of rectal cancer has demanded enhanced efficiency and quality in imaging examinations. FSEDL demonstrated superior image quality and had a 65% reduced acquisition time. FSEDL can improve the diagnostic accuracy of T-staging and reduce the reading time for assessing rectal cancer.
摘要：
目的：评估基于深度学习重建（DLR）的加速直肠磁共振成像（MRI）与标准MRI的比较。
方法：在2022年11月至2023年5月期间在单个中心进行活检证实的直肠腺癌患者被前瞻性纳入标准快速自旋回波（FSEstandard）和基于DLR的FSE（FSEDL）序列之间的个体内比较。在所有患者中评估治疗前MRI的定量和定性图像质量指标；T分期的诊断性能和评估时间，N-staging,壁外血管侵犯（EMVI），在接受根治性手术的患者中，进一步分析了直肠系膜筋膜（MRF）状态，以组织病理学结果为诊断金标准。
结果：共纳入117例患者，有60名患者接受根治性手术。FSEDL比FSEstandard减少了65%的采集时间。FSEDL表现出更高的信噪比，对比噪声比，和主观得分(噪音，肿瘤边缘清晰度，肠壁分层和MRF的可视化，整体图像质量，和诊断置信度）比FSE标准（p<0.001）。在FSEDL中观察到没有解痉挛的患者的伪影减少(p<0.05)。FSEDL为初级读者提供了比FSEstandard更高的T分期准确性（读者1，58.33%vs70.00%，p=0.016；读取器3，60.00%对76.67%，p=0.021),具有类似的N-staging，EMVI,和MRF性能。对于资深读者，没有观察到显着差异。FSEDL在所有读者T分期和总体评估中显示出更短的诊断时间，和初级读者“EMVI和MRF”（p<0.05）。
结论：FSEDL提供了改善的图像质量，阅读时间,和初级放射科医生的T分期准确性比FSEstandard高，同时减少65%的收购时间。
结论：DLR在临床上适用于直肠MRI，以更短的扫描时间提供更高的图像质量，这可以减轻考试负担。它有利于诊断优化，以提高初级放射科医生的T分期准确性和阅读时间。
结论：直肠癌发病率的上升要求提高影像学检查的效率和质量。FSEDL表现出优异的图像质量并且具有减少65%的采集时间。FSEDL可以提高T分期的诊断准确性，减少评估直肠癌的阅读时间。
方法：在2022年11月至2023年5月期间在单个中心进行活检证实的直肠腺癌患者被前瞻性纳入标准快速自旋回波（FSEstandard）和基于DLR的FSE（FSEDL）序列之间的个体内比较。在所有患者中评估治疗前MRI的定量和定性图像质量指标；T分期的诊断性能和评估时间，N-staging,壁外血管侵犯（EMVI），在接受根治性手术的患者中，进一步分析了直肠系膜筋膜（MRF）状态，以组织病理学结果为诊断金标准。
结果：共纳入117例患者，有60名患者接受根治性手术。FSEDL比FSEstandard减少了65%的采集时间。FSEDL表现出更高的信噪比，对比噪声比，和主观得分(噪音，肿瘤边缘清晰度，肠壁分层和MRF的可视化，整体图像质量，和诊断置信度）比FSE标准（p<0.001）。在FSEDL中观察到没有解痉挛的患者的伪影减少(p<0.05)。FSEDL为初级读者提供了比FSEstandard更高的T分期准确性（读者1，58.33%vs70.00%，p=0.016；读取器3，60.00%对76.67%，p=0.021),具有类似的N-staging，EMVI,和MRF性能。对于资深读者，没有观察到显着差异。FSEDL在所有读者T分期和总体评估中显示出更短的诊断时间，和初级读者“EMVI和MRF”（p<0.05）。
结论：FSEDL提供了改善的图像质量，阅读时间,和初级放射科医生的T分期准确性比FSEstandard高，同时减少65%的收购时间。
结论：DLR在临床上适用于直肠MRI，以更短的扫描时间提供更高的图像质量，这可以减轻考试负担。它有利于诊断优化，以提高初级放射科医生的T分期准确性和阅读时间。
结论：直肠癌发病率的上升要求提高影像学检查的效率和质量。FSEDL表现出优异的图像质量并且具有减少65%的采集时间。FSEDL可以提高T分期的诊断准确性，减少评估直肠癌的阅读时间。
