Deep Learning-based Acceleration and Denoising of 0.55T MRI for Enhanced Conspicuity of Vestibular Schwannoma Post Contrast Administration

Background and Purpose Deep-learning (DL) based MRI denoising techniques promise improved image quality and shorter examination times. This advancement is particularly beneficial for 0.55T MRI, where the inherently lower signal-to-noise (SNR) ratio can compromise image quality. Sufficient SNR is crucial for the reliable detection of vestibular schwannoma (VS). The objective of this study is to evaluate the VS conspicuity and acquisition time (TA) of 0.55T MRI examinations with contrast agents using a DL-denoising algorithm. Materials and Methods From January 2024 to October 2024, we retrospectively included 30 patients with VS (9 women). We acquired a clinical reference protocol of the cerebellopontine angle containing a T1w fat-saturated (fs) axial (number of signal averages [NSA] 4) and a T1w Spectral Attenuated Inversion Recovery (SPAIR) coronal (NSA 2) sequences after contrast agent (CA) application without advanced DL-based denoising (w/o DL). We reconstructed the T1w fs CA sequence axial and the T1w SPAIR CA coronal with full DL-denoising mode without change of NSA and secondly with 1 NSA for T1w fs CA axial and T1w SPAIR coronal (DL & 1NSA). Each sequence was rated on a 5-point Likert scale (1: insufficient, 3: moderate, clinically sufficient; 5: perfect) for: overall image quality; VS conspicuity, and artifacts. Secondly, we analyzed the reliability of the size measurements. Two radiologists with focus on head and neck imaging performed the reading and measurements. The Wilcoxon Signed-Rank Test was used for non-parametric statistical comparison. Results The DL & 4NSA axial/coronal study sequence achieved the highest overall IQ (median 4.9). The image quality (IQ) for DL & 1NSA was higher (M: 4.0) than for the reference sequence (w/o DL ; median 4.0 versus 3.5, each p < 0.01). Similarly, the VS conspicuity was best for DL & 4NSA (M: 4.9), decreased for DL &1NSA (M: 4.1) and was lower but still sufficient for w/o DL (M: 3.7, each p < 0.01). The TA for the axial and coronal post-contrast sequences were 8:59 minutes for DL & 4NSA and w/o DL and decreased to 3:24 minutes with DL& 1NSA. Conclusions This study underlines that advanced DL-based denoising techniques can reduce the examination time by more than half while simultaneously improving image quality.