Accelerated T2-Weighted TSE Imaging of the Prostate Using Deep Learning Image Reconstruction: A Prospective Comparison with Standard T2-Weighted TSE Imaging

SIMPLE SUMMARY: Multiparametric magnetic resonance imaging (mpMRI) has become an important diagnostic tool in the assessment of clinically significant prostate cancer. The disadvantages of this technique are primarily related to its long examination time and limited availability. This prospective study presents a novel accelerated deep learning image reconstructed T2-weighted turbo spin echo (TSE) sequence providing an acquisition time reduction of more than 60%. The study results show that the acquisition of three imaging planes of the prostate is feasible within 3:50 min, using deep learning image reconstruction, compared to 10:21 min in standard imaging. Additionally, image quality parameters were evaluated to be superior in deep learning imaging. ABSTRACT: Multiparametric MRI (mpMRI) of the prostate has become the standard of care in prostate cancer evaluation. Recently, deep learning image reconstruction (DLR) methods have been introduced with promising results regarding scan acceleration. Therefore, the aim of this study was to investigate the impact of deep learning image reconstruction (DLR) in a shortened acquisition process of T2-weighted TSE imaging, regarding the image quality and diagnostic confidence, as well as PI-RADS and T2 scoring, as compared to standard T2 TSE imaging. Sixty patients undergoing 3T mpMRI for the evaluation of prostate cancer were prospectively enrolled in this institutional review board-approved study between October 2020 and March 2021. After the acquisition of standard T2 TSE imaging (T2(S)), the novel T2 TSE sequence with DLR (T2(DLR)) was applied in three planes. Overall, the acquisition time for T2(S) resulted in 10:21 min versus 3:50 min for T2(DLR). The image evaluation was performed by two radiologists independently using a Likert scale ranging from 1–4 (4 best) applying the following criteria: noise levels, artifacts, overall image quality, diagnostic confidence, and lesion conspicuity. Additionally, T2 and PI-RADS scoring were performed. The mean patient age was 69 ± 9 years (range, 49–85 years). The noise levels and the extent of the artifacts were evaluated to be significantly improved in T2(DLR) versus T2(S) by both readers (p < 0.05). Overall image quality was also evaluated to be superior in T2(DLR) versus T2(S) in all three acquisition planes (p = 0.005–<0.001). Both readers evaluated the item lesion conspicuity to be superior in T2(DLR) with a median of 4 versus a median of 3 in T2(S) (p = 0.001 and <0.001, respectively). T2-weighted TSE imaging of the prostate in three planes with an acquisition time reduction of more than 60% including DLR is feasible with a significant improvement of image quality.