# Build-A-FLAIR: Synthetic T2-FLAIR Contrast Generation through Physics Informed Deep Learning

## TL;DR

This paper presents a physics-informed deep learning approach to generate synthetic T2-FLAIR MRI images from other contrast images, demonstrating high similarity to real images and emphasizing the importance of physically relevant inputs.

## Contribution

The study introduces a neural network model that leverages physical relationships between MRI contrasts to accurately synthesize T2-FLAIR images, highlighting the role of feature engineering.

## Key findings

- Best model achieved a structural similarity index of 0.909.
- Synthetic images had lower noise and increased smoothness.
- Physically relevant inputs significantly improved performance.

## Abstract

Purpose: Magnetic resonance imaging (MRI) exams include multiple series with varying contrast and redundant information. For instance, T2-FLAIR contrast is based upon tissue T2 decay and the presence of water, also present in T2- and diffusion-weighted contrasts. T2-FLAIR contrast can be hypothetically modeled through deep learning models trained with diffusion- and T2-weighted acquisitions. Methods: Diffusion-, T2-, T2-FLAIR-, and T1-weighted brain images were acquired in 15 individuals. A convolutional neural network was developed to generate a T2-FLAIR image from other contrasts. Two datasets were withheld from training for validation. Results: Inputs with physical relationships to T2-FLAIR contrast most significantly impacted performance. The best model yielded results similar to acquired T2-FLAIR images, with a structural similarity index of 0.909, and reproduced pathology excluded from training. Synthetic images qualitatively exhibited lower noise and increased smoothness compared to acquired images. Conclusion: This suggests that with optimal inputs, deep learning based contrast generation performs well with creating synthetic T2-FLAIR images. Feature engineering on neural network inputs, based upon the physical basis of contrast, impacts the generation of synthetic contrast images. A larger, prospective clinical study is needed.