A deep learning model to reduce agent dose for contrast-enhanced MRI of the cerebellopontine angle cistern

TL;DR

This study develops a deep learning model that significantly reduces contrast agent dose in MRI scans of the CPA cistern while maintaining diagnostic image quality, enabling safer imaging with lower contrast doses.

Contribution

A novel deep learning approach that restores high-quality MRI images from substantially reduced contrast agent doses, validated across multiple centers.

Findings

DL-restored images achieved high similarity to standard-dose images.

Segmentation accuracy improved with DL restoration at low doses.

Image quality was rated excellent at 10-30% contrast doses.

Abstract

Objectives: To evaluate a deep learning (DL) model for reducing the agent dose of contrast-enhanced T1-weighted MRI (T1ce) of the cerebellopontine angle (CPA) cistern. Materials and methods: In this multi-center retrospective study, T1 and T1ce of vestibular schwannoma (VS) patients were used to simulate low-dose T1ce with varying reductions of contrast agent dose. DL models were trained to restore standard-dose T1ce from the low-dose simulation. The image quality and segmentation performance of the DL-restored T1ce were evaluated. A head and neck radiologist was asked to rate DL-restored images in multiple aspects, including image quality and diagnostic characterization. Results: 203 MRI studies from 72 VS patients (mean age, 58.51 \pm 14.73, 39 men) were evaluated. As the input dose increased, the structural similarity index measure of the restored T1ce increased from 0.639 \pm 0.113 to 0.993 \pm 0.009, and the peak signal-to-noise ratio increased from 21.6 \pm 3.73 dB to 41.4 \pm 4.84 dB. At 10% input dose, using DL-restored T1ce for segmentation improved the Dice from 0.673 to 0.734, the 95% Hausdorff distance from 2.38 mm to 2.07 mm, and the average surface distance from 1.00 mm to 0.59 mm. Both DL-restored T1ce from 10% and 30% input doses showed excellent images, with the latter being considered more informative. Conclusion: The DL model improved the image quality of low-dose MRI of the CPA cistern, which makes lesion detection and diagnostic characterization possible with 10% - 30% of the standard dose.