Abstract
ObjectivesTo compare the assessment of patients with multiple sclerosis (MS) using synthetic and conventional MRI.Materials and methodsSynthetic and conventional axial images were prospectively acquired for 52 patients with diagnosed MS. Quantitative MRI (qMRI) was used for measuring proton density and relaxation times (T1, T2) and then, based on these parameters, synthetic T1W, T2W and FLAIR images were calculated. Image stacks were reviewed blindly, independently and in random order by two radiologists. The number and location for all lesions were documented and categorised. A combined report of lesion load and presence of contrast-enhancing lesions was compiled for each patient. Agreement was evaluated using kappa statistic.ResultsThere was no significant difference in lesion detection using synthetic and conventional MRI in any anatomical region or for any of the three image types. Inter- and intra-observer agreements were mainly higher (p < 0.05) using conventional images but there was no significant difference in any specific region or for any image type. There was no significant difference in the outcome of the combined reports.ConclusionSynthetic MR images show potential to be used in the assessment of MS dissemination in space (DIS) despite a slightly lower inter- and intra-observer agreement compared to conventional MRI.Key Points• Synthetic MR images may potentially be useful in the assessment of MS.• Examination times may be shortened.• Inter- and intra-observer agreement is generally higher using conventional MRI.
Highlights
Materials and methodsToday there are several alternatives to quantitative MRI that enable concurrent measurements of the relaxation times (T1 and T2) and proton density (PD) in clinical MR systems [1,2,3,4,5]
These tissue parameters can be exploited for different applications including the creation of synthetic MR images and segmentation of white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF)
Studies of synthetic MR imaging mimicking conventional T1W, T2W and FLAIR have shown that the image qualities of T1W and T2W are comparable but synthetically calculated FLAIR images have an inferior quality compared to conventional images [6, 8]
Summary
Today there are several alternatives to quantitative MRI (qMRI) that enable concurrent measurements of the relaxation times (T1 and T2) and proton density (PD) in clinical MR systems [1,2,3,4,5]. These tissue parameters can be exploited for different applications including the creation of synthetic MR images and segmentation of white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF). The synthetic images, including T1W, T2W and FLAIR, are obtained from one single acquisition compared to conventional imaging where image contrast series are obtained one by one. Studies of synthetic MR imaging mimicking conventional T1W, T2W and FLAIR have shown that the image qualities of T1W and T2W are comparable but synthetically calculated FLAIR images have an inferior quality compared to conventional images [6, 8]
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