Improvement of image quality of diffusion-weighted imaging (DWI) with deep learning reconstruction of the pancreas: comparison with respiratory-gated conventional DWI.

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This study aimed to evaluate the efficacy of deep learning-based reconstruction(DLR) in improving pancreatic diffusion-weighted imaging (DWI) quality. In total, 117 patients (mean age of 68.0 ± 12.9years) suspected of pancreatic diseases underwent magnetic resonance imaging (MRI) between July and December 2023. MRI sequences includedrespiratory-gated conventional diffusion-weighted images (RGC-DWIs), respiratory-gated diffusion-weighted images with deep learning-based reconstruction (DLR) (RGDLR-DWIs), and breath-hold diffusion-weighted images with DLR (BHDLR-DWIs) (short TE and long TE equal to other DWIs) at a 3T MR system. Among these patients, 27 had solid lesions. Two radiologists qualitatively assessed pancreatic shape, main pancreatic duct (MPD) visualization, and solid lesion conspicuity using a 5-point scale. Quantitative analysis included apparent diffusion coefficient (ADC)values for pancreatic parenchyma and solid lesions, signal-to-noise ratio (SNR), pancreas-to-muscle signal-intensity ratio (PM-SIR) and lesion-to-pancreas signal-intensity ratio (LP-SIR). Differences among DWI sequences were analyzed using Friedman's and Bonferroni's tests. Qualitatively, BHDLR-DWIs (short TE) had the highest scores for pancreatic shape and MPD but lowest for solid lesions visibility, whereas RGDLR-DWIs had the highest score for solid lesions. Quantitatively, BHDLR-DWIs (short TE) had the lowest ADC values for pancreatic parenchyma and solid lesions, with the highest PM-SIR. There was no significant difference between BHDLR-DWIs (short TE) and RGDLR-DWIs for solid lesion ADC values. RGC-DWIs had the highest SNR, though differences from RGDLR-DWIs and BHDLR-DWIs (short TE) were not significant. Although LP-SIR in RGDLR-DWIs were the lowest, the difference was not significant. BHDLR-DWIs (short TE) provided the best pancreatic morphology image quality, whereas RGDLR-DWIs were superior for solid lesion detection.