To evaluate the feasibility and utility of a deep learning (DL)-based reconstruction for improving the SNR of hyperpolarized 129Xe lung ventilation MRI. 129Xe lung ventilation MRI data acquired from patients with asthma and/or chronic obstructive pulmonary disease (COPD) were retrospectively reconstructed with a commercial DL reconstruction pipeline at five different denoising levels. Quantitative imaging metrics of lung ventilation including ventilation defect percentage (VDP) and ventilation heterogeneity index (VHI) were compared between each set of DL-reconstructed images and alternative denoising strategies including: filtering, total variation denoising and higher-order singular value decomposition. Structural similarity between the denoised and original images was assessed. In a prospective study, the feasibility of using SNR gains from DL reconstruction to allow natural-abundance xenon MRI was evaluated in healthy volunteers. 129Xe ventilation image SNR was improved with DL reconstruction when compared with conventionally reconstructed images. In patients with asthma and/or COPD, DL-reconstructed images exhibited a slight positive bias in ventilation defect percentage (1.3% at 75% denoising) and ventilation heterogeneity index (˜1.4) when compared with conventionally reconstructed images. Additionally, DL-reconstructed images preserved structural similarity more effectively than data denoised using alternative approaches. DL reconstruction greatly improved image SNR (greater than threefold), to a level that 129Xe ventilation imaging using natural-abundance xenon appears feasible. DL-based image reconstruction significantly improves 129Xe ventilation image SNR, preserves structural similarity, and leads to a minor bias in ventilation metrics that can be attributed to differences in the image sharpness. This tool should help facilitate cost-effective 129Xe ventilation imaging with natural-abundance xenon in the future.
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