Comparison of image quality and lesion conspicuity between conventional and deep learning reconstruction in gadoxetic acid-enhanced liver MRI

Objective To compare the image quality and lesion conspicuity of conventional vs deep learning (DL)-based reconstructed three-dimensional T1-weighted images in gadoxetic acid-enhanced liver magnetic resonance imaging (MRI). Methods This prospective study (NCT05182099) enrolled participants scheduled for gadoxetic acid-enhanced liver MRI due to suspected focal liver lesions (FLLs) who provided signed informed consent. A liver MRI was conducted using a 3-T scanner. T1-weighted images were reconstructed using both conventional and DL-based (AIRTM Recon DL 3D) reconstruction algorithms. Three radiologists independently reviewed the image quality and lesion conspicuity on a 5-point scale. Results Fifty participants (male = 36, mean age 62 +/- 11 years) were included for image analysis. The DL-based reconstruction showed significantly higher image quality than conventional images in all phases (3.71-4.40 vs 3.37-3.99, p < 0.001 for all), as well as significantly less noise and ringing artifacts than conventional images (p < 0.05 for all), while also showing significantly altered image texture (p < 0.001 for all). Lesion conspicuity was significantly higher in DL-reconstructed images than in conventional images in the arterial phase (2.15 [95% confidence interval: 1.78, 2.52] vs 2.03 [1.65, 2.40], p = 0.036), but no significant difference was observed in the portal venous phase and hepatobiliary phase (p > 0.05 for all). There was no significant difference in the figure-of-merit (0.728 in DL vs 0.709 in conventional image, p = 0.474). Conclusion DL reconstruction provided higher-quality three-dimensional T1-weighted imaging than conventional reconstruction in gadoxetic acid-enhanced liver MRI. Critical relevance statement DL reconstruction of 3D T1-weighted images improves image quality and arterial phase lesion conspicuity in gadoxetic acid-enhanced liver MRI compared to conventional reconstruction. Key Points DL reconstruction is feasible for 3D T1-weighted images across different spatial resolutions and phases. DL reconstruction showed superior image quality with reduced noise and ringing artifacts. Hepatic anatomic structures were more conspicuous on DL-reconstructed images.