Super-resolution Deep Learning Reconstruction for 3D Brain MR Imaging: Improvement of Cranial Nerve Depiction and Interobserver Agreement in Evaluations of Neurovascular Conflict

Rationale and Objectives: To determine if super-resolution deep learning reconstruction (SR-DLR) improves the depiction of cranial nerves and interobserver agreement when assessing neurovascular conflict in 3D fast asymmetric spin echo (3D FASE) brain MR images, as compared to deep learning reconstruction (DLR). Materials and Methods: This retrospective study involved reconstructing 3D FASE MR images of the brain for 37 patients using SR-DLR and DLR. Three blinded readers conducted qualitative image analyses, evaluating the degree of neurovascular conflict, structure depiction, sharpness, noise, and diagnostic acceptability. Quantitative analyses included measuring edge rise distance (ERD), edge rise slope (ERS), and full width at half maximum (FWHM) using the signal intensity profile along a linear region of interest across the center of the basilar artery. Results: Interobserver agreement on the degree of neurovascular conflict of the facial nerve was generally higher with SR-DLR (0.429-0.923) compared to DLR (0.175-0.689). SR-DLR exhibited increased subjective image noise compared to DLR (o >= 0.008). However, all three readers found SR-DLR significantly superior in terms of sharpness (o < 0.001); cranial nerve depiction, particularly of facial and acoustic nerves, as well as the osseous spiral lamina (o < 0.001); and diagnostic acceptability (o <= 0.002). The FWHM (mm)/ ERD (mm)/ERS (mm-1) for SR-DLR and DLR was 3.1-4.3/0.9-1.1/8795.5-10,703.5 and 3.3-4.8/1.4-2.1/5157.9-7705.8, respectively, with SR-DLR's image sharpness being significantly superior (o <= 0.001). Conclusion: SR-DLR enhances image sharpness, leading to improved cranial nerve depiction and a tendency for greater interobserver agreement regarding facial nerve neurovascular conflict.