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Clinical validation of synthetic brain MRI in children: initial experience

  • Paediatric Neuroradiology
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Abstract

Introduction

The purpose of this study was to determine the diagnostic accuracy of synthetic MR sequences generated through post-acquisition processing of a single sequence measuring inherent R1, R2, and PD tissue properties compared with sequences acquired conventionally as part of a routine clinical pediatric brain MR exam.

Methods

Thirty-two patients underwent routine clinical brain MRI with conventional and synthetic sequences acquired (22 abnormal). Synthetic axial T1, T2, and T2 fluid attenuation inversion recovery or proton density-weighted sequences were made to match the comparable clinical sequences. Two exams for each patient were de-identified. Four blinded reviewers reviewed eight patients and were asked to generate clinical reports on each exam (synthetic or conventional) at two different time points separated by a mean of 33 days. Exams were rated for overall and specific finding agreement (synthetic/conventional and compared to gold standard consensus review by two senior reviewers with knowledge of clinical report), quality, and diagnostic confidence.

Results

Overall agreement between conventional and synthetic exams was 97%. Agreement with consensus readings was 84% (conventional) and 81% (synthetic), p = 0.61. There were no significant differences in sensitivity, specificity, or accuracy for specific imaging findings involving the ventricles, CSF, brain parenchyma, or vasculature between synthetic or conventional exams (p > 0.05). No significant difference in exam quality, diagnostic confidence, or noise/artifacts was noted comparing studies with synthetic or conventional sequences.

Conclusions

Diagnostic accuracy and quality of synthetically generated sequences are comparable to conventionally acquired sequences as part of a standard pediatric brain exam. Further confirmation in a larger study is warranted.

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Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Hollie West, James L. Leach, Blaise V. Jones, Marguerite Care, Rupa Radhakrishnan, Arnold C. Merrow, Enrique Alvarado & Suraj D. Serai

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  1. Hollie West
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  2. James L. Leach
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  3. Blaise V. Jones
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  4. Marguerite Care
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  5. Rupa Radhakrishnan
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  6. Arnold C. Merrow
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  7. Enrique Alvarado
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  8. Suraj D. Serai
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Corresponding author

Correspondence to Hollie West.

Ethics declarations

We declare that all human and animal studies have been approved by the institutional review board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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West, H., Leach, J.L., Jones, B.V. et al. Clinical validation of synthetic brain MRI in children: initial experience. Neuroradiology 59, 43–50 (2017). https://doi.org/10.1007/s00234-016-1765-z

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  • DOI: https://doi.org/10.1007/s00234-016-1765-z

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