Improving Diagnostic Performance of MRI for Temporal Lobe Epilepsy With Deep Learning-Based Image Reconstruction in Patients With Suspected Focal Epilepsy

• Published in: Korean journal of radiology Vol. 25; no. 4; pp. 374 - 383
• Main Authors: Suh, Pae Sun, Park, Ji Eun, Roh, Yun Hwa, Kim, Seonok, Jung, Mina, Koo, Yong Seo, Lee, Sang-Ahm, Choi, Yangsean, Kim, Ho Sung
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01-04-2024; 대한영상의학회
• Subjects: Adult; Deep Learning; Epilepsy, Temporal Lobe - diagnostic imaging; Epilepsy, Temporal Lobe - pathology; Epilepsy, Temporal Lobe - surgery; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging - methods; Neuroimaging and Head & Neck; Retrospective Studies; 방사선과학; Deep learning; Brain; Temporal lobe; Magnetic resonance imaging; Epilepsy
• ISSN: 1229-6929; 2005-8330
• DOI: 10.3348/kjr.2023.0842

To evaluate the diagnostic performance and image quality of 1.5-mm slice thickness MRI with deep learning-based image reconstruction (1.5-mm MRI + DLR) compared to routine 3-mm slice thickness MRI (routine MRI) and 1.5-mm slice thickness MRI without DLR (1.5-mm MRI without DLR) for evaluating temporal lobe epilepsy (TLE).
This retrospective study included 117 MR image sets comprising 1.5-mm MRI + DLR, 1.5-mm MRI without DLR, and routine MRI from 117 consecutive patients (mean age, 41 years; 61 female; 34 patients with TLE and 83 without TLE). Two neuroradiologists evaluated the presence of hippocampal or temporal lobe lesions, volume loss, signal abnormalities, loss of internal structure of the hippocampus, and lesion conspicuity in the temporal lobe. Reference standards for TLE were independently constructed by neurologists using clinical and radiological findings. Subjective image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were analyzed. Performance in diagnosing TLE, lesion findings, and image quality were compared among the three protocols.
The pooled sensitivity of 1.5-mm MRI + DLR (91.2%) for diagnosing TLE was higher than that of routine MRI (72.1%,
< 0.001). In the subgroup analysis, 1.5-mm MRI + DLR showed higher sensitivity for hippocampal lesions than routine MRI (92.7% vs. 75.0%,
= 0.001), with improved depiction of hippocampal T2 high signal intensity change (
= 0.016) and loss of internal structure (
< 0.001). However, the pooled specificity of 1.5-mm MRI + DLR (76.5%) was lower than that of routine MRI (89.2%,
= 0.004). Compared with 1.5-mm MRI without DLR, 1.5-mm MRI + DLR resulted in significantly improved pooled accuracy (91.2% vs. 73.1%,
= 0.010), image quality, SNR, and CNR (all,
< 0.001).
The use of 1.5-mm MRI + DLR enhanced the performance of MRI in diagnosing TLE, particularly in hippocampal evaluation, because of improved depiction of hippocampal abnormalities and enhanced image quality.