Linkugel Andrew D, Wang Tongyao, Boroojeni Parna Eshraghi, Eldeniz Cihat, Chen Yasheng, Skolnick Gary B, Commean Paul K, Merrill Corinne M, Strahle Jennifer M, Goyal Manu S, An Hongyu, Patel Kamlesh B
From the Division of Plastic and Reconstructive Surgery (A.D.L., G.B.S., C.M.M., K.B.P.), Washington University in St. Louis, St. Louis, Missouri.
Mallinckrodt Institute of Radiology (T.W., P.E.B., C.E., P.K.C., M.S.G., H.A.), Washington University in St. Louis, St. Louis, Missouri.
AJNR Am J Neuroradiol. 2024 Sep 9;45(9):1284-1290. doi: 10.3174/ajnr.A8335.
CT imaging exposes patients to ionizing radiation. MR imaging is radiation free but previously has not been able to produce diagnostic-quality images of bone on a timeline suitable for clinical use. We developed automated motion correction and use deep learning to generate pseudo-CT images from MR images. We aim to evaluate whether motion-corrected pseudo-CT produces cranial images that have potential to be acceptable for clinical use.
Patients younger than age 18 who underwent CT imaging of the head for either trauma or evaluation of cranial suture patency were recruited. Subjects underwent a 5-minute golden-angle stack-of-stars radial volumetric interpolated breath-hold MR image. Motion correction was applied to the MR imaging followed by a deep learning-based method to generate pseudo-CT images. CT and pseudo-CT images were evaluated and, based on indication for imaging, either presence of skull fracture or cranial suture patency was first recorded while viewing the MR imaging-based pseudo-CT and then recorded while viewing the clinical CT.
A total of 12 patients underwent CT and MR imaging to evaluate suture patency, and 60 patients underwent CT and MR imaging for evaluation of head trauma. For cranial suture patency, pseudo-CT had 100% specificity and 100% sensitivity for the identification of suture closure. For identification of skull fractures, pseudo-CT had 100% specificity and 90% sensitivity.
Our early results show that automated motion-corrected and deep learning-generated pseudo-CT images of the pediatric skull have potential for clinical use and offer a high level of diagnostic accuracy when compared with standard CT scans.
CT成像会使患者暴露于电离辐射中。磁共振成像(MR)无辐射,但此前无法在适合临床使用的时间范围内生成具有诊断质量的骨骼图像。我们开发了自动运动校正技术,并利用深度学习从MR图像生成伪CT图像。我们旨在评估经运动校正的伪CT生成的颅脑图像是否有可能达到临床可接受的水平。
招募年龄小于18岁、因头部外伤或评估颅缝通畅情况而接受头部CT成像的患者。受试者接受5分钟的黄金角星状堆叠径向容积插值屏气MR成像。对MR成像应用运动校正,然后采用基于深度学习的方法生成伪CT图像。对CT和伪CT图像进行评估,并根据成像指征,在查看基于MR成像的伪CT时首先记录是否存在颅骨骨折或颅缝通畅情况,然后在查看临床CT时记录。
共有12例患者接受CT和MR成像以评估颅缝通畅情况,60例患者接受CT和MR成像以评估头部外伤。对于颅缝通畅情况,伪CT在识别颅缝闭合方面具有100%的特异性和100%的敏感性。对于识别颅骨骨折,伪CT具有100%的特异性和90%的敏感性。
我们的早期结果表明,经自动运动校正和深度学习生成的小儿颅骨伪CT图像具有临床应用潜力,与标准CT扫描相比具有较高的诊断准确性。