Miller J H, Lefkowitz D, Maulsby G, Mechtler L, Pinter N, Snyder T, Hayes L, Carpenter J, Koral K, Cornejo P, Levendovszky S R, Warntjes J B M, Johansson P, Lange E
From the Department of Radiology (J.H.M., P.C.), Phoenix Children's, Phoenix, Arizona
SimonMed Imaging (D.L., T.S.), Los Angeles, California.
AJNR Am J Neuroradiol. 2025 Jun 3;46(6):1196-1202. doi: 10.3174/ajnr.A8631.
Prior large prospective studies have shown 2D synthetic MR image quality to be similar to that of conventional MR imaging across a wide variety of normal and abnormal subjects. This study is the first large, prospective comparison of 3D synthetic to conventional MR imaging performed in routine clinical settings.
A prospective, multicenter, multireader clinical investigation to evaluate the diagnostic performance of 3D synthetic images based on the novel synthetic MRI 3D-QALAS method compared with conventional 3D MRI was performed. Five blinded neuroradiologists evaluated the 3D synthetic and conventional MR images of 189 subjects who presented at clinical sites for neuroimaging. The objectives were to compare sensitivity and specificity of pathologic findings, accuracy of imaging findings, image quality, legibility of anatomic structures, artifact prevalence, and interrater and intermethod agreement of synthetic 3D MR images with conventional 3D images.
Both sensitivity and specificity of 3D synthetic and conventional images for pathologic findings and diagnostic accuracy of radiologic findings were very similar, 66/68% and 85/85%, respectively. The individual values for the readers varied between 58%-73%/58%-75% for sensitivity and 72%-98%/77%-94% for specificity. No significant difference could be determined between the methods. Ratings (1-5 scale) of synthetic MR image quality were higher than for T1-weighted images (mean score of 4.6 ± 0.6, with 98.6% having a 3 or higher versus 4.5 ± 0.7, with 97.8% having a 3 or higher) and T2-weighted images (4.4 ± 0.7, with 98.0% having a 3 or higher versus 4.2 ± 0.8, with 97.5% having a 3 or higher).
In this study no significant differences were found in the sensitivity and specificity of pathologic findings and accuracy of imaging findings between 3D synthetic T1-weighted and T2-weighted images and 3D conventional images. In addition, 5 blinded neuroradiologists rated 3D synthetic MR images of higher image quality than conventional 3D images.
先前的大型前瞻性研究表明，在各类正常和异常受试者中，二维合成磁共振图像质量与传统磁共振成像相似。本研究是在常规临床环境中对三维合成磁共振成像与传统磁共振成像进行的首次大型前瞻性比较。
进行了一项前瞻性、多中心、多阅片者的临床研究，以评估基于新型合成磁共振成像3D-QALAS方法的三维合成图像与传统三维磁共振成像的诊断性能。五名盲法神经放射科医生对189名到临床机构进行神经成像检查的受试者的三维合成磁共振图像和传统磁共振图像进行了评估。目的是比较病理结果的敏感性和特异性、影像结果的准确性、图像质量、解剖结构的清晰度、伪影发生率，以及合成三维磁共振图像与传统三维图像之间的阅片者间和方法间一致性。
三维合成图像和传统图像在病理结果的敏感性和特异性以及放射学结果的诊断准确性方面非常相似，分别为66/68%和85/85%。各阅片者的敏感性个体值在58%-73%/58%-75%之间，特异性在72%-98%/77%-94%之间。两种方法之间未发现显著差异。合成磁共振图像质量评分（1-5分制）高于T1加权图像（平均得分4.6±0.6，98.6%为3分或更高，而T1加权图像平均得分4.5±0.7，97.8%为3分或更高）和T2加权图像（4.4±0.7，98.0%为3分或更高，而T2加权图像平均得分4.2±0.8，97.5%为3分或更高）。
在本研究中，三维合成T1加权和T2加权图像与三维传统图像在病理结果的敏感性和特异性以及影像结果的准确性方面未发现显著差异。此外，五名盲法神经放射科医生对三维合成磁共振图像质量的评分高于传统三维图像。
