Deep Learning Reconstruction of Diffusion-weighted MRI Enables Shorter Examination Times While Maintaining Image Quality in Head and Neck Imaging

Abstract Rationale and Objectives Diffusion-weighted imaging (DWI) of the head and neck is essential for various clinical applications but is often hampered by artifacts and reduced image quality. Deep learning (DL) reconstruction has the potential to enhance the quality of head and neck DWI. This study aims to evaluate the performance of an accelerated, DL-reconstructed DWI (DWI DL ) in terms of image quality and diagnostic confidence. Materials and Methods This retrospective study included patients who underwent clinically indicated head and neck DWI at 1.5 T and 3 T between August 2023 and January 2024 at a tertiary care center. Imaging was performed at low b‑values (0 or 50 sec/mm 2 ) and high b‑values (800 sec/mm 2 ), and apparent diffusion coefficient (ADC) maps were computed. After acquiring standard single-shot echoplanar imaging DWI sequences, the raw MR datasets underwent simulated acceleration by reducing the number of signal averages. These accelerated exams were then reconstructed using a novel DL-based algorithm that combined DL-based k‑space to image reconstruction with DL-based super-resolution processing (DWI DL ). Three readers analyzed the images using a visual Likert score to evaluate image sharpness, artifacts, noise, overall image quality, and diagnostic confidence. Comparisons were made using the Wilcoxon signed-rank test. A quantitative analysis of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and apparent diffusion coefficient values (ADC) was also performed. Results The study included 30 patients (mean age, 55 ± 19 years; range, 24–84; 18 men) with various pathologies. Scan times were reduced by 67% at 1.5 T and up to 55% at 3 T. The quantitative analysis revealed a minimal but statistically significant decrease in SNR and CNR in the deep learning-reconstructed images ( p = 0.002 and p < 0.001, respectively). However, readers reported no significant differences between DWI and DWI DL regarding image quality parameters or diagnostic confidence for both low and high b‑value images, as well as the ADC (all p > 0.05). Conclusion DL reconstruction of head and neck DWI is feasible, significantly reducing examination time without compromising image quality or diagnostic confidence. This technique enables accelerated and effective diagnostic DWI of the head and neck.