Ultrafast deep learning super-resolution single-shot T2-weighted imaging for robust edema visualization in cardiovascular magnetic resonance

BACKGROUND: To compare the diagnostic quality of deep learning (DL) super-resolution reconstructed breath-hold (BH) and free-breathing (FB) single-shot (SSH) black-blood T2-weighted short tau inversion recovery (STIR) imaging with standard BH T2-STIR in cardiovascular magnetic resonance (CMR). METHODS: In this prospective study, short-axis BH and FB SSH T2-STIR were added to a standard cardiomyopathy CMR protocol at 1.5T, and DL super-resolution reconstruction was performed. Two readers evaluated diagnostic quality and certainty using a five-point Likert scale. Presence of focal edema was assessed on T2-weighted sequences, including standard T2-STIR and T2 mapping (both used for reference clinical assessment) as well as SSH T2 STIR and DL-SSH T2-STIR. Friedman test and one-way ANOVA were performed. RESULTS: Eighty-one participants (mean age: 54 ± 20 years; 50 men) were included. No difference was found in edema detection between reference assessment and DL-SSH T2-STIR (both 26%, (21/81 participants)). Scan time was reduced by 63% for BH and 86% for FB DL-SSH T2-STIR compared to standard T2-STIR (90 ± 6 s vs. 35 ± 3 s vs. 243 ± 16 s; p