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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleADULT BRAIN
Open Access

Synthetic MRI for Clinical Neuroimaging: Results of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial

L.N. Tanenbaum, A.J. Tsiouris, A.N. Johnson, T.P. Naidich, M.C. DeLano, E.R. Melhem, P. Quarterman, S.X. Parameswaran, A. Shankaranarayanan, M. Goyen and A.S. Field
American Journal of Neuroradiology June 2017, 38 (6) 1103-1110; DOI: https://doi.org/10.3174/ajnr.A5227
L.N. Tanenbaum
aFrom Lenox Hill Radiology (L.N.T.), RadNet Inc, New York, New York
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A.J. Tsiouris
bDepartment of Radiology (A.J.T.), Weill Cornell Medical Center, New York, New York
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A.N. Johnson
cDepartment of Technical Communication (A.N.J.), Science and Healthcare, Texas Tech University, Lubbock, Texas
dTechnology and Medical Innovation Organization (A.N.J., S.X.P.)
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T.P. Naidich
hDepartment of Neuroradiology (T.P.N.), The Mount Sinai Hospital, New York, New York
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M.C. DeLano
iDivision of Radiology and Biomedical Imaging (M.C.D.), Michigan State University, Advanced Radiology Services, PC, and Spectrum Health, Grand Rapids, Michigan
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E.R. Melhem
jDepartment of Diagnostic Radiology and Nuclear Medicine (E.R.M.), University of Maryland School of Medicine, Baltimore, Maryland
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P. Quarterman
eHealthcare Imaging-MRI (P.Q.)
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S.X. Parameswaran
dTechnology and Medical Innovation Organization (A.N.J., S.X.P.)
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A. Shankaranarayanan
fHealthcare Imaging-MRI Neuro Applications (A.S.)
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M. Goyen
gMedical Affairs (M.G.), GE Healthcare, Milwaukee, Wisconsin
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A.S. Field
kDepartment of Radiology (A.S.F.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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  • Fig 1.
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    Fig 1.

    Axial synthetic and conventional 3T MR imaging of a normal brain. Conventional (upper row) and synthetic (lower row) image sets exhibit similar legibility and quality. Slight differences in contrast levels are apparent, which do not adversely impact the diagnostic utility of images, particularly between T1 FLAIR and T2 FLAIR views.

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    Fig 2.

    Left frontal lobe cystic tumor on axial synthetic and conventional 3T MR imaging in a 31-year-old woman. Conventional (upper row) and synthetic (lower row) image sets exhibit similar legibility and quality.

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    Fig 3.

    Chronic right cerebellar infarction in a 37-year-old woman on axial synthetic and conventional 3T MR imaging. Conventional (upper row) and synthetic (lower row) image sets exhibit similar legibility and quality.

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    Fig 4.

    Multiple sclerosis in axial synthetic and conventional 3T MR imaging in a 58-year-old woman. Multifocal demyelinating lesions are apparent within the cerebral white matter; these lesions appear similar on conventional (upper row) and synthetic (lower row) image sets. A slight misregistration is apparent due to patient motion between the MDME scan (used for synthetic reconstruction, lower row) and the comparable conventional scan acquired in the study (upper row). While misregistration due to motion can pose challenges in conventional serial acquisitions due to partial section differences in images across contrast views, synthetic reconstruction inherently prevents misregistration across synthetic contrast views.

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    Fig 5.

    Chronic infarction in synthetic and conventional 3T MR imaging shown alongside color functional perfusion maps in a 62-year-old man. Conventional (rows 1 and 3) and synthetic (rows 2 and 4) views show similar legibility and quality. T1 FLAIR and T2 FLAIR views have some granulated white noise in the margins. Color quantitative perfusion maps (lower right) demonstrate decreased flow and prolonged transit time in this region of chronic infarction.

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    Fig 6.

    Subdural hematoma on T2 FLAIR in synthetic and conventional 3T MR imaging demonstrating pronounced artifacts. Conventional (left) and synthetic (right) T2 FLAIR images are shown for a patient with subdural hematoma, in which synthetic T2 FLAIR has notable granulated hyperintensities and lacks contrast between the lesion and surrounding tissues. Artifacts of this severity level were rare among synthetically reconstructed images, possibly due to issues in the MDME acquisition that are typically resolved on rescanning. For cases demonstrating these granulated hyperintensities on the synthetic T2 FLAIR, artifacts were readily recognizable by characteristic distortion and correlation with other contrast views without apparent artifacts. While these could necessitate rescanning with conventional T2 FLAIR in some cases, when coupled with other contrast views, these artifacts did not interfere with the diagnostic accuracy of synthetic MR imaging.

Tables

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  • Diagnostic image-quality ratings by static field strength of scanner and overalla

    Diagnostic Qualityb1.5T Scanner3T ScannerOverall (1.5T + 3T)
    Syn (N = 392)Con (N = 392)Syn (N = 371)Con (N = 371)Syn (N = 763)Con (N = 763)
    Acceptable for diagnostic use (3,4,5)380 (97%)387 (99%)354 (95%)358 (96%)734 (96%)745 (98%)
        Excellent (rated 5)64 (16%)183 (47%)37 (10%)103 (28%)101 (13%)286 (37%)
        Good (rated 4)266 (68%)170 (43%)230 (62%)199 (54%)496 (65%)369 (48%)
        Acceptable (rated 3)50 (13%)34 (9%)87 (23%)56 (15%)137 (18%)90 (12%)
    Unacceptable for diagnostic use (1,2)12 (3%)5 (1%)17 (5%)13 (4%)29 (4%)18 (2%)
    Poor (rated 2)10 (3%)5 (1%)16 (4%)12 (3%)26 (3%)17 (2%)
    Unacceptable (rated 1)2 (1%)01 (0.3%)1 (0.3%)3 (0.4%)1 (0.1%)
    • Note:—Syn indicates synthetic MR imaging; Con = conventional MR imaging (control).

    • ↵a All data are shown as n (n/N%), where n is the count and N is the total reads per category (defined in the upper row of this table).

    • ↵b Five-point scale.

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American Journal of Neuroradiology: 38 (6)
American Journal of Neuroradiology
Vol. 38, Issue 6
1 Jun 2017
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L.N. Tanenbaum, A.J. Tsiouris, A.N. Johnson, T.P. Naidich, M.C. DeLano, E.R. Melhem, P. Quarterman, S.X. Parameswaran, A. Shankaranarayanan, M. Goyen, A.S. Field
Synthetic MRI for Clinical Neuroimaging: Results of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial
American Journal of Neuroradiology Jun 2017, 38 (6) 1103-1110; DOI: 10.3174/ajnr.A5227

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Synthetic MRI for Clinical Neuroimaging: Results of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial
L.N. Tanenbaum, A.J. Tsiouris, A.N. Johnson, T.P. Naidich, M.C. DeLano, E.R. Melhem, P. Quarterman, S.X. Parameswaran, A. Shankaranarayanan, M. Goyen, A.S. Field
American Journal of Neuroradiology Jun 2017, 38 (6) 1103-1110; DOI: 10.3174/ajnr.A5227
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