Deep-Learning-Based Reconstruction of Single-Breath-Hold 3 mm HASTE Improves Abdominal Image Quality and Reduces Acquisition Time: A Quantitative Analysis

Purpose: Breath-hold T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) magnetic resonance imaging (MRI) of the upper abdomen with a slice thickness below 5 mm suffers from high image noise and blurring. The purpose of this prospective study was to improve image quality and accelerate imaging acquisition by using single-breath-hold T2-weighted HASTE with deep learning (DL) reconstruction (DL-HASTE) with a 3 mm slice thickness. Method: MRI of the upper abdomen with DL-HASTE was performed in 35 participants (5 healthy volunteers and 30 patients) at 3 Tesla. In a subgroup of five healthy participants, signal-to-noise ratio (SNR) analysis was used after DL reconstruction to identify the smallest possible layer thickness (1, 2, 3, 4, 5 mm). DL-HASTE was acquired with a 3 mm slice thickness (DL-HASTE-3 mm) in 30 patients and compared with 5 mm DL-HASTE (DL-HASTE-5 mm) and with standard HASTE (standard-HASTE-5 mm). Image quality and motion artifacts were assessed quantitatively using Laplacian variance and semi-quantitatively by two radiologists using five-point Likert scales. Results: In the five healthy participants, DL-HASTE-3 mm was identified as the optimal slice (SNR 23.227 ± 3.901). Both DL-HASTE-3 mm and DL-HASTE-5 mm were assigned significantly higher overall image quality scores than standard-HASTE-5 mm (Laplacian variance, both p < 0.001; Likert scale, p < 0.001). Compared with DL-HASTE-5 mm (1.10 × 10^-5 ± 6.93 × 10^-6), DL-HASTE-3 mm (1.56 × 10^-5 ± 8.69 × 10^-6) provided a significantly higher SNR Laplacian variance (p < 0.001) and sharpness sub-scores for the intestinal tract, adrenal glands, and small anatomic structures (bile ducts, pancreatic ducts, and vessels; p < 0.05). Lesion detectability was rated excellent for both DL-HASTE-3 mm and DL-HASTE-5 mm (both: 5 [IQR4-5]) and was assigned higher scores than standard-HASTE-5 mm (4 [IQR4-5]; p < 0.001). DL-HASTE reduced the acquisition time by 63-69% compared with standard-HASTE-5 mm (p < 0.001). Conclusions: DL-HASTE is a robust abdominal MRI technique that improves image quality while at the same time reducing acquisition time compared with the routine clinical HASTE sequence. Using ultra-thin DL-HASTE-3 mm results in an even greater improvement with a similar SNR.