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Acceleration of Double Inversion Recovery Sequences in Multiple Sclerosis With Compressed Sensing

Eichinger, Paul, MD*; Hock, Andreas, PhD; Schön, Simon, MD*; Preibisch, Christine, PhD*; Kirschke, Jan S., MD*; Mühlau, Mark, MD‡,§; Zimmer, Claus, MD*; Wiestler, Benedikt, MD*

doi: 10.1097/RLI.0000000000000550
Original Articles

Objective The aim of this study was to assess the performance of double inversion recovery (DIR) sequences accelerated by compressed sensing (CS) in a clinical setting.

Materials and Methods We included 106 patients with MS (62 female [58%]; mean age, 44.9 ± 11.0 years) in this prospective study. In addition to a full magnetic resonance imaging protocol including a conventional SENSE accelerated DIR, we acquired a CS DIR (time reduction, 51%). We generated subtraction maps between the two DIR sequences to visualize focal intensity differences. Two neuroradiologists independently assessed these maps for intensity differences, which were categorized into definite MS lesions, possible lesions, or definite artifacts. Counts of focal intensity differences were compared using a Wilcoxon rank sum test. Moreover, conventional lesion counts were acquired for both sequences in independent readouts, and agreement between the DIR variants was assessed with intraclass correlation coefficients.

Results No hyperintensity that was rated as definite lesion was missed in the CS DIR. Two possible lesions were only detected in the conventional DIR, one only in the CS DIR (no significant difference, P = 0.57). The conventional DIR showed significantly more definite artifacts within the white matter (P = 0.024) and highly significantly more at the cortical-sulcal interface (P < 0.001). For both readers, intraclass correlation coefficient between the lesion counts in the two DIR variants was near perfect (0.985 for reader 1 and 0.981 for reader 2).

Conclusions Compressed sensing can be used to substantially reduce scan time of DIR sequences without compromising diagnostic quality. Moreover, the CS accelerated DIR proved to be significantly less prone to imaging artifacts.

From the *Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich;

Philips GmbH Market DACH, Hamburg;

Department of Neurology, and

§TUM-NIC, NeuroImaging Center, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.

Received for publication October 1, 2018; and accepted for publication, after revision, December 7, 2018.

Conflicts of interest and sources of funding: P.E. received speaker honoraria (not related to this study) from Philips Healthcare DACH and travel support from GSK foundation; A.H. is an employee of Philips Health Systems, Schweiz; J.S.K. received research grant from Nvidia, speaker honoraria from Philips Healthcare DACH, and travel support from Kaneka Europe; M.M. received research grants from Merck and Novartis; C.Z. received speaker honoraria from Philips and Bayer, as well as compensation for clinical trials from Biogen Idec, Quintiles, MSD, Boehringer Ingelheim, Inventive Health Clinical, and Advance Cor; and B.W. received speaker honoraria from Bayer. For the remaining authors, no conflicts of interest are declared.

Correspondence to: Paul Eichinger, MD, Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675 Munich, Germany. E-mail:

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