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Research ArticleSpine

Deep Learning–Generated Synthetic MR Imaging STIR Spine Images Are Superior in Image Quality and Diagnostically Equivalent to Conventional STIR: A Multicenter, Multireader Trial

L.N. Tanenbaum, S.C. Bash, G. Zaharchuk, A. Shankaranarayanan, R. Chamberlain, M. Wintermark, C. Beaulieu, M. Novick and L. Wang
American Journal of Neuroradiology August 2023, 44 (8) 987-993; DOI: https://doi.org/10.3174/ajnr.A7920
L.N. Tanenbaum
aFrom RadNet (L.N.T., S.C.B.), New York, New York
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  • ORCID record for L.N. Tanenbaum
S.C. Bash
aFrom RadNet (L.N.T., S.C.B.), New York, New York
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G. Zaharchuk
bStanford University Medical Center (G.Z., C.B.), Stanford, California
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A. Shankaranarayanan
cSubtle Medical (A.S., R.C., L.W.), Menlo Park, California
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R. Chamberlain
cSubtle Medical (A.S., R.C., L.W.), Menlo Park, California
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M. Wintermark
dMD Anderson Cancer Center (M.W.), University of Texas, Houston, Texas
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C. Beaulieu
bStanford University Medical Center (G.Z., C.B.), Stanford, California
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M. Novick
eAll-American Teleradiology (M.N.), Bay Village, Ohio
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L. Wang
cSubtle Medical (A.S., R.C., L.W.), Menlo Park, California
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Figures

  • FIG 1.
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    FIG 1.

    A, L2 body fracture. Conventional acquired STIR (left) and DL synthesized STIR (right). Note the Syn-STIR manifests fewer motion artifacts, improved sharpness, and greater apparent SNR. B, Sacral metastasis. Conventional Acq-STIR (left) and DL Syn-STIR (right). Note the striking reduction in motion artifacts as well as superior overall quality of the Syn-STIR.

  • FIG 2.
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    FIG 2.

    Interchangeability when accounting for readers and cases as random effects under the whole-cohort estimated >1000 bootstrapped samples.

  • FIG 3.
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    FIG 3.

    Interchangeability when accounting for readers and cases as random effects under the trauma cohort estimated >1000 bootstrapped samples. The x-axis represents the estimated interchangeabilities in the unit of percentage, and the y-axis represents the count of bootstrapped samples. A, Trauma class I. B, Trauma class II. C, Trauma class III. D, Mixed effect for all 3 classes.

  • FIG 4.
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    FIG 4.

    Bland-Altman plots for each tissue from 80 clinical cases. The x-axis represents the mean of the normalized intensity value from Syn-STIR and its nearest neighbor from Acq-STIR, and the y-axis represents the difference between the normalized intensity value from Syn-STIR and its nearest neighbor from the Acq-STIR.

  • FIG 5.
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    FIG 5.

    Passing-Bablok regression applied to estimate the regression line and intercept. The slope of the disc, CSF, and spinal cord is 1.06, 1.05, and 1.07, which indicates a high correlation between the 2 results. The slope of bone and fat is 0.85 and 0.78, respectively. The results indicate excellent voxelwise consistency between the Acq-STIR and Syn-STIR images.

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American Journal of Neuroradiology: 44 (8)
American Journal of Neuroradiology
Vol. 44, Issue 8
1 Aug 2023
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Cite this article
L.N. Tanenbaum, S.C. Bash, G. Zaharchuk, A. Shankaranarayanan, R. Chamberlain, M. Wintermark, C. Beaulieu, M. Novick, L. Wang
Deep Learning–Generated Synthetic MR Imaging STIR Spine Images Are Superior in Image Quality and Diagnostically Equivalent to Conventional STIR: A Multicenter, Multireader Trial
American Journal of Neuroradiology Aug 2023, 44 (8) 987-993; DOI: 10.3174/ajnr.A7920

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Deep Learning for STIR Spine MRI Quality
L.N. Tanenbaum, S.C. Bash, G. Zaharchuk, A. Shankaranarayanan, R. Chamberlain, M. Wintermark, C. Beaulieu, M. Novick, L. Wang
American Journal of Neuroradiology Aug 2023, 44 (8) 987-993; DOI: 10.3174/ajnr.A7920
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