Deep learning-based image reconstruction improves radiologic evaluation of pituitary axis and cavernous sinus invasion in pituitary adenoma

Purpose: To compare performance of 1-mm deep learning reconstruction (DLR) with 3-mm routine MRI imaging for the delineation of pituitary axis and identification of cavernous sinus invasion for pituitary macroadenoma.Method: This retrospective study included 104 patients (59.4 +/- 13.1 years; 46 women) who underwent an MRI protocol including 1-mm deep learning-reconstructed and 3-mm routine images for evaluating pituitary ade-noma between August 2019 and October 2020. Five readers (24, 9, 2 years, and <1 year of experience) assessed the delineation of pituitary axis (gland and stalk) and the presence of cavernous sinus invasion for using a pairwise design. The signal-to-noise ratio (SNR) was measured. Diagnostic performance as well as image pref-erence data were analysed and compared according to the readers' experience using the McNemar test.Results: For delineation of normal pituitary axis, all readers preferred thin 1-mm DLR MRI over 3-mm MRI (overall superiority, 55.8 %, P <.001), with this preference being greater in the less experienced readers (92.3 % vs. 55.8 % [expert], P <.001). The readers showed higher diagnostic performance for cavernous sinus invasion on 1-mm (AUC, 0.91 and 0.92) than on 3-mm imaging (AUC, 0.87 and 0.88). The SNR of the 1-mm DLR was 1.21-fold higher than that of the routine 3-mm imaging.Conclusion: Deep learning reconstruction-based 1-mm imaging demonstrates improved image quality and better delineation of microstructure in the sellar fossa and is preferred by both radiologists and non-radiologist phy-sicians, especially in less experienced readers.

Automated summary

A comparative study on 104 patients found that 1-mm deep learning reconstruction (DLR) provides better delineation of the pituitary axis and identification of cavernous sinus invasion for pituitary macroadenoma compared to routine 3-mm MRI imaging.