Background Deep learning (DL)-accelerated MRI can substantially reduce examination times. However, studies prospectively evaluating the diagnostic performance of DL-accelerated MRI reconstructions in acute suspected stroke are lacking. Purpose To investigate the interchangeability of DL-accelerated MRI with conventional MRI in patients with suspected acute ischemic stroke at 1.5 T. Materials and Methods In this prospective study, 211 participants with suspected acute stroke underwent clinically indicated MRI at 1.5 T between June 2022 and March 2023. For each participant, conventional MRI (including T1-weighted, T2-weighted, T2*-weighted, T2 fluid-attenuated inversion-recovery, and diffusion-weighted imaging; 14 minutes 18 seconds) and DL-accelerated MRI (same sequences; 3 minutes 4 seconds) were performed. The primary end point was the interchangeability between conventional and DL-accelerated MRI for acute ischemic infarction detection. Secondary end points were interchangeability regarding the affected vascular territory and clinically relevant secondary findings (eg, microbleeds, neoplasm). Three readers evaluated the overall occurrence of acute ischemic stroke, affected vascular territory, clinically relevant secondary findings, overall image quality, and diagnostic confidence. For acute ischemic lesions, size and signal intensities were assessed. The margin for interchangeability was chosen as 5%. For interrater agreement analysis and interrater reliability analysis, multirater Fleiss κ and the intraclass correlation coefficient, respectively, was determined. Results The study sample consisted of 211 participants (mean age, 65 years ± 16 [SD]); 123 male and 88 female). Acute ischemic stroke was confirmed in 79 participants. Interchangeability was demonstrated for all primary and secondary end points. No individual equivalence indexes (IEIs) exceeded the interchangeability margin of 5% (IEI, -0.002 [90% CI: -0.007, 0.004]). Almost perfect interrater agreement was observed (P > .91). DL-accelerated MRI provided higher overall image quality (P < .001) and diagnostic confidence (P < .001). The signal properties of acute ischemic infarctions were similar in both techniques and demonstrated good to excellent interrater reliability (intraclass correlation coefficient, ≥0.8). Conclusion Despite being four times faster, DL-accelerated brain MRI was interchangeable with conventional MRI for acute ischemic lesion detection. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Haller in this issue.

Objective: To provide a new approach to spectral quantification for magnetic resonance spectroscopic imaging (MRSI), incorporating both spatial and spectral priors. Methods: A novel signal model is proposed, which represents the spectral distributions of each molecule as a subspace and the entire spectrum as a union of subspaces. Based on this model, the spectral quantification can be solved in two steps: 1) subspace estimation based on the empirical distributions of the spectral parameters estimated using spectral priors; and 2) parameter estimation for the union-of-subspaces model incorporating spatial priors. Results: The proposed method has been evaluated using both simulated and experimental data, producing impressive results. Conclusion: The proposed union-of-subspaces representation of spatiospectral functions provides an effective computational framework for solving the MRSI spectral quantification problem with spatiospectral constraints. Significance: The proposed approach transforms how the MRSI spectral quantification problem is solved and enables efficient and effective use of spatiospectral priors to improve parameter estimation. The resulting algorithm is expected to be useful for a wide range of quantitative metabolic imaging studies using MRSI.

Defining the connectome, the complete matrix of structural connections between the nervous system nodes, is a challenge for human systems neuroscience due to the range of scales that must be bridged. Here we report the design of the Connectome 2.0 human magnetic resonance imaging (MRI) scanner to perform connectomics at the mesoscopic and microscopic scales with strong gradients for in vivo human imaging. We construct a 3-layer head-only gradient coil optimized to minimize peripheral nerve stimulation while achieving a gradient strength of 500 mT m ⁻¹ and a slew rate of 600 T m ⁻¹ s ⁻¹ , corresponding to a 5-fold greater gradient performance than state-of-the-art research gradient systems, including the original Connectome (Connectome 1.0) scanner. We find that gains in sensitivity of up to two times were achieved by integrating a 72-channel in vivo head coil and a 64-channel ex vivo whole-brain radiofrequency coil with built-in field monitoring for data fidelity. We demonstrate mapping of fine white matter pathways and inferences of cellular and axonal size and morphology approaching the single-micron level, with at least a 30% sensitivity improvement compared with Connectome 1.0.