Background: Deep learning (DL) reconstruction techniques have shown promise in reducing MRI acquisition times while maintaining image quality. However, the impact of different acceleration factors on diagnostic accuracy in shoulder MRI remains unexplored in clinical practice. Purpose: The purpose of this study was to evaluate the diagnostic accuracy of 2-fold and 4-fold DL-accelerated shoulder MRI protocols compared to standard protocols in clinical practice. Materials and Methods: In this prospective single-center study, 88 consecutive patients (49 males, 39 females; mean age, 51 years) underwent shoulder MRI examinations using standard, 2-fold (DL2), and 4-fold (DL4) accelerated protocols between June 2023 and January 2024. Four independent radiologists (experience range: 4–25 years) evaluated the presence of bone marrow edema (BME), rotator cuff tears, and labral lesions. The sensitivity, specificity, and interobserver agreement were calculated. Diagnostic confidence was assessed using a 4-point scale. The impact of reader experience was analyzed by stratifying the radiologists into ≤10 and >10 years of experience. Results: Both accelerated protocols demonstrated high diagnostic accuracy. For BME detection, DL2 and DL4 achieved 100% sensitivity and specificity. In rotator cuff evaluation, DL2 showed a sensitivity of 98–100% and specificity of 99–100%, while DL4 maintained a sensitivity of 95–98% and specificity of 99–100%. Labral tear detection showed perfect sensitivity (100%) with DL2 and slightly lower sensitivity (89–100%) with DL4. Interobserver agreement was excellent across the protocols (Kendall’s W = 0.92–0.98). Reader experience did not significantly impact diagnostic performance. The area under the ROC curve was 0.94 for DL2 and 0.90 for DL4 (p = 0.32). Clinical Implications: The implementation of DL-accelerated protocols, particularly DL2, could improve workflow efficiency by reducing acquisition times by 50% while maintaining diagnostic reliability. This could increase patient throughput and accessibility to MRI examinations without compromising diagnostic quality. Conclusions: DL-accelerated shoulder MRI protocols demonstrate high diagnostic accuracy, with DL2 showing performance nearly identical to that of the standard protocol. While DL4 maintains acceptable diagnostic accuracy, it shows a slight sensitivity reduction for subtle pathologies, particularly among less experienced readers. The DL2 protocol represents an optimal balance between acquisition time reduction and diagnostic confidence.

Purpose: to outline the role of CT in pre- and post-treatment evaluation in the case of lumbar endoscopic foraminotomy. Methods: This prospective study, conducted between September 2020 and January 2024, included consecutive patients with clinical symptoms of lumbar sciatica/lumbalgia/lombo-cruralgia/lower limb peripheral neuropathy. Pre- and post-foraminotomy CT imaging was used to assess the foraminal diameters (cranio-caudal, transverse and free hand ROI area) before and after the treatment. Two independent blinded readers assessed the CT randomly. VAS pain scale and the measurements of each foramen were compared before and after treatment. Interobserver agreement was assessed using the Intraclass Correlation Coefficient (ICC). Results: A total of 47 participants were enrolled, with 53 intervertebral levels analyzed. The mean VAS value decreased from 9.17 in the preoperative period to 0.66 at the one-month postoperative follow-up. The clinical response was associated with statistically significant changes in the cranio-caudal and transverse diameters, as well as the area of the treated neuroforamina (p-values < 0.05). Inter-rater reliability between the two operators ranged from 0.75 to 0.90. Conclusions: CT can demonstrate a significant enlargement of the neuroforaminal diameters after the endoscopic foraminotomy, with good correlation with clinical improvement.