Deep learning for contrast-enhanced MRI in pediatric brain imaging.
PURPOSE A deep learning algorithm for contrast amplification in brain MRI, trained exclusively on adult data, was tested for cross-population generalization to pediatric patients, including subjects aged 0-2 years. METHODS A retrospective monocentric dataset (n = 22 cases) comprising pediatric patients (0-17 years old) diagnosed with various brain tumors was used to evaluate the algorithm, which takes T1-weighted pre- and standard post-contrast images as input and generates an output image with amplified contrast, further post-processed with an HDR algorithm. Quantitative comparisons between standard and amplified images were performed using contrast-to-noise ratio (CNR), contrast enhancement percentage (CEP), and lesion-to-background ratio (LBR). Three neuroradiologists performed qualitative assessment using a 4-point Likert scale, focusing on lesion contrast and delineation. Anatomical similarity was assessed using SSIM and log-Jacobian range. Statistical significance was evaluated using two-tailed paired t-tests. RESULTS Compared to standard-dose images, contrast-amplified images showed significantly higher values for CNR (+ 186.5%), LBR (+ 61.9%), and CEP (+ 110.4%). Qualitative assessments demonstrated comparable lesion visualization, with improvements observed in selected cases. Reader 1 preferred the contrast-amplified image in 12 of 22 cases (54.5%), reader 2 favored it in 18 of 22 cases (81.8%) and reader 3 in 13/22 cases (59.1%). One reader reported improved overall image quality (mean score: 3.95 vs. 3.73). The average SSIM between amplified and standard-dose images was 0.98, and any significant anatomical differences were highlighted by the log-Jacobian range (p-value = 0.556). CONCLUSION An algorithm for contrast amplification based on deep learning, trained with adult data, significantly enhances quantitative contrast metrics in images from pediatric patients. It is preferred over standard-dose images in the majority of cases when used for pediatric brain MRI, indicating its promising application for cross-population applicability.