Enhanced image quality in head and neck MRI with PROPELLER and deep learning reconstruction

Purpose: To evaluate the benefits of combining the Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) acquisition technique and deep learning-based reconstruction (DLR) for fat-suppressed T2-weighted imaging (Fs-T2WI) and diffusion-weighted imaging (DWI) in head and neck MRI. Materials and methods: This retrospective study included 34 patients who underwent 3.0-T head and neck MRI. Imaging protocols comprised PROPELLER-based Fs-T2WI and DWI, which were compared against conventional multiplanar fast spin-echo Fs-T2WI and single-shot echo-planar imaging DWI. All sequences were reconstructed using a DLR algorithm. Two radiologists independently performed qualitative assessment, evaluating overall image quality, lesion conspicuity, anatomical delineation, and artifact severity using a 5-point Likert scale. The quantitative assessment involved measurements of the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the lesions, adjacent muscle, parotid glands, and submandibular glands. Interobserver agreement was determined using weighted kappa statistics, and Wilcoxon signed-rank test was used for statistical comparisons. Results: The PROPELLER sequences exhibited significantly higher qualitative scores for all evaluated parameters in both Fs-T2WI and DWI compared to the conventional sequences (p < 0.001). The interobserver agreement for the Fs-T2WI was moderate (0.47-0.53), and that for DWI was good (0.76-0.83). The quantitative analysis further demonstrated significantly higher SNRs and lesion-to-muscle CNRs with the PROPELLER sequences (p < 0.001). Conclusion: The combination of PROPELLER acquisition and DLR significantly improves the image quality and lesion conspicuity in head and neck MRI. This approach effectively suppresses artifacts and improves quantitative image metrics, thereby positioning it as a reliable imaging strategy for routine clinical assessments of head and neck lesions.