Accelerating 7T Gradient-Echo Brain MRI With Generative AI Denoising.

RATIONALE AND OBJECTIVES: This study aimed to efficiently denoise short 7 T MRI acquisitions to achieve the image quality of longer scans using a generative Artificial Intelligence (AI) model. MATERIALS AND METHODS: A 7T Conditional Diffusion Model (7TCDM) was trained on an in-house 7T dataset of 11 examinations consisting of multi-repetition 2D T2-weighted gradient-echo acquisitions. The model utilized native single-acquisition 2D reconstructions, using multi-repetition images as a reference to guide denoising and enhance signal-to-noise ratio and contrast. Performance was compared to the same single-acquisition reconstruction either unprocessed or enhanced by a similarly trained convolutional neural network, vision transformer, and generative adversarial network, using Mean Squared Error (MSE), Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), and comprehensive neuroradiologic ratings. RESULTS: 7TCDM was tested on 2D T2-weighted gradient-echo images from 19 participants: eight healthy controls, six individuals with mild cognitive impairment, and five with Alzheimer's disease. Referencing the multi-repetition reference standard, 7TCDM improved the single-acquisition original image by 31.7% in MSE, 4.9% in PSNR, and 7.5% in SSIM, outperforming all other models in all metrics (P < 0.001). Expert rater evaluations confirmed superior image quality, with significantly enhanced detail (P < 0.001) and contrast preservation (P < 0.001) for the hippocampi, for white matter lesions, and for small cortical veins. CONCLUSIONS: Generative AI denoising provides high-quality denoised images from shorter scans, increasing the feasibility of scanning patients in shorter times while preserving essential anatomical and pathological details.