Clinical Evaluation of Deep Learning–Reconstructed Postcontrast 3D T1-Weighted Volume Interpolated Breath-Hold Examination (VIBE) Compared with Standard VIBE for Detection of Internal Auditory Canal Lesions

BACKGROUND AND PURPOSE: Contrast-enhanced volume interpolated breath-hold examination (VIBE) is commonly used for evaluating internal auditory canal (IAC) pathology. Deep learning (DL)–reconstruction has been shown to reduce scan time while maintaining diagnostic quality. Our purpose was to compare the image quality of a DL-reconstructed post-contrast-enhanced VIBE sequence with standard 3D VIBE in a clinical setting. MATERIALS AND METHODS: This study included 74 patients undergoing contrast-enhanced MRI for the assessment of IAC pathology. The participants were scanned with a standard 3D VIBE sequence and DL-reconstructed VIBE (DL-VIBE) sequences. Two neuroradiologists performed a head-to-head evaluation of both sequences in terms of image-quality metrics, identification of key anatomic structures, and pathologic enhancement when present. A third neuroradiologist adjudicated the discrepant results. Superiority testing was performed to compare DL-VIBE with standard VIBE in image quality metrics, and a noninferiority test with a 15% margin was performed to test the visibility of key anatomic structures and pathologic enhancing lesions. Interrater agreement and quantitative assessment of an image-wise SNR, contrast-noise ratio, IAC-specific SNR, and tumor volumetric measurements as applicable were performed. RESULTS: DL-VIBE enabled approximately 25% scan time reduction (from 3 minutes 2 seconds on the standard sequence to 2 minutes 17 seconds on the DL sequence). DL-VIBE was superior to standard VIBE for all image-quality metrics (P < .01). DL-VIBE was noninferior to standard VIBE for structural visibility of key structures (P < .001) and was noninferior for pooled pathologic enhancement (P = .049). Interrater agreements were moderate to almost perfect across all categories (κ = 0.515–1). DL-VIBE provided significantly higher mean image-wise SNR (71.8 [SD, 23.2] versus 39.4 [SD, 10.7], respectively; P < .001), while providing comparable lesion conspicuity and volumetric assessment. CONCLUSIONS: DL-VIBE is a strong alternative to standard 3D VIBE for clinical IAC assessment, providing superior image quality and comparable visibility of key anatomic structures and enhancing pathology while offering higher image SNR with 25% reduced scan time.