Ultrafast Brain MRI: Clinical Deployment and Comparison to Conventional Brain MRI at 3T.
To compare an ultrafast brain magnetic resonance imaging (MRI) protocol to the conventional protocol in motion-prone inpatient clinical settings.



This retrospective study was HIPAA compliant and approved by the Institutional Review Board with waived inform consent. Fifty-nine inpatients (30 males, 29 females; mean age 55.1, range 23-93 years)who underwent 3-Tesla brain MRI using ultrafast and conventional protocols, both including five sequences, were included in the study. The total scan time for five ultrafast sequences was 4 minutes 59 seconds. The ideal conventional acquisition time was 10 minutes 32 seconds but the actual acquisition took 15-20 minutes. The average scan times for ultrafast localizers, T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted, T2*-weighted sequences were 14, 41, 62, 96, 80, 6 seconds, respectively. Two blinded neuroradiologists independently assessed three aspects: (1) image quality, (2) gray-white matter (GM-WM) differentiation, and (3) diagnostic concordance for the detection of six clinically relevant imaging findings. Wilcoxon signed-rank test was used to compare image quality and GM-WM scores. Interobserver reproducibility was calculated.



The ultrafast T1-weighted sequence demonstrated significantly better image quality (P = .005) and GM-WM differentiation (P < .001) compared to the conventional sequence. There was high agreement (>85%) between both protocols for the detection of mass-like lesion, hemorrhage, diffusion restriction, WM FLAIR hyperintensities, subarachnoid FLAIR hyperintensities, and hydrocephalus.



The ultrafast protocol achieved at least comparable image quality and high diagnostic concordance compared to the conventional protocol. This fast protocol can be a viable option to replace the conventional protocol in motion-prone inpatient clinical settings.
Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, MA.|Department of Radiology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Supada
S
Prakkamakul
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA.
Thomas
T
Witzel
Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, MA.|Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA.
Susie
S
Huang
Neuroradiology Division, Department of Radiology, Ohio State University, Columbus, OH.
Daniel
D
Boulter
Neuroradiology Division, Department of Radiology, New York University School of Medicine, New York, NY.
Maria J
MJ
Borja
Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, MA.
Pamela
P
Schaefer
Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA.
Bruce
B
Rosen
Siemens Medical Solutions USA, Charlestown, MA.
Keith
K
Heberlein
Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, MA.|Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA.
Eva
E
Ratai
Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, MA.|Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA.
Gilberto
G
Gonzalez
Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, MA.
Otto
O
Rapalino
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D001927:Brain Diseases / Q000000981:diagnostic imaging*; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
MRI; brain; fast imaging; image quality