BACKGROUND AND PURPOSE: Synthetic MR imaging enables reconstruction of various image contrasts from 1 scan, reducing scan times and potentially providing novel information. This study is the first large, prospective comparison of synthetic-versus-conventional MR imaging for routine neuroimaging. MATERIALS AND METHODS: A prospective multireader, multicase noninferiority trial of 1526 images read by 7 blinded neuroradiologists was performed with prospectively acquired synthetic and conventional brain MR imaging case-control pairs from 109 subjects (mean, 53.0 ± 18.5 years of age; range, 19–89 years of age) with neuroimaging indications. Each case included conventional T1- and T2-weighted, T1 and T2 FLAIR, and STIR and/or proton density and synthetic reconstructions from multiple-dynamic multiple-echo imaging. Images were randomized and independently assessed for diagnostic quality, morphologic legibility, radiologic findings indicative of diagnosis, and artifacts. RESULTS: Clinical MR imaging studies revealed 46 healthy and 63 pathologic cases. Overall diagnostic quality of synthetic MR images was noninferior to conventional imaging on a 5-level Likert scale (P 95%, except in the posterior limb of the internal capsule for T1, T1 FLAIR, and proton-density views (all, >80%). Synthetic T2 FLAIR had more pronounced artifacts, including +24.1% of cases with flow artifacts and +17.6% cases with white noise artifacts. CONCLUSIONS: Overall synthetic MR imaging quality was similar to that of conventional proton-density, STIR, and T1- and T2-weighted contrast views across neurologic conditions. While artifacts were more common in synthetic T2 FLAIR, these were readily recognizable and did not mimic pathology but could necessitate additional conventional T2 FLAIR to confirm the diagnosis.

http://www.ajnr.org/content/ajnr/38/6/1103.full.pdf

Synthetic MRI for Clinical Neuroimaging: Results of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial.

https://www.creatis.insa-lyon.fr/~yougz/references/beno05-simri.pdf

The SIMRI project: a versatile and interactive MRI simulator

The purpose of this report is to describe computed diffusion-weighted MR imaging as a method to obtain high-b-value images from imaging performed at lower b values and to investigate the feasibility of the technique to improve lesion detection in oncologic cases.

Computed Diffusion-weighted MR Imaging May Improve Tumor Detection

BACKGROUND AND PURPOSE: Quantitative MR imaging techniques are gaining interest as methods of reducing acquisition times while additionally providing robust measurements. This study aimed to implement a synthetic MR imaging method on a new scanner type and to compare its diagnostic accuracy and volumetry with conventional MR imaging in patients with MS and controls. MATERIALS AND METHODS: Twenty patients with MS and 20 healthy controls were enrolled after ethics approval and written informed consent. Synthetic MR imaging was implemented on a Siemens 3T scanner. Comparable conventional and synthetic proton-density–, T1-, and T2-weighted, and FLAIR images were acquired. Diagnostic accuracy, lesion detection, and artifacts were assessed by blinded neuroradiologic evaluation, and contrast-to-noise ratios, by manual tracing. Volumetry was performed with synthetic MR imaging, FreeSurfer, FMRIB Software Library, and Statistical Parametric Mapping. Repeatability was quantified by using the coefficient of variance. RESULTS: Synthetic proton-density–, T1-, and T2-weighted images were of sufficient or good quality and were acquired in 7% less time than with conventional MR imaging. Synthetic FLAIR images were degraded by artifacts. Lesion counts and volumes were higher in synthetic MR imaging due to differences in the contrast of dirty-appearing WM but did not affect the radiologic diagnostic classification or lesion topography (P = .50–.77). Synthetic MR imaging provided segmentations with the shortest processing time (16 seconds) and the lowest repeatability error for brain volume (0.14%), intracranial volume (0.12%), brain parenchymal fraction (0.14%), and GM fraction (0.56%). CONCLUSIONS: Synthetic MR imaging can be an alternative to conventional MR imaging for generating diagnostic proton-density–, T1-, and T2-weighted images in patients with MS and controls while additionally delivering fast and robust volumetric measurements suitable for MS studies.

http://www.ajnr.org/content/ajnr/37/6/1023.full.pdf

Clinical Feasibility of Synthetic MRI in Multiple Sclerosis: A Diagnostic and Volumetric Validation Study

BACKGROUND:Conventional magnetic resonance imaging (MRI) has relatively long scan times for routine examinations, and the signal intensity of the images is related to the specific MR scanner settin ...

/pdf/synthetic-mri-of-the-brain-in-a-clinical-setting-2q4osaxsz0.pdf

Synthetic MRI of the brain in a clinical setting

The authors describe an automated technique of magnetic resonance (MR) image synthesis. Given a specific pulse sequence, MR signals are acquired for several pulse delay and/or repetition times and used to compute images of intrinsic parameters T1, T2, and N(H). Both the computed images and operator-specified pulse delay and repetition times are then used to "synthesize" a new image based on equations descriptive of MR signal behavior and comparable to that acquired by using the operator-specified parameters in an actual MR study. Instrumentation enabling rapid operator-interactive generation of synthesized images is described and initial results presented, allowing for dependence of the signal on T2 in spin echo images. Extension to full T1, T2, and N(H) dependence for arbitrary pulse sequences is described. Major advantages of this technique include retrospective optimization of contrast between arbitrary materials, rapid and systematic image analysis, and reduced scanning time; potential limitations inc...

Automated MR image synthesis: feasibility studies.

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Automated MR image synthesis: feasibility studies.