Objectives To evaluate the diagnostic interchangeability, image quality, and scan time of deep learning (DL)-reconstructed magnetic resonance imaging (MRI) compared with conventional MRI for the temporomandibular joint (TMJ). Materials and methods Patients with suspected TMJ disorder underwent sagittal proton density-weighted (PDW) and T2-weighted fat-suppressed (T2W FS) MRI using both conventional and DL reconstruction protocols in a single session. Three oral radiologists independently assessed disc shape, disc position, and joint effusion. Diagnostic interchangeability for these findings was evaluated by comparing interobserver agreement, with equivalence defined as a 95% confidence interval (CI) within ±5%. Qualitative image quality (sharpness, noise, artifacts, overall) was rated on a 5-point scale. Quantitative image quality was assessed by measuring the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the condyle, disc, and background air. Image quality scores were compared using the Wilcoxon signed-rank test, and SNR/CNR using paired t-tests. Scan times were directly compared. Results A total of 176 TMJs from 88 patients (mean age, 37 ± 16 years; 43 men) were analyzed. DL-reconstructed MRI demonstrated diagnostic equivalence to conventional MRI for disc shape, position, and effusion (equivalence indices < 3%; 95% CIs within ±5%). DL reconstruction significantly reduced noise in PDW and T2W FS sequences (p < 0.05) while maintaining sharpness and artifact levels. SNR and CNR were significantly improved (p < 0.05), except for disc SNR in PDW (p = 0.189). Scan time was reduced by 49.2%. Conclusion DL-reconstructed TMJ MRI is diagnostically interchangeable with conventional MRI, offering improved image quality with a shorter scan time. Key Points <Emphasis Type="BoldItalic">Question</Emphasis> Long MRI scan times in patients with temporomandibular disorders can increase pain and motion-related artifacts, often compromising image quality in diagnostic settings. <Emphasis Type="BoldItalic">Findings</Emphasis> DL reconstruction is diagnostically interchangeable with conventional MRI for assessing disc shape, disc position, and effusion, while improving image quality and reducing scan time. <Emphasis Type="BoldItalic">Clinical relevance</Emphasis> DL reconstruction enables faster and more tolerable TMJ MRI workflows without compromising diagnostic accuracy, facilitating broader adoption in clinical settings where long scan times and motion artifacts often limit diagnostic efficiency. Graphical Abstract

Deep learning reconstruction for temporomandibular joint MRI: diagnostic interchangeability, image quality, and scan time reduction

期刊论文
发表日期：

2025年9月25日

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Gyu-Dong Jo,
Kug Jin Jeon,
Yoon Joo Choi,
Chena Lee,
Sang-Sun Han

摘要

Objectives

To evaluate the diagnostic interchangeability, image quality, and scan time of deep learning (DL)-reconstructed magnetic resonance imaging (MRI) compared with conventional MRI for the temporomandibular joint (TMJ).

Materials and methods

Patients with suspected TMJ disorder underwent sagittal proton density-weighted (PDW) and T2-weighted fat-suppressed (T2W FS) MRI using both conventional and DL reconstruction protocols in a single session. Three oral radiologists independently assessed disc shape, disc position, and joint effusion. Diagnostic interchangeability for these findings was evaluated by comparing interobserver agreement, with equivalence defined as a 95% confidence interval (CI) within ±5%. Qualitative image quality (sharpness, noise, artifacts, overall) was rated on a 5-point scale. Quantitative image quality was assessed by measuring the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the condyle, disc, and background air. Image quality scores were compared using the Wilcoxon signed-rank test, and SNR/CNR using paired t-tests. Scan times were directly compared.

Results

A total of 176 TMJs from 88 patients (mean age, 37 ± 16 years; 43 men) were analyzed. DL-reconstructed MRI demonstrated diagnostic equivalence to conventional MRI for disc shape, position, and effusion (equivalence indices < 3%; 95% CIs within ±5%). DL reconstruction significantly reduced noise in PDW and T2W FS sequences (p < 0.05) while maintaining sharpness and artifact levels. SNR and CNR were significantly improved (p < 0.05), except for disc SNR in PDW (p = 0.189). Scan time was reduced by 49.2%.

Conclusion

DL-reconstructed TMJ MRI is diagnostically interchangeable with conventional MRI, offering improved image quality with a shorter scan time.

Key Points

Question Long MRI scan times in patients with temporomandibular disorders can increase pain and motion-related artifacts, often compromising image quality in diagnostic settings.

Findings DL reconstruction is diagnostically interchangeable with conventional MRI for assessing disc shape, disc position, and effusion, while improving image quality and reducing scan time.

Clinical relevance DL reconstruction enables faster and more tolerable TMJ MRI workflows without compromising diagnostic accuracy, facilitating broader adoption in clinical settings where long scan times and motion artifacts often limit diagnostic efficiency.

Graphical Abstract