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Ai-assisted compressed sensing with deep learning reconstruction for accelerated rectal MRI: A prospective intra-individual study of image quality and preoperative staging

In brief

AI-assisted rectal MRI halves scan time and improves T-stage accuracy

In 107 patients, AI-assisted compressed-sensing MRI cut acquisition time by 50% and yielded higher subjective image quality than conventional parallel imaging. The high-strength deep-learning reconstruction (ACS-H) boosted accuracy of T-stage and mesorectal fascia assessment and raised EMVI detection, while nodal staging was unchanged. Larger studies are needed to confirm these gains before routine adoption.

Journal
European journal of radiology (Q1)
Published
25 August 2026
Study design
Prospective / inception cohort
Evidence level
Level 2, Moderate (CEBM 2b)
Authors
Yuedi Ma, Dongqiu Shan, Junhui Yuan, Xiaoxian Zhang, Dechang Yuan, Guangguang An, et al.
PMID
42700701
DOI
10.1016/j.ejrad.2026.113191

Why clinicians should know about it

Abstract

OBJECTIVES: This study aimed to compare image quality and diagnostic performance between artificial intelligence-assisted compressed sensing (ACS) images reconstructed using deep learning reconstruction (ACS-DLR) and conventional parallel imaging (PI) images in rectal cancer MRI. METHODS: 107 patients with biopsy-proven rectal cancer were included. MRI included conventional PI and ACS acquisitions, with the ACS raw data reconstructed at three deep learning reconstruction strength levels (ACS-L, ACS-M, and ACS-H). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared across four image sets using the Friedman test. Subjective image quality was assessed using a 5-point Likert scale for overall image quality, noise, artefact, and edge sharpness. Interobserver agreement for objective metrics was measured by ICC, and for subjective metrics by Cohen's kappa. Diagnostic performance was evaluated using postoperative histopathology, including T stage, N stage, extramural venous invasion (EMVI), and mesorectal fascia (MRF) involvement. RESULTS: ACS reduced acquisition time by 50 % (from 3 min 20 s to 1 min 40 s). Lesion SNR did not differ significantly among the four image sets (P > 0.05), but ACS-H showed the highest muscle SNR. CNR showed significant differences in selected pairwise comparisons. ACS-H achieved the highest subjective scores for overall image quality, noise reduction, and lesion edge sharpness. In the surgical subcohort, ACS-H improved T staging accuracy (P = 0.010; P = 0.018), MRF involvement assessment (P = 0.004; P = 0.012), and EMVI sensitivity (P = 0.039; P = 0.041). N staging accuracy was not significantly different (P = 0.521; P = 0.841). CONCLUSION: ACS reduced acquisition time, while ACS-DLR improved subjective image quality. ACS-H improved T-stage and MRF assessment and increased EMVI sensitivity, whereas N-stage accuracy did not improve significantly.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.