Advanced intelligent Clear-IQ Engine (AiCE) Improves Image Quality and Scan Times

Dr. Keita Satoyoshi Chief, Department of Radiology, Samukawa Hospital, Japan

Samukawa Hospital is a 99-bed core hospital with close ties to the local community in Samukawamachi, Koza-gun, Kanagawa, Japan. The hospital is committed to establishing a robust community healthcare system by creating strong alliances with a range of healthcare facilities in the region.
In 2020, Samukawa Hospital replaced its current 1.5T MRI system with a Vantage Orian 1.5T built with Advanced intelligent Clear-IQ Engine (AiCE) technology. AiCE represents the world’s first AI-based solution for improving the signal-to-noise ratio (SNR) of medical images, which the hospital is currently using in its routine clinical practice. In this report, radiologists at Samukawa Hospital discuss their experience with AiCE.

The Vantage Orian that has recently entered operation at our hospital features reconstruction technology known as AiCE in which a Deep Learning approach is used to reduce noise. AiCE is an innovative technology that can significantly improve the SNR of MRI images, while avoiding any loss in image quality or increase in scan times.
In our actual clinical practice, the introduction of Vantage Orian with AiCE has made it possible for us to acquire high-resolution images in routine examinations with short scan times. Previously, it was difficult for us to perform such examinations due to concerns that the SNR would be unacceptably low.
Figure 1 shows high-resolution images of a patient with an injury of the right supraspinatus tendon. As shown in the images on the left, noise levels can be markedly increased when images are acquired at higher resolution. However, as shown in the images on the right, the use of AiCE ensures an acceptable SNR. High-resolution images can more clearly depict the structural details of such injuries, which means that our radiologists can deliver a diagnosis with greater confidence.

The Director of our hospital, Dr. Hiroyuki Narumi, is a gastroenterologist, which means we receive a large number of requests for magnetic resonance cholangiopancreatography (MRCP). The ability to obtain high-quality MRCP images was a key consideration during our MRI system selection process.
We chose Vantage Orian because it allows us to perform MRCP very efficiently by employing AiCE, which improves image quality, in combination with Fast 3D mode, which reduces scan times.
Figure 2 shows preoperative and postoperative images of a patient with choledocholithiasis. The MRCP images showed excellent agreement with the findings of endoscopic retrograde cholangiopancreatography (ERCP). Furthermore, the images were obtained in just 1 minute and 7 seconds, considerably less than the standard seven-minute scan time of our old system.
The postoperative MRCP images were also of a remarkably high quality. This was in spite of the fact that even shorter scan times were used because postoperative imaging was only intended to confirm relief of bile duct dilatation.
Scanning could also be performed with a breath-hold time of just 21 seconds. Dr. Narumi, who frequently refers patients for MRCP, was very impressed that Vantage Orian could provide such high-quality diagnostic images with low noise levels and short scan times, providing significant benefit to patients.

In addition to the use of AiCE in routine high-resolution imaging as discussed above, AiCE also allows scan times to be shortened while maintaining the same level of image quality. With our previous MRI system, we needed to reduce the spatial resolution or slice thickness in order to compensate for the loss of SNR at short scan times. With Vantage Orian, because AiCE ensures that an acceptable SNR is maintained, we can perform examinations with shorter scan times with no compromise in spatial resolution or slice thickness.
Figure 3 shows a patient with mild cervical spondylosis.
Sagittal images were obtained in a short scan time of about 1 minute and 30 seconds. Before installation of Vantage Orian, the scan time for such images was more than 3 minutes. This means that scan times can now be reduced by half.
As shown in the images on the left, noise levels are quite high when images are acquired without AiCE. However, as shown in the images on the right, AiCE allows clear images to be obtained even with short scan times. It is often difficult for patients with cervical spine problems to remain still for a prolonged period, so the ability to perform routine examinations with such short scan times is a great benefit for our patients.

AiCE enables us to employ short scan times as standard practice in routine head studies. Before installation of our Vantage Orian system, the time required for such studies was around 18 minutes. However, after installation, the time required has been halved to about 9 minutes. Images with a higher SNR can be obtained with almost no loss of spatial resolution, even with short scan times. We think this is a testament to the effectiveness of AiCE.
Figure 4 shows images of a patient with acute-phase stroke in the right putamen. Each of the 2D contrast-enhanced images was obtained in a short scan time. The MRA image was obtained at high resolution with a little longer scan time. High signal intensity in the putamen is observed in the T2WI, fluid-attenuated inversion recovery (FLAIR), and DWI images, indicating acute-phase stroke. The total scan time in this case was as short as 8 minutes and 54 seconds. We are very satisfied with our Vantage Orian system with AiCE because it improves examination efficiency while maintaining excellent diagnostic performance.

One of the greatest advantages of AiCE is its wide range of clinical utility. Not only is AiCE useful for examining all regions of the body, it also supports 2D scanning as well as 3D scanning and can be employed in many types of examinations. In the future, we plan to expand the application of AiCE in order to further improve both image quality and examination efficiency.
We are committed to promoting close cooperation between the hospitals in our community, and we actively accept examination referrals from other healthcare facilities in the area. Our new Vantage Orian system has also made it easier for us to manage our examination scheduling, resulting in improved efficiency. We now enjoy greater flexibility in accepting urgent unscheduled examinations, and we expect this to further strengthen our regional healthcare alliance.