Super-resolution deep learning reconstruction improves brain MRI quality and detection of metastases

Abstract Purpose Accurate identification of brain metastases is critical for determining prognosis and guiding treatment. Deep learning reconstruction (DLR) enhances MRI quality by reducing noise, while super-resolution DLR (SR-DLR) may further improve spatial resolution and lesion detectability. To evaluate SR-DLR versus conventional DLR in detecting and visualizing brain metastases on postcontrast T1-weighted brain MRI. Materials and methods This retrospective study included 47 consecutive patients who underwent postcontrast 3D whole-brain T1-weighted MRI between July and December 2024. Images were reconstructed using both SR-DLR and DLR. Three independent readers evaluated metastatic lesion detection and rated image quality. Subjective assessments included lesion visibility, visibility of normal structures, sharpness, noise, and overall image quality. Objective metrics—full width at half maximum (FWHM), edge rise distance (ERD), edge rise slope (ERS), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR)—were also measured. Statistical tests included jackknife alternative free-response receiver operating characteristic (JAFROC) analysis, Wilcoxon signed-rank test, McNemar’s test, and paired t -tests, with significance threshold of p < 0.050. Results A total of 117 brain metastases were detected in 47 patients (mean age, 59 years ± 18; 27 men). SR-DLR demonstrated significantly better lesion detection performance than DLR (mean figure of merit = 0.842 vs. 0.797; p = 0.042). Subjective image quality ratings favored SR-DLR for lesion and structure visibility, sharpness, noise, and overall quality in most cases. Objectively, SR-DLR yielded lower FWHM (1.2 mm vs. 1.9 mm; p < 0.001), higher ERS (791.3 mm − 1 vs. 645.3 mm − 1 ; p = 0.013) indicating enhanced sharpness as well as improved CNR (27.5 vs. 24.9; p < 0.001) compared to DLR. Conclusion Compared to DLR, SR-DLR significantly enhances brain MRI quality and improves detection of metastatic lesions.