Is a 3-Minute Knee MRI Protocol Sufficient for Daily Clinical Practice? A SuperResolution Reconstruction Approach Using AI and Compressed Sensing

<b>Objectives:</b> The purpose of this study was to assess whether a 3-min 2D knee protocol can meet the needs for clinical application if using a SuperResolution reconstruction approach. <b>Methods:</b> In this prospective study, a total of 20 volunteers underwent imaging of the knee using a 3T MRI scanner (Philips Ingenia Elition X 3.0T, Philips). The imaging protocol, consisting of a fat-saturated 2D proton density sequence in coronal, sagittal, and transverse orientations, as well as a sagittal T1-weighted sequence, was acquired with standard and ultra-low resolution. The standard sequences were reconstructed using an AI-assisted Compressed SENSE method (SmartSpeed). The ultra-low-resolution sequences have been reconstructed using a vendor-provided prototype. Four experienced readers (two radiologists and two orthopedic surgeons) evaluated the sequences for image quality, anatomical structures, and incidental pathologies. The consensus evaluation of two different experienced radiologists specialized in musculoskeletal imaging served as the gold standard. <b>Results:</b> The acquisition time for the entire protocol was 11:01 min for standard resolution and 03:36 min for ultra-low resolution. In the overall assessment, CS-SuperRes-reconstructed sequences showed slightly improved accuracy and increased specificity compared to the standard CS-AI method (0.87 vs. 0.86 and 0.9 vs. 0.87, respectively), while the standard method exhibited a higher sensitivity (0.73 vs. 0.57). Overall, 24 out of 40 pathologies were detected in the ultra-low-resolution images compared to 26 in the standard images. <b>Conclusions:</b> The CS-SuperRes method enables a 2D knee protocol to be completed in 3 min, with improved accuracy compared to the clinical standard.