Synthesis of Double Inversion Recovery-like Images for Superior Contrast and Multiple Sclerosis Lesion Visibility

Motivation: Double Inversion Recovery (DIR) can enhance lesion detection, particularly in multiple sclerosis (MS) where juxtacortical and infratentorialplaques are challenging to detect with conventional techniques. Goal(s): This study evaluates DIR-like images(Syn-DIR) generated from T1 and T2 FLAIR for brain structure and lesion visibility Approach: The study evaluates 30 subjects to assess quantitative segmentation, volumetric consistency, and lesion-to-white-matter contrast. A second longitudinal study cohort assessed 20 additional subjects scanned at two time points to evaluate performance consistency over time. Results: Syn-DIR demonstrated high structural agreement to the reference set and showed significantly higher lesion-to-white matter contrast, with stable gray-to-white-matter contrast across time points. Impact: Syn-DIR provides superior lesion visibility and consistent brain structure representation. The strong agreement in quantitative lesion and regional brain volumes demonstrates its robustness for clinical and research applications.