Research Appraisalobservational

Automatic field-of-view planning for magnetic resonance shoulder imaging using Deep Learning

Journal of medical imaging and radiation sciencesQuinsten, Anton Sheahan, Hornisch, Simon Joshua, Gratz, Marcel et al.1 May 2026DOI

Clinical Snapshot

95CEBM
Evidence: Strongobservational

PICO Framework

P — Population575 shoulder MRI examinations from four medical centers (2019-2025)
I — InterventionDeep learning-based automated field-of-view (FOV) prescription using YOLOv11 oriented bounding box variants
C — ComparatorManual radiographer FOV prescription (reference standard)
O — OutcomesMean absolute slice difference (MASD), intersection over union (IoU), mean absolute angle difference (MAAD), clinical utility ratings

Bottom Line

This multicenter study demonstrates that deep learning-based automated field-of-view prescription for shoulder MRI achieves performance comparable to experienced radiographers. The YOLOv11-based system showed high accuracy (IoU >0.84) and clinical utility (97.2%) across four different sites. Key advantages include reduced operator dependence, improved workflow efficiency, and standardized image prescription. The technology appears ready for clinical implementation, though prospective validation studies would strengthen the evidence. For Australian radiology departments, this represents a promising tool for addressing workforce pressures while maintaining diagnostic quality. The multicenter validation suggests good generalizability, though local validation would be prudent before widespread adoption.

Evidence: Strong

Key Findings

  • P Value: Not reported for primary comparisons

  • Effect Size: IoU: 0.847±0.003 (coronal), 0.852±0.007 (sagittal)

  • Primary Outcome: Automated FOV prescription performance metrics

  • Nnt Or Sensitivity: Clinical utility rating: 97.2% acceptable prescriptions

  • Confidence Interval: MASD: 1.016±0.153 slices, MAAD: 3.259±0.190°

Clinical Application

High - technology integrable into existing MRI workflows with standard equipment Highly relevant to Australian radiology departments seeking workflow optimization and standardization, aligns with RANZCR quality improvement initiatives Patients requiring shoulder MRI across diverse healthcare settings

Abstract

INTRODUCTION: Accurate prescription of oblique coronal and oblique sagittal field of views (FOV) is essential for diagnostic shoulder MRI. Manual planning is radiographer-dependent, time-consuming, and subject to inter- and intra-operator variability, leading to inconsistent image quality and incomplete coverage. Although deep learning (DL) has advanced automated scan planning in non-oblique planes, oblique shoulder prescriptions remain underexplored; an automated DL approach could standardize FOV prescription, reduce operator dependence, and improve reproducibility and workflow without compromising diagnostic quality. METHODS: In this retrospective multicenter study, 575 shoulder MRI examinations (2019-2025) from four sites were included. Sites A (n=151) and B (n=220) were used for training; testing was performed on sites C (n=61), and D (n=143). A two-stage pipeline was implemented using five oriented bounding box (OBB) variants of YOLOv11 (n, s, m, l, x): Stage 1 performed slice selection; Stage 2 performed FOV prescription. Performance was evaluated against radiographers' prescriptions using mean absolute slice difference (MASD, slices), intersection over union (IoU), and mean absolute angle difference (MAAD, degrees). Clinical utility was assessed by three raters. RESULTS: The YOLOv11-OBB-l model achieved the lowest MASD for Stage 1 (1.016±0.153 slices). For Stage 2, YOLOv11-OBB-x performed best (coronal IoU, 0.847±0.003; sagittal IoU, 0.852±0.007; MAAD, 3.259±0.190°). During testing across each site, MASD ranged from 0.700±0.837 to 1.192±2.550 slices; MAAD from 2.811±2.348 to 4.396±7.158°; coronal IoU from 0.800±0.092 to 0.872±0.065; and sagittal IoU from 0.824±0.111 to 0.887±0.047. Mean clinical utility was 97.2%. Performance was noninferior to interrater variability across all sites and metrics. CONCLUSION: DL-based automated FOV prescription for shoulder MRI achieves performance comparable to radiographers, generalizes across institutions, and demonstrates high clinical utility.

References

  1. 1.Quinsten, A., Sheahan, A. H., Hornisch, S. J., Gratz, M., Holtkamp, M., Forsting, M., Nassenstein, K., Umutlu, L., Lühr, A., Kleesiek, J., Kim, M.-S., & Demircioğlu, A. (2026). Automatic field-of-view planning for magnetic resonance shoulder imaging using Deep Learning. Journal of Medical Imaging and Radiation Sciences. https://doi.org/10.1016/j.jmir.2026.102197
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