Random forest FLAIR reconstruction from T1, T2, and PD-weighted MRI

Fluid Attenuated Inversion Recovery (FLAIR) is a commonly acquired pulse sequence for multiple sclerosis (MS) patients. MS white matter lesions appear hyperintense in FLAIR images and have excellent contrast with the surrounding tissue. Hence, FLAIR images are commonly used in automated lesion segmentation algorithms to easily and quickly delineate the lesions. This expedites the lesion load computation and correlation with disease progression. Unfortunately for numerous reasons the acquired FLAIR images can be of a poor quality and suffer from various artifacts. In the most extreme cases the data is absent, which poses a problem when consistently processing a large data set. We propose to fill in this gap by reconstructing a FLAIR image given the corresponding T₁-weighted, T₂-weighted, and P_D-weighted images of the same subject using random forest regression. We show that the images we produce are similar to true high quality FLAIR images and also provide a good surrogate for tissue segmentation.