Anatomically Faithful Artifact Suppression in SENSE Accelerated Brain MRI

Background: Four-fold accelerated sensitivity encoding (SENSE4) can shorten brain MRI acquisition time but may amplify noise and result in residual aliasing artifacts after conventional reconstruction. Purpose: To evaluate whether an image-domain refinement framework can improve the quality of SENSE4 brain MRI while preserving anatomical information for quantitative measurements. Methods: In this prospective paired study, 80 participants underwent fully sampled and four-fold accelerated SENSE T1-weighted MRI. We developed an Anatomy-aware Residual Attention Network (ART-Net) to refine accelerated reconstructions through generalized self-attention and correlation-based residual artifact regularization. Participant-level splitting yielded training, validation, and independent test cohort (45/5/30 participants). The independent test cohort underwent quantitative, segmentation-based, and blinded radiologist assessments of image quality and anatomical preservation. Results: ART-Net demonstrated highly competitive reconstruction performance, achieving the highest peak signal-to-noise ratio (31.03 +/- 2.88 dB) and structural similarity index (0.963 +/- 0.022) among evaluated methods. It also demonstrated improved anatomical fidelity, with numerically highest Dice coefficients for medial temporal structures relevant to atrophy assessment (0.8824 +/- 0.0827) and whole-brain regions (0.8857 +/- 0.0885). Moreover, ART-Net improved gradient fidelity, regional contrast preservation, and radiologist-rated structural quality. Conclusion: ART-Net improved agreement between SENSE4 and fully sampled T1-weighted images in a single-center, held-out test cohort while maintaining segmentation-derived anatomical measurements. These findings suggest that ART-Net may support accelerated brain MRI by improving image fidelity and enabling reliable downstream anatomical analysis.