Gudmundson, A. T.; Shams, Z.; Gad, A.; Wang, S.; Simicic, D.; Murali-Manohar, S.; Simegn, G. L.; Özdemir, I.; Davies-Jenkins, C. W.; Yedavalli, V.; Oeltzschner, G.; Demirel, O. B.; Sulam, J.; schär, M.; Ganji, S.; Edden, R. A. E.

Purpose: To present a first-of-its-kind artificial intelligence (AI-)integrated MR pulse sequence that detects out-of-voxel (OOV) artifacts in real-time (within-TR) and responds prospectively by updating the crusher gradient scheme. Methods: Per Excitation Real-time Execution & Guided Responses with Integrated Neural-network Evaluation (PEREGRINE), developed for deployment of deep learning models and sequence updates, operated time-domain (TD) and frequency-domain (FD) convolutional autoencoders that detect OOV artifacts. Scans without (AI-off) and with (AI-on) updates were collected from the prefrontal cortex of healthy volunteers using edited MRS. The degree of OOV contamination (OOV score) was quantified per transient based upon the prevalence of OOV signals in the TD and FD data. OOV scores above a user-defined threshold triggered an update of the gradient scheme, iterating through 48 permutations (6 axis transpositions x 8 polarity flips). Results: Within each 2-second TR, PEREGRINE successfully provided single-transient OOV scores and updated gradients accordingly. No difference was observed between the OOV scores from the full ('Full' condition) AI-on and AI-off sessions due to the AI-on scan cycling over better and worse gradient permutations relative to the AI-off scan. However, the AI-on scan had significantly lower OOV scores than the AI-off scan when selecting the transients where PEREGRINE persisted ('Dwell' condition) on a given gradient permutation. Ultimately, Fit Quality Number (FQN), from linear combination modeling, improved significantly for the AI-on compared to the AI-off scan. Conclusion: PEREGRINE enabled an AI-integrated sequence allowing for real-time evaluation and reduction of OOV artifacts, identifying gradient modifications that produced less OOV contamination.