Advanced Diffusion-Weighted Imaging Sequences for Breast MRI: Comprehensive Comparison of Improved Sequences and Ultra-High B-Values to Identify the Optimal Combination

Author:

Hausmann Daniel12ORCID,Todorski Inga3ORCID,Pindur Alexandra1,Weiland Elisabeth4,Benkert Thomas4ORCID,Bosshard Lars56,Prummer Michael56,Kubik-Huch Rahel A.1ORCID

Affiliation:

1. Department of Radiology, Kantonsspital Baden, 5404 Baden, Switzerland

2. Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, Heidelberg University, 69117 Mannheim, Germany

3. Department of Radiology, Balgrist University Hospital, 8008 Zurich, Switzerland

4. MR Application Predevelopment, Siemens Healthcare GmbH, 91052 Erlangen, Germany

5. Nexus Personalized Health Technologies, ETH Zurich, 8005 Zurich, Switzerland

6. Swiss Institute for Bioinformatics (SIB), 8005 Zurich, Switzerland

Abstract

This study investigated the image quality and choice of ultra-high b-value of two DWI breast-MRI research applications. The study cohort comprised 40 patients (20 malignant lesions). In addition to s-DWI with two m-b-values (b50 and b800) and three e-b-values (e-b1500, e-b2000, and e-b2500), z-DWI and IR m-b1500 DWI were applied. z-DWI was acquired with the same measured b-values and e-b-values as the standard sequence. For IR m-b1500 DWI, b50 and b1500 were measured, and e-b2000 and e-b2500 were mathematically extrapolated. Three readers used Likert scales to independently analyze all ultra-high b-values (b1500–b2500) for each DWI with regards to scan preference and image quality. ADC values were measured in all 20 lesions. z-DWI was the most preferred (54%), followed by IR m-b1500 DWI (46%). b1500 was significantly preferred over b2000 for z-DWI and IR m-b1500 DWI (p = 0.001 and p = 0.002, respectively). Lesion detection was not significantly different among sequences or b-values (p = 0.174). There were no significant differences in measured ADC values within lesions between s-DWI (ADC: 0.97 [±0.09] × 10−3 mm2/s) and z-DWI (ADC: 0.99 [±0.11] × 10−3 mm2/s; p = 1.000). However, there was a trend toward lower values in IR m-b1500 DWI (ADC: 0.80 [±0.06] × 10−3 mm2/s) than in s-DWI (p = 0.090) and z-DWI (p = 0.110). Overall, image quality was superior and there were fewer image artifacts when using the advanced sequences (z-DWI + IR m-b1500 DWI) compared with s-DWI. Considering scan preferences, we found that the optimal combination was z-DWI with a calculated b1500, especially regarding examination time.

Publisher

MDPI AG

Subject

Clinical Biochemistry

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