Solomon Eddy, Liberman Gilad, Nissan Noam, Furman-Haran Edna, Sklair-Levy Miri, Frydman Lucio
Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel.
Department of Radiology, Sheba-Medical-Center, Ramat-Gan, Israel.
Magn Reson Med. 2020 Sep;84(3):1391-1403. doi: 10.1002/mrm.28213. Epub 2020 Feb 20.
Diffusion weighted imaging (DWI) is increasingly used in evaluating breast cancer, as complement to DCE measurements of superior spatial resolution. Extracting fine morphological features in DWI is complicated by limitations that sequences such as EPI face, when applied to heterogeneous organs. This study investigates the ability of spatiotemporal encoding (SPEN) MRI to screen breast cancers and define diffusivity features at mm and sub-mm resolutions on a 3T scanner METHODS: Twenty-one patients with biopsy-confirmed breast cancer lesions were examined by T2-weighted and DCE protocols, by EPI-based DWI, and by SPEN-based protocols optimized for SNR, robustness and spatial resolution, respectively.
Excellent agreement was found between the diffusivity parameters measured by all SPEN protocols and by EPI, with the lower ADCs characteristic of tumors being readily detected. SPEN provided systematically better SNR and improved qualitative results, particularly when dealing with small lesions surrounded by fatty tissue, or lesions close to tissue/air interfaces. SPEN-derived ADC maps collected at sub-mm in-plane resolutions recapitulated the high-resolution morphology shown by lesions using more sensitive DCE protocols.
Measurements on a patient cohort validated SPEN's ability to quantify the diffusivity changes associated with the presence of breast cancers, while imaging the lesions with reduced distortions at sub-mm resolutions.
扩散加权成像(DWI)作为具有卓越空间分辨率的动态对比增强(DCE)测量的补充手段,在乳腺癌评估中的应用日益广泛。当诸如回波平面成像(EPI)等序列应用于异质性器官时,其局限性使得在DWI中提取精细形态特征变得复杂。本研究调查了时空编码(SPEN)磁共振成像(MRI)在3T扫描仪上以毫米和亚毫米分辨率筛查乳腺癌并定义扩散特征的能力。方法:对21例经活检证实患有乳腺癌病灶的患者分别采用T2加权和DCE方案、基于EPI的DWI以及分别针对信噪比(SNR)、稳健性和空间分辨率进行优化的基于SPEN的方案进行检查。
所有基于SPEN的方案与基于EPI的方案所测量的扩散参数之间具有极佳的一致性,肿瘤较低的表观扩散系数(ADC)特征易于检测。SPEN系统性地提供了更好的SNR并改善了定性结果,尤其是在处理被脂肪组织包围的小病灶或靠近组织/空气界面的病灶时。在亚毫米平面分辨率下采集的基于SPEN的ADC图重现了使用更敏感的DCE方案时病灶所显示的高分辨率形态。
对一组患者的测量验证了SPEN在以亚毫米分辨率对病灶进行成像时减少失真的同时量化与乳腺癌存在相关的扩散变化的能力。