Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY (I.D.N., R.L.G., E.A.M., T.L., K.P., S.B.T.); Department of Radiology, Breast Imaging Division, Istituto Europeo di Oncologia, Milan, Italy (R.L.G.); MR Application and Workflow Team, GE Healthcare, New York, NY (M.M.F.); MR Application and Workflow Team, GE Healthcare, Boston, Mass (A.G.); Department of Biomedical Imaging and Image-guided Therapy, Molecular and Gender Imaging Service, Medical University of Vienna, Vienna, Austria (K.P.); and Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (S.B.T.).
Radiol Imaging Cancer. 2020 May 29;2(3):e190076. doi: 10.1148/rycan.2020190076. eCollection 2020 May.
Multishot multiplexed sensitivity-encoding diffusion-weighted imaging is a feasible and easily implementable routine breast MRI protocol that yields high-quality diffusion-weighted breast images. To compare multiplexed sensitivity-encoding (MUSE) diffusion-weighted imaging (DWI) and single-shot DWI for lesion visibility and differentiation of malignant and benign lesions within the breast. In this prospective institutional review board-approved study, both MUSE DWI and single-shot DWI sequences were first optimized in breast phantoms and then performed in a group of patients. Thirty women (mean age, 51.1 years ± 10.1 [standard deviation]; age range, 27-70 years) with 37 lesions were included in this study and underwent scanning using both techniques. Visual qualitative analysis of diffusion-weighted images was accomplished by two independent readers; images were assessed for lesion visibility, adequate fat suppression, and the presence of artifacts. Quantitative analysis was performed by calculating apparent diffusion coefficient (ADC) values and image quality parameters (signal-to-noise ratio [SNR] for lesions and fibroglandular tissue; contrast-to-noise ratio) by manually drawing regions of interest within the phantoms and breast tumor tissue. Interreader variability was determined using the Cohen κ coefficient, and quantitative differences between MUSE DWI and single-shot DWI were assessed using the Mann-Whitney test; significance was defined at < .05. MUSE DWI yielded significantly improved image quality compared with single-shot DWI in phantoms (SNR, = .001) and participants (lesion SNR, = .009; fibroglandular tissue SNR, = .05; contrast-to-noise ratio, = .008). MUSE DWI ADC values showed a significant difference between malignant and benign lesions ( < .001). No significant differences were found between MUSE DWI and single-shot DWI in the mean, maximum, and minimum ADC values ( = .96, = .28, and = .49, respectively). Visual qualitative analysis resulted in better lesion visibility for MUSE DWI over single-shot DWI (κ = 0.70). MUSE DWI is a promising high-spatial-resolution technique that may enhance breast MRI protocols without the need for contrast material administration in breast screening. Breast, MR-Diffusion Weighted Imaging, Oncology© RSNA, 2020.
多射多重敏感编码弥散加权成像（Multishot Multiplexed Sensitivity-Encoding Diffusion-Weighted Imaging，MUSE DWI）是一种可行且易于实施的常规乳腺 MRI 方案，可生成高质量的弥散加权乳腺图像。本研究旨在比较多重敏感编码（multiplexed sensitivity-encoding，MUSE）弥散加权成像（diffusion-weighted imaging，DWI）和单次激发 DWI 对乳腺内良恶性病变的显示和鉴别能力。本前瞻性机构审查委员会批准的研究首先在乳腺体模中优化 MUSE DWI 和单次激发 DWI 序列，然后在一组患者中进行。该研究纳入 37 个病灶的 30 名女性（平均年龄 51.1 岁±10.1[标准差]；年龄范围 27-70 岁），并使用这两种技术进行扫描。两名独立的读者对弥散加权图像进行视觉定性分析；评估病变的显示、充分的脂肪抑制和伪影的存在。通过手动在体模和乳腺肿瘤组织内画感兴趣区来进行定量分析，计算表观弥散系数（apparent diffusion coefficient，ADC）值和图像质量参数（病灶和纤维腺体组织的信噪比[signal-to-noise ratio，SNR]；对比噪声比）。采用 Cohen κ 系数确定观察者间变异性，采用 Mann-Whitney U 检验评估 MUSE DWI 和单次激发 DWI 之间的定量差异；以 P <.05 为差异有统计学意义。体模（SNR，P =.001）和参与者（病灶 SNR，P =.009；纤维腺体组织 SNR，P =.05；对比噪声比，P =.008）中，MUSE DWI 均比单次激发 DWI 获得显著改善的图像质量。MUSE DWI 的 ADC 值在良恶性病变之间存在显著差异（P <.001）。MUSE DWI 的平均、最大和最小 ADC 值与单次激发 DWI 之间无显著差异（P 值分别为 =.96、=.28 和 =.49）。视觉定性分析结果显示，MUSE DWI 较单次激发 DWI 具有更好的病变显示能力（κ = 0.70）。MUSE DWI 是一种很有前途的高空间分辨率技术，在乳腺筛查中无需使用对比剂即可增强乳腺 MRI 方案。
乳房；磁共振弥散加权成像；肿瘤学
