Iima Mami, Nakayama Rena, Kataoka Masako, Otikovs Martins, Nissan Noam, Frydman Lucio, Urushibata Yuta, Honda Maya, Okazawa Aika, Satake Hiroko, Naganawa Shinji, Nakamoto Yuji
Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan.
Magn Reson Med Sci. 2024 Sep 26. doi: 10.2463/mrms.tn.2024-0089.
This study investigated the breast lesion conspicuity and apparent diffusion coefficient (ADC) reliability for three different diffusion-weighted imaging (DWI) protocols: spatiotemporal encoding (SPEN), single-shot echo-planar imaging (SS-EPI), and readout segmentation of long variable echo-trains (RESOLVE).
Sixty-five women suspected of having breast tumors were included in this study, with 44 lesions (36 malignant, 8 benign) analyzed further. Breast MRI was performed on a 3 Tesla (3T) system (MAGNETOM Prisma, Siemens) equipped with a dedicated 18-channel breast array coil for a phantom and patients. Three DWI protocols-SPEN, SS-EPI, and RESOLVE-were used. SS-EPI was acquired with an in-plane resolution of 2 × 2 mm, a slice thickness of 3 mm, and b-values of 0 and 1000 s/mm. SPEN had a higher in-plane resolution of 1 × 1 mm, a slice thickness of 1.5 mm, and b-values of 0, 850, and 1500 s/mm. RESOLVE was acquired with an in-plane resolution of 1 × 1 mm, a slice thickness of 1.5 mm, and b-values of 0 and 850 s/mm. Lesion conspicuity and ADC values were evaluated.
The average lesion conspicuity scores were significantly higher for RESOLVE (3.54 ± 0.65) than for SPEN (3.07 ± 0.91) or SS-EPI (2.48 ± 0.78) (P < 0.01). The SPEN score was significantly higher than the SS-EPI score (P < 0.01). Phantom measurements indicated marginally lower ADC values for SPEN compared to SS-EPI and RESOLVE across all concentrations. The results revealed that SPEN (b = 0, 850, 1500 sec/mm) yielded significantly lower ADC values compared to SPEN (b = 0, 850 sec/mm) in malignant lesions (P < 0.01), with no significant difference observed between SPEN (b = 0, 850 sec/mm), SS-EPI, and RESOLVE. For benign lesions, no significant difference in ADC values was found between SPEN (b = 0, 850 sec/mm), SPEN (b = 0, 850, 1500 sec/mm), SS-EPI, and RESOLVE.
RESOLVE provided the highest lesion conspicuity, and ADC values in breast lesions were not significantly different among sequences ranging b values 850-1000 sec/mm. SPEN with higher b-values (0, 850, 1500 vs. 0, 850 sec/mm) yielded significantly lower ADC values in malignant lesions, highlighting the importance of b-value selection in ADC quantification.
本研究调查了三种不同的扩散加权成像（DWI）方案：时空编码（SPEN）、单次激发回波平面成像（SS-EPI）和长可变回波链读出分割（RESOLVE）对乳腺病变的显示能力及表观扩散系数（ADC）的可靠性。
本研究纳入了65名疑似患有乳腺肿瘤的女性，对其中44个病变（36个恶性，8个良性）进行了进一步分析。在配备有专用18通道乳腺阵列线圈的3特斯拉（3T）系统（MAGNETOM Prisma，西门子）上对乳腺进行磁共振成像（MRI），包括体模和患者。使用了三种DWI方案——SPEN、SS-EPI和RESOLVE。SS-EPI的层面内分辨率为2×2毫米，层厚为3毫米，b值为0和1000 s/mm²。SPEN具有更高的层面内分辨率，为1×1毫米，层厚为1.5毫米，b值为0、850和1500 s/mm²。RESOLVE的层面内分辨率为1×1毫米，层厚为1.5毫米，b值为0和850 s/mm²。对病变的显示能力和ADC值进行了评估。
RESOLVE的平均病变显示能力评分（3.54±0.65）显著高于SPEN（3.07±0.91）或SS-EPI（2.48±0.78）（P<0.01）。SPEN的评分显著高于SS-EPI的评分（P<0.01）。体模测量表明，在所有浓度下，与SS-EPI和RESOLVE相比，SPEN的ADC值略低。结果显示，在恶性病变中，与SPEN（b = 0，850 s/mm²）相比，SPEN（b = 0，850，1500 s/mm²）产生的ADC值显著更低（P<0.01），而在SPEN（b = 0，850 s/mm²）、SS-EPI和RESOLVE之间未观察到显著差异。对于良性病变，在SPEN（b = 0，850 s/mm²）、SPEN（b = 0，850，1500 s/mm²）、SS-EPI和RESOLVE之间，ADC值未发现显著差异。
RESOLVE提供了最高的病变显示能力，并且在b值范围为850 - 1000 s/mm²的序列中，乳腺病变的ADC值在各序列之间无显著差异。具有更高b值（0，850，1500 vs. 0，850 s/mm²）的SPEN在恶性病变中产生的ADC值显著更低，突出了b值选择在ADC定量中的重要性。
