A feasibility study of reduced full-of-view synthetic high-b-value diffusion-weighted imaging in uterine tumors

Abstract

Objectives This study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b value diffusion-weighted images (rFOV-syDWIs) in the clinical application of cervical cancer based on image quality and diagnostic efficacy. Methods We retrospectively evaluated the data of 35 patients with cervical cancer and 35 healthy volunteers from May to November 2021. All patients and volunteers underwent rFOV-DWI scans, including a 13b-protocol: b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, and 1500 s/mm2 and a 5b-protocol: b = 0, 100, 400, 800,1500 s/mm2. rFOV-syDWIs with b values of 1200 (rFOV-syDWIb=1200) and 1500 (rFOV-syDWIb=1500) were generated from two different multiple-b-value image datasets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by the Levene’s test and Shapiro–Wilk test, the inter-modality differences of quantitative measurements were, respectively, examined by Wilcoxon signed-rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann–Whitney U test. Results A higher inter-reader agreement between SNRs and CNRs was found in 13b-protocol and 5b-protocol rFOV-syDWIb=1200/1500 compared to 13b-protocol rFOV-sDWIb=1200/1500 (p < 0.05). AUC of 5b-protocol syADCmean,b=1200/1500 and syADCminimum,b=1200/1500 was equal or higher than that of 13b-protocol sADCmean,b=1200/1500 and sADCminimum,b=1200/1500. Conclusions rFOV-syDWIs provide better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shorten scan time, and synthetic ADCs offer reliable diagnosis value as scanned 13b-protocol DWIs.

Synthetic high b-value FOCUS-MUSE diffusion-weighted imaging in identifying early-stage cervical cancer

“…Therefore, a multiple-b-value protocol played a key role in synthesizing high-b-value DWIs with better background suppression and lesion conspicuity (i.e., higher SNR/CNR). In consistent with our previous study of synthetic 5b-protocol FOCUS DWI on a 1.5T MR scanner [29], 5b-protocol syFOCUS-MUSE 5b,1500 possessed higher SNR than sFOCUS-MUSE b=1500 but lower than 13b-protocol syFOCUS-MUSE 13b,1500 and 5b-protocol syFOCUS 5b,1500 . ) as well as offer diagnosis and prognosis of tumor histological heterogeneity information even including in low-and high-grade positive-and negative CC [43].…”

“…Similarly, there was the excellent agreement of diagnostic performance for syADC 10b,1500 and sADC 10b,1500 in assessment of liver, spleen, and paravertebral muscles in pediatric patients [30]. In other words, high-b-value-computed ADC could be derived from low-b-value DWIs with relatively small errors regardless of magnetic eld strength [29,44]. Moreover, syFOCUS-MUSE 13b/5b,1500 with both features of MUSE DWI and FOCUS DWI mitigated imaging interference factors and had more reliable ADC values for tumor staging.…”

“…In a 1.5 uterus MRI study of synthetic FOCUS DWI (syFOCUS DWI), 5b-protocol syFOCUS DWIs with b values of 1200 and 1500 s/mm 2 showed image quality and diagnosis as good as 13b-protocol ones, and both synthetic DWIs had better subjective assessment than actual scanned DWIs [29].…”

“…In general, a reliable synthetic high-b-value DWI image can be generated using at least 2-5 b-values. Few applications of synthetic high-b-value DWI using FOCUS DWI sequence in prostate cancer [27], pancreatic cancer [28] and uterus [29] have shown better image quality and superior or equivalent diagnostic accuracy of tumor detection to scanned DWI without additional scan time.…”

Application of an inline synthetic high b-value reduced filed-of-view diffusion weighted imaging on differentiation prostate cancer from benign prostatic hyperplasia

“…Histogram-derived ADC values-mean and median of both actually scanned and synthetic ADC values reached perfect diagnosis e cacy with AUC of almost close and equal to 1.000 in our study, implying mean and median of ADC values possess good diagnosis e cacy in detection of prostate cancer and its invasiveness [28,29] .There was no difference of 5b-protocol and 13b-protocol mean and median of syADC b=1000, 1500 in tumor tissues. In accordance to a study of synthetic high-b-value DWIs in diagnosis of cervical cancer [30] , the diagnosis e cacy of both 5b-protocol and 13b-protocol syADC mean, b=1000, 1500 was rather competitive. This result might attribute to several reasons.…”