Breast DWI at 3 T: influence of the fat-suppression technique on image quality and diagnostic performance

Nogueira, Luísa; Brandão, Sofia; Nunes, Rita G.; Ferreira, Hugo Alexandre; Loureiro, Joana; Ramos, Isabel

doi:10.1016/j.crad.2014.11.012

Cited by 30 publications

(17 citation statements)

References 40 publications

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“…Another group [32] reports that the CV R was 1.5 % on phantoms, and less than 4 % for cerebral parenchyma. Impact of acquisition parameters has also been investigated [33–35]. …”

Section: Discussionmentioning

confidence: 99%

“…Another group [ 32 ] reports that the CV R was 1.5 % on phantoms, and less than 4 % for cerebral parenchyma. Impact of acquisition parameters has also been investigated [ 33 – 35 ]. Impacts of post-processing software were documented by Zeilinger et al [ 36 ], reporting up to 8 % variation when ADC was processed by four different types of software.…”

Section: Discussionmentioning

confidence: 99%

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How reliable are ADC measurements? A phantom and clinical study of cervical lymph nodes

et al. 2018

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ObjectiveTo assess the reliability of ADC measurements in vitro and in cervical lymph nodes of healthy volunteers.MethodsWe used a GE 1.5 T MRI scanner and a first ice-water phantom according to recommendations released by the Quantitative Imaging Biomarker Alliance (QIBA) for assessing ADC against reference values. We analysed the target size effect by using a second phantom made of six inserted spheres with diameters ranging from 10 to 37 mm. Thirteen healthy volunteers were also scanned to assess the inter- and intra-observer reproducibility of volumetric ADC measurements of cervical lymph nodes.ResultsOn the ice-water phantom, the error in ADC measurements was less than 4.3 %. The spatial bias due to the non-linearity of gradient fields was found to be 24 % at 8 cm from the isocentre. ADC measure reliability decreased when addressing small targets due to partial volume effects (up to 12.8 %). The mean ADC value of cervical lymph nodes was 0.87.10-3 ± 0.12.10-3 mm2/s with a good intra-observer reliability. Inter-observer reproducibility featured a bias of -5.5 % due to segmentation issues.ConclusionADC is a potentially important imaging biomarker in oncology; however, variability issues preclude its broader adoption. Reliable use of ADC requires technical advances and systematic quality control.Key Points• ADC is a promising quantitative imaging biomarker.• ADC has a fair inter-reader variability and good intra-reader variability.• Partial volume effect, post-processing software and non-linearity of scanners are limiting factors.• No threshold values for detecting cervical lymph node malignancy can be drawn.Electronic supplementary materialThe online version of this article (10.1007/s00330-017-5265-2) contains supplementary material, which is available to authorized users.

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“…Another group [32] reports that the CV R was 1.5 % on phantoms, and less than 4 % for cerebral parenchyma. Impact of acquisition parameters has also been investigated [33–35]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How reliable are ADC measurements? A phantom and clinical study of cervical lymph nodes

et al. 2018

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“…The comparison between two commonly used techniques for breast DWI, SPAIR, and STIR, on fat-suppression uniformity, SNR, CNR, image quality, lesion visibility, and ADC values, have been reported before. 25,26 It was found that STIR could achieve a better uniformity compared with SPAIR, but SPAIR had slightly improved lesion visibility. Their SNR and CNR, and also the overall diagnostic performance, were comparable; thus, it was concluded that both techniques were suitable for use in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Diagnostic Performance of Voxelwise Computed Diffusion‐Weighted Imaging in Breast Cancer

Zhou

Chen

et al. 2018

Magnetic Resonance Imaging

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Background Conventional diffusion‐weighted imaging (DWI) with high b‐values may improve lesion conspicuity, but with a low signal intensity and thus a low signal‐to‐noise ratio (SNR). The voxelwise computed DWI (vcDWI) may generate high‐quality images with a strong lesion signal and low background. Purpose To evaluate the feasibility and diagnostic performance of vcDWI. Study Type Retrospective. Population In all, 67 patients with 72 lesions, 33 malignant and 39 benign. Field Strength/Sequence 3T, including T2/T1, DWI with two b‐values, and dynamic contrast‐enhanced MRI (DCE‐MRI). Assessment Computed DWI (cDWI) with high b‐values of 1500, 2000, 2500 s/mm2 (cDWI1500, cDWI2000, cDWI2500) and vcDWI were generated from measured DWI (mDWI). The mDWI, cDWIs and vcDWI were evaluated by three readers independently to determine lesion conspicuity, background signal suppression, overall image quality using 1–5 rating scales, as well as to give BI‐RADS scores. The mean apparent diffusion coefficient (ADC) value for each lesion was measured. Statistical Tests Agreement among the three readers was evaluated by the intraclass correlation coefficient. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic performance based on reading of mDWI, cDWIs, vcDWI, and the measured ADC values. Results vcDWI provided the best lesion conspicuity compared with mDWI and cDWIs (P < 0.005). For overall image quality, vcDWI was significantly better than cDWI (P < 0.005), but not significantly better compared with mDWI for two readers (P = 0.037 and P = 0.013) and significantly worse for the third reader (P < 0.005). Background signal suppression was the best on cDWI2500, and better on vcDWI than on mDWI, cDWI1500, and cDWI2000. The AUC value for differential diagnosis was 0.868 for mDWI, 0.862 for cDWI1500, 0.781 for cDWI2000, 0.704 for cDWI2500, 0.946 for vcDWI, 0.704 for ADC value, and 0.961 for DCE‐MRI. Data Conclusion vcDWI was implemented without increasing scanning time, and it provided excellent lesion conspicuity for detection of breast lesions and assisted in differentiating malignant from benign breast lesions. Level of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.

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“…Apart from low SNR, a commonly encountered problem is insufficient fat suppression, which leads to ghosting and potentially to underestimation of ADC values. Spectral attenuated inversion recovery (SPAIR), which employs both T1 contrast and spectral selectivity, is recommended given a moderate preference in literature in comparison with short tau inversion recovery (STIR) [59,60] and based on the consensus among the panel. However, if unsuccessful, STIR may be an acceptable alternative as this technique is independent from B 0 field inhomogeneity [61].…”

Section: What Sequence Type and Parameters Are Recommended For Breastmentioning

confidence: 99%

Diffusion-weighted imaging of the breast—a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group

et al. 2019

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The European Society of Breast Radiology (EUSOBI) established an International Breast DWI working group. The working group consists of clinical breast MRI experts, MRI physicists, and representatives from large vendors of MRI equipment, invited based upon proven expertise in breast MRI and/or in particular breast DWI, representing 25 sites from 16 countries. The aims of the working group are (a) to promote the use of breast DWI into clinical practice by issuing consensus statements and initiate collaborative research where appropriate; (b) to define necessary standards and provide practical guidance for clinical application of breast DWI; (c) to develop a standardized and translatable multisite multivendor quality assurance protocol, especially for multisite research studies; (d) to find consensus on optimal methods for image processing/analysis, visualization, and interpretation; and (e) to work collaboratively with system vendors to improve breast DWI sequences. First consensus recommendations, presented in this paper, include acquisition parameters for standard breast DWI sequences including specifications of b values, fat saturation, spatial resolution, and repetition and echo times. To describe lesions in an objective way, levels of diffusion restriction/hindrance in the breast have been defined based on the published literature on breast DWI. The use of a small ROI placed on the darkest part of the lesion on the ADC map, avoiding necrotic, noisy or non-enhancing lesion voxels is currently recommended. The working group emphasizes the need for standardization and quality assurance before ADC thresholds are applied. The working group encourages further research in advanced diffusion techniques and tailored DWI strategies for specific indications.

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Breast DWI at 3 T: influence of the fat-suppression technique on image quality and diagnostic performance

Abstract: The fat-saturation technique used in the present study may influence image quality and ADC quantification. Nevertheless, STIR and SPAIR techniques showed similar diagnostic performances, and therefore, both are suitable for use in clinical practice.

Cited by 30 publications

References 40 publications

How reliable are ADC measurements? A phantom and clinical study of cervical lymph nodes

How reliable are ADC measurements? A phantom and clinical study of cervical lymph nodes

Feasibility and Diagnostic Performance of Voxelwise Computed Diffusion‐Weighted Imaging in Breast Cancer

Diffusion-weighted imaging of the breast—a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group

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