Magnetic resonance cholangiopancreatography with compressed sensing at 1.5 T: clinical application for the evaluation of branch duct IPMN of the pancreas

Abstract

Objectives To evaluate magnetic resonance cholangiopancreatography (MRCP) with compressed sensing (CS) for the assessment of branch duct intraductal papillary mucinous neoplasm (BD-IPMN) of the pancreas. For this purpose, conventional navigator-triggered (NT) sampling perfection with application-optimized contrast using different flip angle evolutions (SPACE) MRCP was compared with various CS-SPACE-MRCP sequences in a clinical setting. Methods A total of 41 patients (14 male, 27 female, mean age 68 years) underwent 1.5-T MRCP for the evaluation of BD-IPMN. The MRCP protocol consisted of the following sequences: conventional NT-SPACE-MRCP, CS-SPACE-MRCP with long (BHL, 17 s) and short single breath-hold (BHS, 8 s), and NT-CS-SPACE-MRCP. Two board-certified radiologists evaluated image quality, duct sharpness, duct visualization, lesion conspicuity, confidence, and communication with the main pancreatic duct in consensus using a 5-point scale (1–5), with higher scores indicating better quality/delineation/confidence. Maximum intensity projection reconstructions and originally acquired data were used for evaluation. Wilcoxon signed-rank test was used to compare the intra-individual difference between sequences. Results BHS-CS-SPACE-MRCP had the highest scores for image quality (3.85 ± 0.79), duct sharpness (3.81 ± 1.05), and duct visualization (3.81 ± 1.01). There was a significant difference compared with NT-CS-SPACE-MRCP (p < 0.05) but no significant difference to the standard NT-SPACE-MRCP (p > 0.05). Concerning diagnostic quality, BHS-CS-SPACE-MRCP had the highest scores in lesion conspicuity (3.95 ± 0.92), confidence (4.12 ± 1.08), and communication (3.8 ± 1.06), significantly higher compared with NT-SPACE-MRCP, BHL-SPACE-MRCP, and NT-CS-SPACE-MRCP (p = <0.05). Conclusions MRCP with CS 3D SPACE for the evaluation of BD-IPMN at 1.5 T provides the best results using a short breath-hold sequence. This approach is feasible and an excellent alternative to standard NT 3D MRCP sequences. Key Points • 1.5-T MRCP with compressed sensing for the evaluation of branch duct IPMN is a feasible method. • Short breath-hold sequences provide the best results for this purpose.

Single-Breath-Hold MRI-SPACE Cholangiopancreatography with Compressed Sensing versus Conventional Respiratory-Triggered MRI-SPACE Cholangiopancreatography at 3Tesla: Comparison of Image Quality and Diagnostic Confidence

“…The optimized CS-BH-MRCP proposed by Song et al showed very interesting results and significantly better demonstrated the communication between the pancreatic cyst and the MPD as compared to the conventional MRCP [32]. With 41 patients included for the evaluation BD-IPMN using MRCP at 1.5T, the short single BH CS-MRCP sequence at 1.5T proposed by Henninger et al demonstrated significantly higher scores in all the diagnostic approach criteria (lesion conspicuity, confidence, communication) compared to the conventional NT-MRCP, a CS-NT-MRCP, and a long single BH CS-MRCP sequences [33]. CS-BH-MRCP sequences that are specifically optimized for pancreatic ducts diseases assessment, could therefore improve the diagnostic performance in this indication.…”

“…At 1.5T, in Blaise et al's study, the conventional RT-MRCP acquisition showed a significant superior overall image quality with better visualization of the biliopancreatic ducts, whereas only sharpness was improved with BH-CS-MRCP [24]. In a recent study, a short single BH CS-MRCP sequence, that allowed a reduced acquisition time of 8 s, demonstrated higher scores for image quality, duct sharpness and duct visualization than the conventional NT-MRCP, a CS-NT-MRCP, and a long single BH CS-MRCP (acquisition time of 17 s) sequences, the results being not always significant for all criteria and sequence to sequence comparison [33]. This highlights the potential superiority of the CS-BH-MRCP sequence, even at 1.5T and with an even shorter acquisition time.…”

Three‐Dimensional (3D) Breath‐Hold Zoomed MR Cholangiopancreatography (MRCP): Evaluation of Additive Value to Conventional 3D Navigator Triggering MRCP in Patients With Branch Duct Intraductal Papillary Mucinous Neoplasms

“…20 IPMNs are precursors for cancer with a spectrum of hyperplasia, low-grade dysplasia, and invasive adenocarcinoma. 21,22 In international guidelines, sequential imaging surveillance was proposed with a possible follow-up interval of 6 months, over a period of 2 years, to assess the growth characteristics of suspected BD-IPMN. 23,24 Thus, it is clinically important to determine optimized MRCP protocols for surveillance MR examinations.…”