Simultaneous Multislice Echo Planar Imaging for Accelerated Diffusion-Weighted Imaging of Malignant and Benign Breast Lesions

Ohlmeyer, Sabine; Laun, Frederik Bernd; Palm, Theresa; Janka, Rolf; Weiland, Elisabeth; Uder, Michael; Wenkel, Evelyn

doi:10.1097/rli.0000000000000560

Cited by 40 publications

(33 citation statements)

References 60 publications

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“…The longer acquisition time of the rs‐EPI sequence compared to ss‐EPI was a major limitation for its use 11–13 . To overcome the longer scan time, the SMS acceleration technique, which has been used in the ss‐EPI sequence for breast MRI, can also be implemented in rs‐EPI sequences of breast MRI 15,16,18,28,29 . Filli et al 17 reported that the scan time was reduced from 4 minutes 21 seconds to 2 minutes 35 seconds with the implementation of two‐fold SMS acceleration to the rs‐EPI sequence, which was similar to our scan time reduction from 4 minutes 30 seconds to 2 minutes 31 sec.…”

Section: Discussionsupporting

confidence: 76%

Simultaneous Multislice Readout‐Segmented Echo Planar Imaging for Diffusion‐Weighted MRI in Patients With Invasive Breast Cancers

Song

Woo

Cho

et al. 2020

Magnetic Resonance Imaging

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Background In diffusion‐weighted imaging (DWI) of breast MRI, simultaneous multislice acceleration techniques can be used for readout‐segmented echo planar imaging (rs‐EPI) to shorten the scan time. Purpose To compare the image quality, apparent diffusion coefficient (ADC) value, and scan time of rs‐EPI and simultaneous multislice rs‐EPI (SMS rs‐EPI) sequences. Study Type Retrospective. Subjects In all, 134 consecutive women (mean age: 55.3 years) with invasive breast cancer who underwent preoperative MRI. Field Strength/ Sequences 3.0T; rs‐EPI sequence, prototypic SMS rs‐EPI sequence and dynamic contrast‐enhanced MRI (DCE‐MRI) sequence Assessment For quantitative comparison, two radiologists independently measured the signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR), lesion contrast, and apparent diffusion coefficient (ADC). For qualitative comparison, image quality, lesion conspicuity, and reader preference were assessed with a reference of DCE‐MRI. Statistical Tests Paired t‐tests and Mann–Whitney tests were used. Results For SNR and CNR, there were no differences between the sequences (P = 0.342 and 0.665 for reader 1; P = 0.606 and P = 0.116 for reader 2). Lesion contrast of SMS rs‐EPI was higher than that of rs‐EPI (P < 0.05 for both reader 1 and reader 2). Mean tumor ADC was similar in rs‐EPI and SMS rs‐EPI sequences (0.98 ± 0.22 vs. 1.00 ± 0.22; P = 0.291 for reader 1, 0.98 ± 0.21 vs. 1.00 ± 0.22; P = 0.418 for reader 2). Regarding qualitative comparison, image quality and lesion conspicuity were higher in SMS rs‐EPI than in rs‐EPI (both P < 0.05 for both readers). The two readers regarded SMS rs‐EPI as superior or equal to rs‐EPI in over 90% of cases. The acquisition time was 4:30 minutes for rs‐EPI and 2:31 minutes for SMS rs‐EPI. Data Conclusion The SMS rs‐EPI sequence resulted in a similar ADC value and better image quality than the rs‐EPI sequence in a 44.1% reduced scan time. Level of Evidence 4 Technical Efficacy 3

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Section: Discussionsupporting

confidence: 76%

Simultaneous Multislice Readout‐Segmented Echo Planar Imaging for Diffusion‐Weighted MRI in Patients With Invasive Breast Cancers

Song

Woo

Cho

et al. 2020

Magnetic Resonance Imaging

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“…Ohlmeyer et al and Frost et al both describe that SMS acquisitions do not introduce serious artifacts [24,25]. However, Filli et al describe an increase of shading in the prepectoral region and ghosting [26].…”

Section: Discussionmentioning

confidence: 99%

Comparison of simultaneous multi-slice single-shot DWI to readout-segmented DWI for evaluation of breast lesions at 3T MRI

Sanderink

Teuwen

Appelman

et al. 2021

European Journal of Radiology

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To compare diffusion-weighted imaging of the breast performed with a conventional readout-segmented echo-planar imaging (rs-EPI) sequence to when using a prototype simultaneous multi-slice single-shot EPI (SMSss-EPI) acquisition. Method: From September 2017 to December 2018, 26 women with histologically proven breast cancer were scanned with the conventional rs-EPI and the SMS-ss-EPI at 3 T during the same imaging examination. Four breast radiologists (4-13 years of experience) independently scored both acquired series of 25 women (one case was used for training) for overall image quality (1: extremely poor to 9: excellent) and artifacts (1: very disturbing to 5: not present). All lesions (n = 52; 40 malignant, 12 benign) were also evaluated for visibility (1: not visible, 2: visible if location is given, 3: visible). In addition, lesion characteristics were rated, and a BI-RADS score was given. Results were analyzed using visual grading characteristics and the resulting area under the curve (AUC VGC ), weighted kappa, McNemar test, and dependent-samples t-test when appropriate. Results: Overall, radiologists significantly preferred the image quality in rs-EPI over that of SMS-ss-EPI (AUC VGC : 0.698, P = 0.002). Infolding and ghosting, and distortion artifacts were significantly less apparent in the rs-EPI (AUC VGC : 0.660, P = 0.022 and AUC VGC : 0.700 P = 0.002, respectively). Lesions were, however, significantly better visible on the SMS-ss-EPI images (AUC VGC : 0.427, P = 0.016). Malignant lesions had significantly higher visibility with SMS-ss-EPI (P = 0.035). Sensitivity and specificity were comparable between both sequences (P = 0.760 and P = 0.549, respectively). Conclusions: Despite the perceived lower image quality and the increased presence of artifacts in the SMS-ss-EPI sequence, malignant lesions are better visualized using this sequence.

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“…Another concern about multishot imaging is the increased scan time due to the increased number of shots. Multislice imaging, especially recently developed multiband multislice imaging, could help reduce the scan time of multishot imaging 35–37 . Navigator data that provides phase information for each shot may improve the performance of MUSE and shot‐LLR for a high number of shots.…”

Section: Discussionmentioning

confidence: 99%

Multishot Diffusion‐Weighted MRI of the Breast With Multiplexed Sensitivity Encoding (MUSE) and Shot Locally Low‐Rank (Shot‐LLR) Reconstructions

Ikeda

Pittman

et al. 2020

Magnetic Resonance Imaging

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Background Diffusion‐weighted imaging (DWI) has shown promise to screen for breast cancer without a contrast injection, but image distortion and low spatial resolution limit standard single‐shot DWI. Multishot DWI methods address these limitations but introduce shot‐to‐shot phase variations requiring correction during reconstruction. Purpose To investigate the performance of two multishot DWI reconstruction methods, multiplexed sensitivity encoding (MUSE) and shot locally low‐rank (shot‐LLR), compared to single‐shot DWI in the breast. Study Type Prospective. Population A total of 45 women who consented to have multishot DWI added to a clinically indicated breast MRI. Field Strength/Sequences Single‐shot DWI reconstructed by parallel imaging, multishot DWI with four or eight shots reconstructed by MUSE and shot‐LLR, 3D T2‐weighted imaging, and contrast‐enhanced MRI at 3T. Assessment Three blinded observers scored images for 1) general image quality (perceived signal‐to‐noise ratio [SNR], ghosting, distortion), 2) lesion features (discernment and morphology), and 3) perceived resolution. Apparent diffusion coefficient (ADC) of the lesion was also measured and compared between methods. Statistical Tests Image quality features and perceived resolution were assessed with a mixed‐effects logistic regression. Agreement among observers was estimated with a Krippendorf's alpha using linear weighting. Lesion feature ratings were visualized using histograms, and correlation coefficients of lesion ADC between different methods were calculated. Results MUSE and shot‐LLR images were rated to have significantly better perceived resolution (P < 0.001), higher SNR (P < 0.005), and a lower level of distortion (P < 0.05) with respect to single‐shot DWI. Shot‐LLR showed reduced ghosting artifacts with respect to both MUSE (P < 0.001) and single‐shot DWI (P < 0.001). Eight‐shot DWI had improved perceived SNR and perceived resolution with respect to four‐shot DWI (P < 0.005). Data Conclusion Multishot DWI enables increased resolution and improved image quality with respect to single‐shot DWI in the breast. Shot‐LLR reconstructs multishot DWI with minimal ghosting artifacts. The improvement of multishot DWI in image quality increases with an increased number of shots. Level of Evidence 2 Technical Efficacy Stage 2

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Simultaneous Multislice Echo Planar Imaging for Accelerated Diffusion-Weighted Imaging of Malignant and Benign Breast Lesions

Cited by 40 publications

References 60 publications

Simultaneous Multislice Readout‐Segmented Echo Planar Imaging for Diffusion‐Weighted MRI in Patients With Invasive Breast Cancers

Simultaneous Multislice Readout‐Segmented Echo Planar Imaging for Diffusion‐Weighted MRI in Patients With Invasive Breast Cancers

Comparison of simultaneous multi-slice single-shot DWI to readout-segmented DWI for evaluation of breast lesions at 3T MRI

Multishot Diffusion‐Weighted MRI of the Breast With Multiplexed Sensitivity Encoding (MUSE) and Shot Locally Low‐Rank (Shot‐LLR) Reconstructions

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