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Accelerating Diffusion-Weighted MRI Without Compromising Image Quality: Rectal MRI Use Case

      Multiparametric magnetic resonance imaging (MRI) is an important diagnostic tool to stage rectal cancer and to assess the impact of treatment and has been recommended by both the European Society of Gastrointestinal and Abdominal Radiology and the Society of Abdominal Radiology (SAR) Rectal and Anal Cancer Disease-Focused Panel (
      • Beets-Tan R.G.H.
      • et al.
      Magnetic resonance imaging for clinical management of rectal cancer: updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.
      ,
      • Gollub M.J.
      • et al.
      Use of magnetic resonance imaging in rectal cancer patients: Society of Abdominal Radiology (SAR) rectal cancer disease-focused panel (DFP) recommendations 2017.
      ). In particular, diffusion-weighted imaging (DWI) provides useful information, especially following neoadjuvant chemoradiotherapy and has become a routine part of the rectal cancer MRI examination (
      • Foti P.V.
      • et al.
      Locally advanced rectal cancer: qualitative and quantitative evaluation of diffusion-weighted MR imaging in the response assessment after neoadjuvant chemo-radiotherapy.
      ,
      • Kim S.H.
      • et al.
      Locally advanced rectal cancer: added value of diffusion-weighted MR imaging in the evaluation of tumor response to neoadjuvant chemo- and radiation therapy.
      ,
      • Rao S.X.
      • et al.
      The value of diffusion-weighted imaging in combination with T2-weighted imaging for rectal cancer detection.
      ,
      • Song I.
      • et al.
      Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison with T2 weighted and PET/CT imaging.
      ,
      • van der Paardt M.P.
      • et al.
      Patients who undergo preoperative chemoradiotherapy for locally advanced rectal cancer restaged by using diagnostic MR imaging: a systematic review and meta-analysis.
      ). As a relatively signal-poor pulse sequence, despite compensating with low spatial resolution (fewer phase encoding steps than other pulse sequences), DWI requires multiple signal averages and typically incurs long image acquisition times up to 7 or 8 minutes. Koëter, et al. propose the use of a simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) pulse sequence to decrease DWI acquisition time nearly 50%.” (
      • Koeter T.
      • et al.
      Reducing acquisition time of diffusion weighted MR imaging of the rectum with simultaneous multi-slice acquisition: a reader study.
      ) Furthermore, reducing image acquisition time so drastically potentially offers the opportunity to balance the time reduction with other improvements, such as increasing spatial resolution, applying superior and more-time consuming fat suppression techniques or other advantages. Of course, such tradeoffs are possible only if SMS-DWI image quality is preserved and this was also observed by the authors.
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      Reference

        • Beets-Tan R.G.H.
        • et al.
        Magnetic resonance imaging for clinical management of rectal cancer: updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.
        Eur Radiol. 2018; 28: 1465-1475
        • Gollub M.J.
        • et al.
        Use of magnetic resonance imaging in rectal cancer patients: Society of Abdominal Radiology (SAR) rectal cancer disease-focused panel (DFP) recommendations 2017.
        Abdom Radiol (NY). 2018; 43: 2893-2902
        • Foti P.V.
        • et al.
        Locally advanced rectal cancer: qualitative and quantitative evaluation of diffusion-weighted MR imaging in the response assessment after neoadjuvant chemo-radiotherapy.
        Eur J Radiol Open. 2016; 3: 145-152
        • Kim S.H.
        • et al.
        Locally advanced rectal cancer: added value of diffusion-weighted MR imaging in the evaluation of tumor response to neoadjuvant chemo- and radiation therapy.
        Radiology. 2009; 253: 116-125
        • Rao S.X.
        • et al.
        The value of diffusion-weighted imaging in combination with T2-weighted imaging for rectal cancer detection.
        Eur J Radiol. 2008; 65: 299-303
        • Song I.
        • et al.
        Value of diffusion-weighted imaging in the detection of viable tumour after neoadjuvant chemoradiation therapy in patients with locally advanced rectal cancer: comparison with T2 weighted and PET/CT imaging.
        Br J Radiol. 2012; 85: 577-586
        • van der Paardt M.P.
        • et al.
        Patients who undergo preoperative chemoradiotherapy for locally advanced rectal cancer restaged by using diagnostic MR imaging: a systematic review and meta-analysis.
        Radiology. 2013; 269: 101-112
        • Koeter T.
        • et al.
        Reducing acquisition time of diffusion weighted MR imaging of the rectum with simultaneous multi-slice acquisition: a reader study.
        Acad Radiol. 2022; 29: 1802-1807
        • Park J.H.
        • et al.
        Feasibility of simultaneous multislice acceleration technique in diffusion-weighted magnetic resonance imaging of the rectum.
        Korean J Radiol. 2020; 21: 77-87
        • Stijns R.C.
        • et al.
        The influence of endorectal filling on rectal cancer staging with MRI.
        Br J Radiol. 2018; 9120180205
        • Obele C.C.
        • et al.
        Simultaneous multislice accelerated free-breathing diffusion-weighted imaging of the liver at 3T.
        Abdom Imaging. 2015; 40: 2323-2330