Rationale and Objectives
In breast MRI with diffusion-weighted imaging (DWI), fat suppression is essential
for eliminating the dominant lipid signal. This investigation evaluates a combined
water-excitation-spectral-fatsat method (WEXfs) versus standard spectral attenuated
inversion recovery (SPAIR) in high-resolution 3-Tesla breast MRI.
Materials and Methods
Multiparametric breast MRI with 2 echo-planar DWI sequences was performed in 83 patients
(50.1 ± 12.6 years) employing either WEXfs or SPAIR for fat signal suppression. Three
radiologists assessed overall DWI quality and delineability of 88 focal lesions (28
malignant, 60 benign) on images with b values of 800 and 1600 s/mm2, as well as apparent diffusion coefficient (ADC) maps. For each fat suppression method
and b value, the longest lesion diameter was determined in addition to measuring the
signal intensity in DWI and ADC value in standardized regions of interest.
Results
Regardless of b values, image quality (all p < 0.001) and lesion delineability (all p ≤ 0.003) with WEXfs-DWI were deemed superior
compared to SPAIR-DWI in benign and malignant lesions. Irrespective of lesion characterization,
WEXfs-DWI provided superior signal-to-noise, contrast-to-noise and signal-intensity
ratios with 1600 s/mm2 (all p ≤ 0.05). The lesion size difference between contrast-enhanced T1 subtraction
images and DWI was smaller for WEXfs compared to SPAIR fat suppression (all p ≤ 0.007).
The mean ADC value in malignant lesions was lower for WEXfs-DWI (p < 0.001), while no significant ADC difference was ascertained between both techniques
in benign lesions (p = 0.947).
Conclusion
WEXfs-DWI provides better subjective and objective image quality than standard SPAIR-DWI,
resulting in a more accurate estimation of benign and malignant lesion size.
Key Words
Abbreviations:
ADC (apparent diffusion coefficient), CNR (contrast-to-noise ratio), DCE (dynamic contrast enhanced), DWI (diffusion-weighted imaging), ROI (region of interest), SD (standard deviation), SI (signal intensity), SIR (signal-intensity ratio), SNR (signal-to-noise ratio), SPAIR (spectral attenuated inversion recovery), WEXfs (water-excitation-spectral-fatsat combination)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 08, 2023
Accepted:
January 12,
2023
Received in revised form:
January 5,
2023
Received:
November 16,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
