Dreher C, Kuder TA, König F, Paech D, Tavakoli A, Flothow F, Gnirs R, Benkert T, Strecker R, Schlemmer HP, Bickelhaupt S, Laun FB (2020)
Publication Type: Journal article
Publication year: 2020
Book Volume: 55
Pages Range: 285-292
Journal Issue: 5
DOI: 10.1097/RLI.0000000000000639
INTRODUCTION: Magnetic resonance imaging (MRI) of the abdomen increasingly incorporates diffusion-weighted imaging (DWI) sequences. Whereas DWI can substantially aid in detecting and characterizing suspicious findings, it remains unclear to what extent the use of ultra-high b-value DWI might further be of aid for the radiologist especially when using DWI sequences with advanced processing. The target of this study was therefore to compare high and ultra-high b-value DWI in abdominal MRI examinations. METHODS: This institutional review board-approved, prospective study included abdominal MRI examinations of 70 oncologic patients (mean age, 58 years; range, 21-90 years) examined with a clinical 1.5 T MRI scanner (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany) with an advanced echo planar DWI sequence (b = 0, 50, 900, and 1500 s/mm) after ex vivo phantom and in vivo volunteer investigations. High b900 and ultra-high b1500 DWIs were compared by a qualitative reading for image quality and lesion conspicuity using a 5-point Likert scale with 2 radiologists as readers. The ratios of apparent signal intensities of suspicious lesions/normal tissue of the same organ (LNTRs) were calculated. Appropriate methods were used for statistical analysis, including Wilcoxon signed-rank test and κ statistic for interreader agreement analysis (P < 0.05/0.0125/0.005 after Bonferroni correction). RESULTS: Image quality was significantly increased with b900 as compared with b1500 DWI (P < 0.001) despite using an advanced DWI sequence. A total of 153 suspicious lesions were analyzed. Overall reader confidence for characterization/detection of malignant lesions and, correspondingly, the LNTR (mean, 2.7 ± 1.8 vs 2.4 ± 1.6) were significantly higher with b900 than with b1500 DWI (P < 0.001 and P < 0.001). The increased confidence of lesion recognition and LNTR in the b900 DWI remained significant qualitatively in lymphatic and hepatic lesions and quantitatively in lymphatic, pulmonal, and osseous lesions. CONCLUSIONS: Using high b-value DWI (900 s/mm) provided an improved image quality and also lesion conspicuity as compared with ultra-high b-value DWI (1500 s/mm) in oncologic abdominal examinations despite using advanced processing. Consequently, the value for additional ultra-high b-value DWI in oncologic examinations should be critically evaluated in future studies.
APA:
Dreher, C., Kuder, T.A., König, F., Paech, D., Tavakoli, A., Flothow, F.,... Laun, F.B. (2020). Advanced Diffusion-Weighted Abdominal Imaging: Qualitative and Quantitative Comparison of High and Ultra-High b-Values for Lesion Detection and Image Quality. Investigative Radiology, 55(5), 285-292. https://dx.doi.org/10.1097/RLI.0000000000000639
MLA:
Dreher, Constantin, et al. "Advanced Diffusion-Weighted Abdominal Imaging: Qualitative and Quantitative Comparison of High and Ultra-High b-Values for Lesion Detection and Image Quality." Investigative Radiology 55.5 (2020): 285-292.
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