Comparing Lesion Conspicuity and ADC Reliability in High-resolution Diffusion-weighted Imaging of the Breast

Mami Iima; Rena Nakayama; Masako Kataoka; Martins Otikovs; Noam Nissan; Lucio Frydman; Yuta Urushibata; Maya Honda; Aika Okazawa; Hiroko Satake; Shinji Naganawa; Yuji Nakamoto

doi:10.2463/mrms.tn.2024-0089

Comparing Lesion Conspicuity and ADC Reliability in High-resolution Diffusion-weighted Imaging of the Breast

Magn Reson Med Sci. 2024 Sep 26. doi: 10.2463/mrms.tn.2024-0089. Online ahead of print.

Authors

Mami Iima^{1

2}, Rena Nakayama^{2

3}, Masako Kataoka², Martins Otikovs⁴, Noam Nissan⁵, Lucio Frydman⁴, Yuta Urushibata⁶, Maya Honda^{2

7}, Aika Okazawa², Hiroko Satake⁸, Shinji Naganawa⁸, Yuji Nakamoto²

Affiliations

¹ Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
² Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan.
³ NTT Medical Center Tokyo Hospital, Tokyo, Japan.
⁴ Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel.
⁵ Department of Radiology, Sheba-Medical-Center, Ramat-Gan, Israel.
⁶ Siemens Healthcare K.K., Tokyo, Japan.
⁷ Department of Diagnostic Radiology, Kansai Electric Power Hospital, Osaka, Osaka, Japan.
⁸ Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

PMID: 39322567
DOI: 10.2463/mrms.tn.2024-0089

Abstract

Purpose: This study investigated the breast lesion conspicuity and apparent diffusion coefficient (ADC) reliability for three different diffusion-weighted imaging (DWI) protocols: spatiotemporal encoding (SPEN), single-shot echo-planar imaging (SS-EPI), and readout segmentation of long variable echo-trains (RESOLVE).

Methods: Sixty-five women suspected of having breast tumors were included in this study, with 44 lesions (36 malignant, 8 benign) analyzed further. Breast MRI was performed on a 3 Tesla (3T) system (MAGNETOM Prisma, Siemens) equipped with a dedicated 18-channel breast array coil for a phantom and patients. Three DWI protocols-SPEN, SS-EPI, and RESOLVE-were used. SS-EPI was acquired with an in-plane resolution of 2 × 2 mm², a slice thickness of 3 mm, and b-values of 0 and 1000 s/mm². SPEN had a higher in-plane resolution of 1 × 1 mm², a slice thickness of 1.5 mm, and b-values of 0, 850, and 1500 s/mm². RESOLVE was acquired with an in-plane resolution of 1 × 1 mm², a slice thickness of 1.5 mm, and b-values of 0 and 850 s/mm². Lesion conspicuity and ADC values were evaluated.

Results: The average lesion conspicuity scores were significantly higher for RESOLVE (3.54 ± 0.65) than for SPEN (3.07 ± 0.91) or SS-EPI (2.48 ± 0.78) (P < 0.01). The SPEN score was significantly higher than the SS-EPI score (P < 0.01). Phantom measurements indicated marginally lower ADC values for SPEN compared to SS-EPI and RESOLVE across all concentrations. The results revealed that SPEN (b = 0, 850, 1500 sec/mm²) yielded significantly lower ADC values compared to SPEN (b = 0, 850 sec/mm²) in malignant lesions (P < 0.01), with no significant difference observed between SPEN (b = 0, 850 sec/mm²), SS-EPI, and RESOLVE. For benign lesions, no significant difference in ADC values was found between SPEN (b = 0, 850 sec/mm²), SPEN (b = 0, 850, 1500 sec/mm²), SS-EPI, and RESOLVE.

Conclusion: RESOLVE provided the highest lesion conspicuity, and ADC values in breast lesions were not significantly different among sequences ranging b values 850-1000 sec/mm². SPEN with higher b-values (0, 850, 1500 vs. 0, 850 sec/mm²) yielded significantly lower ADC values in malignant lesions, highlighting the importance of b-value selection in ADC quantification.

Keywords: breast lesions; breast magnetic resonance imaging; high-resolution diffusion-weighted imaging.