Abstract
BackgroundTo evaluate whether readout-segment echo-planar imaging (RS-EPI) can provide better image quality in assessing bladder cancer than single-shot echo-planar imaging (SS-EPI) and to compare quantitative imaging parameters derived from both techniques.MethodsSeventy patients with bladder lesions were enrolled and underwent diffusion-weighted imaging on a 3 Tesla magnetic resonance scanner using axial RS-EPI and SS-EPI techniques. Two observers independently assessed the susceptibility, detectability, motion artefacts and blurring of the images using qualitative scores. The signal-to-noise ratio (SNR), signal intensity ratio (SIR), contrast-to-noise ratio (CNR) and ADC values of the bladder lesions were measured and compared between the two techniques and between two observers. Qualitative and quantitative comparisons of image quality were performed using the Wilcoxon signed-rank test and paired t-test. In addition, the agreement of the ADC measurements was evaluated using ICC values and Bland-Altman plots.ResultsSixty-eight patients were included in the final analysis. The scores of image susceptibility, detectability and blurring for RS-EPI were significantly higher than those for SS-EPI (all p < 0.05), while the motion artefact was not. There were significant differences between RS-EPI and SS-EPI in the CNR and SIR values (all p < 0.05) but not in the SNR or ADC values (all p > 0.05). The ICC values and Bland-Altman plots also showed excellent agreement between the measured ADC values of the bladder lesions.ConclusionsThe RS-EPI technique provides significantly better image quality in patients with bladder cancer than the SS-EPI technique, without a significant difference in the ADC value.
Highlights
To evaluate whether readout-segment echo-planar imaging (RS-EPI) can provide better image quality in assessing bladder cancer than single-shot echo-planar imaging (SS-EPI) and to compare quantitative imaging parameters derived from both techniques
Patients A total of 70 patients were recruited for RS-EPI and SSEPI Diffusionweighted imaging (DWI)
Pathological staging showed that 48 patients had T1, 2 patients had T2, 5 patients had T3a, 4 patients had T3b, 3 patients had T4, in addition, 6 patients were identified as having muscle invasive bladder cancer (> T1), but the exact stages were not determined because the whole bladder was not resected and pathological sections of the bladder tumour and the bladder wall could not be obtained
Summary
To evaluate whether readout-segment echo-planar imaging (RS-EPI) can provide better image quality in assessing bladder cancer than single-shot echo-planar imaging (SS-EPI) and to compare quantitative imaging parameters derived from both techniques. There were 429,800 new cases of bladder cancer and 165,100 related deaths worldwide in 2012 [1]. In 2015, there were approximately 80,000 new cases of bladder cancer and 34,000 related deaths in China [2]. Chen et al Cancer Imaging (2019) 19:59 lesions, such as inflammation, fibrosis and oedema, leading to excessive staging [6, 7]. Dynamic contrast-enhanced MRI can be used to differentiate bladder tumours and muscles according to the different enhancement modes of the lesions, while the enhancement of small blood vessels located at the base of the tumour is similar to that of the tumour, which leads to over-staging [8, 9]. Several studies have reported that DWI plays a significant role in preoperative staging and grading for the diagnosis of bladder cancer [6, 11,12,13,14]
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