Abstract
To investigate the feasibility and effectiveness of high-resolution readout-segmented echo planar imaging (rs-EPI), diffusion-weighted imaging (DWI) is used simultaneously with multi-slice (SMS) imaging (SMS rs-EPI) for the differentiation of breast malignant and benign lesions in comparison to conventional rs-EPI on a 3T MR scanner. A total of 102 patients with 113 breast lesions underwent bilateral breast MRI using a prototype SMS rs-EPI sequence and a conventional rs-EPI sequence. Subjective image quality was assessed using a 5-point Likert scale (1 = poor, 5 = excellent). Signal-to-noise ratio (SNR), lesion contrast-to-noise ratio (CNR) and apparent diffusion coefficients (ADC) value of the lesion were measured for comparison. Receiver operating characteristic curve analysis was performed to evaluate the diagnosis performance of ADC, and the corresponding area under curve (AUC) was calculated. The image quality scores in anatomic distortion, lesion conspicuity, sharpness of anatomical details and overall image quality of SMS rs-EPI were significantly higher than those of conventional rs-EPI. CNR was enhanced in the high-resolution SMS rs-EPI acquisition (6.48 ± 1.71 vs. 4.23 ± 1.49; p < 0.001). The mean ADC value was comparable in SMS rs-EPI and conventional rs-EPI (benign 1.45 × 10−3 vs. 1.43 × 10−3 mm2/s, p = 0.702; malignant 0.91 × 10−3 vs. 0.89 × 10−3 mm2/s, p = 0.076). The AUC was 0.957 in SMS rs-EPI and 0.983 in conventional rs-EPI. SMS rs-EPI technique allows for higher spatial resolution and slight reduction of scan time in comparison to conventional rs-EPI, which has potential for better differentiation between malignant and benign lesions of the breast.
Highlights
Breast cancer is one of the most common malignancies among women in the world [1].Magnetic resonance imaging (MRI) has unique advantages in the diagnosis and evaluation of breast lesions
In Dynamic contrast enhancement magnetic resonance imaging (DCE-MRI), high resolution morphological information and semi-quantitative tumor angiogenesis characteristics can be provided using the dynamic changes of T1 signals after injection of gadolinium-based contrast agents [5]
The detection sensitivity of DCE-MRI of the breast on the 3T MRI scanner was nearly up to 100%, while specificity ranged from 49.1% to 87.5% [6,7,8,9]
Summary
Magnetic resonance imaging (MRI) has unique advantages in the diagnosis and evaluation of breast lesions. It performs high accuracy in the detection and diagnosis of breast cancer, but it is used to evaluate the treatment response of tumors through the information of pharmacokinetics, tissue microcirculation, and pathophysiology from a microscopic point of view [2,3]. Dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) is the backbone scanning sequence of current breast MR, according to the American College of Radiology criteria [4]. In DCE-MRI, high resolution morphological information and semi-quantitative tumor angiogenesis characteristics can be provided using the dynamic changes of T1 signals after injection of gadolinium-based contrast agents [5]. To overcome the limitations of specificity, there is increasing interest in exploring the combined application of other functional parametric maps for differential diagnosis
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