Takeshi Yoshikawa1, Katsusuke Kyotani2, Yoshiharu Ohno1, Yoshimori Kassai3, Hisanobu Koyama4, Kouya Nishiyama2, Shinichiro Seki4, and Kazuro Sugimura4
1Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Japan, 2Radiology, Kobe University Hospital, Kobe, Japan, 3Toshiba Medical Systems Co., Otawara, Japan, 4Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
Synopsis
To
reduce distortion on abdominal EPI-DWI, we developed Fast Advanced Spin Echo
(FASE)-DWI for abdominal 3T imaging. We found FASE-DWI can provide additional
diagnostic information in evaluation of various abdominal diseases and be used
as an alternative to EPI-DWI.INTRODUCTION
In current abdominal MRI, DWI is one of the
most important techniques and routinely used worldwide.
However, problems still remain such as poor
image quality and distortion due to air in lung or intestinal, or outside the
body, especially when using single-shot EPI at 3T.
To
solve this problem, we developed Fast Advanced Spin Echo (FASE)-DWI for
abdominal 3T imaging.
PURPOSE
Our
purpose was to assess fast advanced spin echo (FASE)-DWI in the abdomen.
MATERIALS & METHODS
52 patients (32men, 20women, mean:
69.4years), who were suspected to have hepato-biliary-pancreatic malignancy and
underwent 3T-MRI, were enrolled. FSE-T2WI, SE-EPI-DWI, and FASE-DWI were
obtained.
Amount of abdominal gas and ascites was
recorded using a 5-point scale. Anteroposterior (AP) and right-to-left (RL)
abdominal diameters were measured on the slice with most severe image
distortion and diameters of the right upper liver near the diaphragm were
measured. Correlation analyses were performed.
Image quality and severity of image
distortion were assessed using a 5-point scale on EPI-DWI and FASE-DWI, and
compared. Regression analyses were done to estimate factors for low image
quality and severe distortion.
Malignant lesion (n=39) conspicuity was
assessed separately on EPI-DWI and FASE-DWI, and compared. Diagnostic
confidence for malignant lesion was compared between EPI-DWI alone and
EPI-DWI+FASE-DWI.
RESULTS
Correlation coefficient was the highest
between T2WI and FASE-DWI for all the diameters. Lower correlation
coefficients, indicating more severe distortion, were observed in abdominal AP
direction and right liver AP direction on EPI-DWI.
Image distortion was significantly more
severe on EPI-DWI (p<0.0001). There was no significant difference between
overall image quality and malignant lesion conspicuity.
Age, sex, and gas were found to be
significant factors for image quality on EPI-DWI (0.047, 0.004, 0.018), and sex
and AP diameter were significant factors for image quality on FASE-DWI (0.005,
0.043).
Diagnostic confidence was significantly
higher on EPI-DWI+FASE-DWI (0.022).
SUMMARY & DISCUSSION
Quantitative Analysis
Distortion was reduced on FASE-DWI.
Qualitative Analysis
No significant deference in image quality.
Distortion was reduced on FASE-DWI.
FASE-DWI was useful in the abdominal parts
near air.
Image quality was better in young men on both.
Image quality on EIP-DWI was significantly affected by abdominal gas.
Lesion Assessment
Conspicuity is similar both on EPI-DWI and
FASE-DWI.
Diagnostic confidence was improved on
EPI+FASE.
CONCLUSION
FASE-DWI can provide additional diagnostic information
in evaluation of various abdominal diseases and be used as an alternative to
EPI-DWI.
Acknowledgements
No acknowledgement found.References
•There are only a few reports on application
of FSE/TSE-based DWI technique to abdominal field.
FASE-DWI
Ohno Y, et al. EJR 2015 (Lung CA,
N-staging)
Kito S, et al. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 2006(head & neck abscesses)
Non-EPI-DWI
Jin N, et al. JMRI 2011 (kidney, SPLICE)
Deng J, et al. MRM 2008(upper abdomen,
SPLICE·PROPELLER)
Other organs: brain, spinal cord, prostate,
muscle-skeletal, etc.