EPI-based diffusion imaging methods are dominantly used, but suffer from susceptibility associated distortion and signal loss, making it challenging to achieve high-quality high-resolution diffusion imaging results. To overcome these challenges, we implemented monopolar diffusion preparation module for TSE sequence (DP-TSE) and evaluated the performance in comparison to readout segmented multi-shot echo planner (RESOLVE) sequence for diffusion weighted imaging (DWI). Our study results suggest that Diffusion-Prepared TSE is a promising alternative for distortion-free, high-resolution diffusion imaging with superior diffusion SNR.
Studies were performed on a honey-dew melon (phantom) and several healthy human subjects on a 3T clinical MR scanner (Magnetom Prisma, Siemens Healthcare, Erlangen, Germany) under an IRB approved protocol with written informed consent. The body coil was used for RF transmission and a 32-channel phased array head coil for signal reception. The sequence diagram of the implemented imaging method is presented in Figure 1. A monopolar, instead of a bipolar, diffusion preparation module using a pair of Stejskal and Tanner diffusion gradients4 was used to reduce diffusion preparation time and minimize the signal loss due to T2 decay. Two optimized spoiler gradients were applied around the preparation module to eliminate any potential residual signal.
To assess the accuracy of the implemented method and investigate the balance between imaging quality and acquisition time, diffusion imaging studies with the honey-dew melon were first performed using a series of b-values along with varied echo train lengths (ETLs): FOV = 192 x 192 mm2; matrix size = 192 x 192; in-plain resolution = 1.0 x 1.0 mm2; slice thickness = 3 mm; TE = 10 ms; TR = 2000 ms; ETL = 1, 5, 7, 11; and b-value = 500, 1500 s/mm2. To further evaluate the implemented method, especially its robustness for in vivo imaging, diffusion studies of the corpus callosum were performed with a series of volunteers using the following parameters: FOV = 240 x 240 mm2; matrix size = 192 x 192; in-plain resolution = 1.25 x 1.25 mm2; slice thickness = 3 mm; TE = 10 ms; TR = 1500 ms; ETL = 11; b-value = 500, 1000 s/mm2. For comparison purpose, in vivo multi-shot RESOLVE diffusion imaging was also performed using matched parameters with 7 readout segments. Post-processing, including co-registration and reconstruction of apparent diffusion coefficient (ADC) maps, were performed in MATLAB
ADC map comparisons between DP-TSE and RESOLVE of melon are displayed in Figure 2, followed by a quantitative comparison for different DWI methods in scan time, mean/std ADC value, SNR and SNR efficiency summarized in Table 1. Diffusion-weighted images of corpus callosum and whole brain ADC map comparisons between DP-TSE and RESOLVE are shown in Figure 3 and 4.
The study results indicated that non-distorted, high SNR and accurate diffusion weighted images can be achieved by diffusion-prepared TSE sequence. ADC values were consistent with varied ETL numbers in DP-TSE DWI measurement. Although TSE-based DWI sequences5,6 still consumes more time than RESOLVE sequence, the SNR efficiency of DP-TSE is generally higher than 7-shot segmented RESOLVE. The diffusion signal higher intensity and SNR of DP-TSE may potentially help push the resolution of diffusion imaging to be higher.
In the human study, the ADC results of corpus callosum were comparable between DP-TSE and RESOLVE measurements. Our in vivo study results further confirmed that the DP-TSE method could provide ADC values comparable to those from RESOLVE and in literature7 (Figure 3), but suffers less from susceptibility distortion (Figure 4). The limitation of DP-TSE is the potential sensitivity to motion, which may be addressed by motion insensitive trajectory such as PROPELLER or radial readout.