Rui Wang1, Qifan Ma1, Mengxiao Liu2, Ying Yuan1, and Xiaofeng Tao1
1Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine., Shang hai, China, 2MR scientific Marketing,Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China, Shang hai, China
Synopsis
Keywords: Diffusion Analysis & Visualization, Diffusion/other diffusion imaging techniques, 0.55T MR system
Motivation: Comparing the image quality, distortion, and stability of quantitative parameters of MRI in parotid gland images across 0.55T, 1.5T, and 3T.
Goal(s): To compare the clinical performance of 0.55T magnetic resonance imaging (MRI) systems in parotid glands with 1.5T and 3T.
Approach: Evaluating image quality, distortion in DWI, and the stability and differences of quantitative parameters derived from IVIM across different field strengths.
Results: 0.55T MRI significantly reduces image distortion and maintains stable ADC values in DWI while providing comparable morphologic image quality to 1.5T. Additionally, the diffusion parameters in 0.55T showed significant differences compared to those of 1.5T and 3T.
Impact: 0.55T
MRI may offer a valuable alternative with the significant altered IVIM-DKI parameters for parotid gland imagings in patients with
limited conditions, maintaining image quality and stable ADC values, potentially improving the diagnostic process for certain individuals.
Introduction
Parotid
tumors are the most common salivary gland tumors, comprising about 3% of all
head and neck tumors, with approximately 80% being benign and 20% malignant.
Functional magnetic resonance imaging (MRI) techniques, such as
diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and
diffusion kurtosis imaging (DKI), are noninvasive methods that provide valuable
insights into tumor characteristics. While MRI scans are frequently performed
at 1.5T and 3T, there's growing interest in the potential of 7T MRI systems.
Additionally, low-field MRI systems, equipped with advanced hardware and
imaging techniques, are gaining traction for clinical applications, especially
for patients with specific needs. The objective of this research is to
establish parameter intervals across different MRI field strengths (0.55T,
1.5T, and 3T) and evaluate their clinical feasibility, thereby indicating the further
advantages of low-field imaging for the detection of parotid tumors.Materials and Methods
Nineteen
healthy volunteers underwent maxillofacial imaging using 0.55T, 1.5T, and 3T
MRI machines. Scanning sequences included T2 fat-saturation (T2-FS) and
diffusion imaging with various b values across the three field strengths(Table
1). Two radiologists, each with 5 and 15 years of diagnostic experience in head
and neck imaging, subjectively evaluated T2-FS images using a 5-point method
across five aspects in a double-blind manner. Objective image quality was
assessed using signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).
The research compared the extent of parotid gland distortion in
diffusion-weighted imaging (DWI), the stability, and interval range differences
of apparent diffusion coefficient (ADC), and corresponding parameters obtained
from intravoxel incoherent motion-diffusion kurtosis imaging (IVIM-DKI) across
various field strengths. Statistical analysis and image fusion were carried out
using GraphPad Prism 8.0 software and 3D slicer. Quality measurements and
quantitative parameters were analyzed through one-way ANOVA. Inter-observer
consistency was assessed using Spearman's coefficient correlation, and the
stability of parameters was evaluated using the Bland-Altman method and
coefficients of variation (CV). Differences were considered statistically
significant at P<0.05.Results
T2-FS
images exhibited the lowest SNR and CNR at 0.55T, with no significant differences
between 0.55T and 1.5T (P>0.05) (Fig.1 and Table2). DWI distortion at 0.55T
was significantly lower than at 1.5T with SS-EPI (P<0.0001), while no
differences were observed in axial slices compared to RESOLVE-DWI at 3T. ADC
stability was highest at 0.55T compared to 1.5T and 3T (R, CV=6.17; L, CV=6.89 vs. R, CV=8.38; L, CV=8.48 vs. R,
CV=10.80; L, CV=10.20). Furthermore, parameters from different
diffusion sequences at 0.55T significantly differed from those at higher field
strengths (P<0.0001), except for Dt
values (P>0.05) (Table 3). Dt
values exhibited the highest stability across different field strengths, while Dp values were the lowest.
Inter-observer agreement on morphologic image quality was good, with subjective
scores showing significant differences between 0.55T and both 1.5T and 3T
(p<0.0001).Discussion
Our
results showed that the image quality of 0.55T with high-performance
accessories is comparable to that of 1.5T in both subjective and objective
assessments. Furthermore, the reduction of artifacts related to susceptibility
effects is significant compared to the single-shot EPI sequence in 1.5T and
comparable to the readout segmentation of long variable echo-trains diffusion
weighted imaging (RESOLVE-DWI) in 3T. It is worth pointing out that the
stability of ADC values measured in 0.55T was higher than that of RESOLVE-DWI
in 3T. The interval range of ADC values in 0.55T had no significant difference
compared with 1.5T; however, both of them were significantly higher than in 3T. Previous findings suggest that the variability in ADC values is likely
influenced by both field strength, due to the noise floor effect, and
anatomical sites, primarily due to tissue heterogeneities. The image noise, problem
of curve fitting, sets of b values, system bias, individual differences,
and different anatomical regions related to different physiologic changes can
also lead to inconsistent results of measured parameter
values. Thus, our results suggest that when ADC, IVIM, and DKI parameter values
are used to assess a patient’s treatment response or probable outcome in
parotid glands, the variability due to different field strengths imagers should
be taken into account.Conclusion
The
study demonstrated that 0.55T MRI significantly reduces image distortion,
maintains stable ADC values in DWI, and provides image quality comparable to
that of 1.5T MRI. This indicates the benefits of low field compared to higher
field with higher susceptibility and distortion which would prevent the
visibility and proper assessment of the parotid tumors close to sinuses and
oral cavities. Additionally, caution is advised when using diffusion parameters
as biomarkers for diagnosing parotid gland tumors across different field
strengths, as they exhibit significant differences.Acknowledgements
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