Evaluation of Thin-slice Coronal Single-shot Turbo Spin-echo Diffusion-weighted Imaging of the Hand: A Comparison with Conventional Echo-planar Diffusion-weighted Imaging

Abstract

We prospectively evaluated thin-slice coronal turbo spin-echo (TSE) diffusion-weighted imaging (DWI) covering a larger area with the recently-developed techniques on a 3T MRI scanner, compared with echoplanar imaging (EPI)-DWI in patients undergoing routine hand MRI. Visual score assessment and apparent diffusion coefficient (ADC) measurement were performed for patients with suspected hand tumors. TSE-DWI was superior to EPI-DWI, with less image distortion. The visual score and ADC comparison assessments proved that the image noise of TSE-DWI was acceptable.breast and lung cancers, and spinal cord infarction. 1,5-10 To the best of our knowledge, however, there have been no TSE-DWI studies evaluating musculoskeletal lesions of the hand or foot. In addition, only one previous case report evaluated middle ear cholesteatoma using 2-mm-thick single-shot TSE-DWI, but ADC measurement was not performed and the acquisition time was not presented. 6 TSE-DWI using the recently-developed parallel imaging and single-shot technique on 3T MRI might yield a superior image quality and is already used clinically. However, the image quality of thin-slice TSE-DWI for the assessment of small musculoskeletal lesions has not yet been clarified. Thus, the purpose of this study was to prospectively examine whether the 2-mm-thick coronal TSE-DWI covering a larger area and small lesions could substitute for conventional EPI-DWI in patients undergoing routine hand MRI on a 3T scanner. Materials and Methods Study designThis prospective study was performed in accordance with the ethical standards of our Institutional Review Board. Written informed consent was obtained from the patients and their privacy was completely protected. Eligibility criteria for entry were: (1) adult patients suspected of having or being followed for a musculoskeletal tumor of the hand or finger, (2) patient agreement to cooperate, and (3) examination on a Philips 3T MRI scanner (Ingenia; Philips Medical Systems, Eindhoven, The Netherlands). The exclusion criteria were:(1) contraindications to MR (incompatible metal implants or pacemakers), and (2) motion artifacts and artifacts from unsuppressed fat on the images. The primary endpoint of the

T-staging of rectal cancer: Utility of single-shot turbo spin-echo diffusion-weighted imaging with T2-weighted images and fusion images

“…), so a meaningful difference in the score was assumed to be 1. In previous TSE-DWI studies using point scales, the standard deviations (SDs) for the score were up to 0.8 [14,17]. However, the SD might be higher in pelvic DWI images due to the inhomogeneous magnetic field.…”

“…Nevertheless, combined use of parallel imaging and single-shot technique, generally used for ultrafast breath-hold T2WI, became applicable to TSE-DWI sequence in recent years, reducing motion artifacts. Single-shot TSE-DWI has issues with severe blurring and image noise, but development of parallel imaging technique and multichannel coil solved these issues [10,17].…”

“…Recently, the parallel imaging technique improved these problems of single-shot TSE-DWI [9,10]. The utility of TSE-DWI has been reported in evaluations of middle ear, orbital/ neck lesions, lung and breast cancers, and hand lesions [11][12][13][14][15][16][17]. TSE-DWI may therefore improve T-staging of rectal cancer due to its comparatively low image distortion.…”

Echo-planar imaging is superior to fast spin-echo diffusion-weighted imaging for cranioplasty using titanium mesh in brain magnetic resonance imaging: a phantom study

“…On the other method, image distortion can be reduced using fast spin-echo (FSE) sequences. The FSE technique is an alternative approach for DWI, because it uses a refocusing pulse for each measured echo, and its susceptibility artifacts and image distortion are lower than those on EPI-DWI [22][23][24].…”