How to Improve the Conspicuity of Breast Tumors on Computed High &lt;i&gt;b&lt;/i&gt;-value Diffusion-weighted Imaging

Tamura, Takayuki; Takasu, Miyuki; Higaki, Toru; Yokomachi, Kazushi; Akiyama, Yuji; Sumida, H; Nagata, Yasushi; Awai, Kazuo

doi:10.2463/mrms.mp.2018-0011

Cited by 11 publications

(9 citation statements)

References 21 publications

(17 reference statements)

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“…Previous studies have reported increased tumor detection in cDWI images for prostate, pancreatic, and hepatic cancer [13,15,16]. However, contradictory findings were reported by Tamura et al in a study on cDWI in breast cancer [17]. Particularly, degraded image quality remains a major limitation in cDWI [12,13,17,18].…”

Section: Introductionmentioning

confidence: 97%

“…However, contradictory findings were reported by Tamura et al in a study on cDWI in breast cancer [17]. Particularly, degraded image quality remains a major limitation in cDWI [12,13,17,18]. High-resolution DWI (i.e., reduced field-of-view DWI (rDWI)) has been introduced to significantly improve image quality and diagnostic certainty in pancreatic pathologies, due to reduced motion and susceptibility artifacts, as well as a more precise method of lesion detection [19,20].…”

Section: Introductionmentioning

confidence: 99%

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High-Resolution, High b-Value Computed Diffusion-Weighted Imaging Improves Detection of Pancreatic Ductal Adenocarcinoma

Harder

Jung

McTavish

et al. 2022

Cancers

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Background: Our purpose was to investigate the potential of high-resolution, high b-value computed DWI (cDWI) in pancreatic ductal adenocarcinoma (PDAC) detection. Materials and Methods: We retrospectively enrolled 44 patients with confirmed PDAC. Respiratory-triggered, diffusion-weighted, single-shot echo-planar imaging (ss-EPI) with both conventional (i.e., full field-of-view, 3 × 3 × 4 mm voxel size, b = 0, 50, 300, 600 s/mm2) and high-resolution (i.e., reduced field-of-view, 2.5 × 2.5 × 3 mm voxel size, b = 0, 50, 300, 600, 1000 s/mm2) imaging was performed for suspected PDAC. cDWI datasets at b = 1000 s/mm2 were generated for the conventional and high-resolution datasets. Three radiologists were asked to subjectively rate (on a Likert scale of 1–4) the following metrics: image quality, lesion detection and delineation, and lesion-to-pancreas intensity relation. Furthermore, the following quantitative image parameters were assessed: apparent signal-to-noise ratio (aSNR), contrast-to-noise ratio (aCNR), and lesion-to-pancreas contrast ratio (CR). Results: High-resolution, high b-value computed DWI (r-cDWI1000) enabled significant improvement in lesion detection and a higher incidence of a high lesion-to-pancreas intensity relation (type 1, clear hyperintense) compared to conventional high b-value computed and high-resolution high b-value acquired DWI (f-cDWI1000 and r-aDWI1000, respectively). Image quality was rated inferior in the r-cDWI1000 datasets compared to r-aDWI1000. Furthermore, the aCNR and CR were higher in the r-cDWI1000 datasets than in f-cDWI1000 and r-aDWI1000. Conclusion: High-resolution, high b-value computed DWI provides significantly better visualization of PDAC compared to the conventional high b-value computed and high-resolution high b-value images acquired by DWI.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

High-Resolution, High b-Value Computed Diffusion-Weighted Imaging Improves Detection of Pancreatic Ductal Adenocarcinoma

Harder

Jung

McTavish

et al. 2022

Cancers

View full text Add to dashboard Cite

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“…However, lesion visibility was not significantly different between acquired and computed images. A study by Tamura et al [ 29 ] suggested improving the conspicuity of breast tumors on computed high b-value DWI by 1.5-T MRI, and the CNR of computed DWI generated from high SNR images and a high number of excitations (NEX) was superior to that of acquired DWI. However, the CNR on computed DWI obtained using the same scanning parameters was inferior to the acquired DWI.…”

Section: Discussionmentioning

confidence: 99%

Image quality and diagnostic value of diffusion-weighted breast magnetic resonance imaging: Comparison of acquired and computed images

Ahn

Kim

et al. 2021

PLoS ONE

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Purpose To compare the image quality of acquired diffusion-weighted imaging (DWI) and computed DWI and evaluate the lesion detectability and likelihood of malignancy in these datasets. Materials and methods This prospective study was approved by our institutional review board. A total of 29 women (mean age, 43.5 years) underwent DWI between August 2018 and April 2019 for 32 breast cancers and 16 benign breast lesions. Three radiologists independently reviewed the acquired DWI with b-values of 1000 and 2000 s/mm2 (A-b1000 and A-b2000) and the computed DWI with a b-value of 2000 s/mm2 (C-b2000). Image quality was scored and compared between the three DWI datasets. Lesion detectability was recorded, and the lesion’s likelihood for malignancy was scored using a five-point scale. Results The A-b1000 images were superior to the A-b2000 and C-b2000 images in chest distinction, fat suppression, and overall image quality. The A-b2000 and C-b2000 images showed comparable scores for all image quality parameters. C-b2000 showed the highest values for lesion detection among all readers, although there was no statistical difference in sensitivity, specificity, positive predictive value, negative predictive value, and accuracy between the DWI datasets. The malignancy scores of the DWI images were not significantly different among the three readers. Conclusions A-b1000 DWI is suitable for breast lesion evaluations, considering its better image quality and comparable diagnostic values compared to that of A-b2000 and C-b2000 images. The additional use of computed high b-value DWI may have the potential to increase the detectability of breast masses.

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“…Most of the studies have almost exclusively focused on the visibility of breast cancer [20,22,[33][34][35][36]; therefore, there is limited information on the conspicuity of benign breast lesions at high or synthetic b-values. While Chen et al [37] found no significant differences in conspicuity grades using b-values of 600, 800, and 1000 s/mm 2 , our results point to a difference in conspicuity.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, an improvement of tumor visibility without contrast injection could improve the cost-effectiveness of MRI [ 39 ]. However, extremely high b-values, i.e., b-1800 s/mm 2 , have a low signal which can cause lesions located on the fat tissue to be overlooked, especially if fat is poorly suppressed [ 33 ]. In light of our results, b-1200 s/mm 2 could be the best option for an optimal lesion visualization with the best conspicuity, which could enhance lesion characterization by a better correlation on ADC maps and more accurate ADC values.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of diffusion-weighted imaging with synthetic b-values in breast tumors: comparison with dynamic contrast-enhanced and multiparametric MRI

et al. 2020

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Objectives To assess DWI for tumor visibility and breast cancer detection by the addition of different synthetic b-values. Methods Eighty-four consecutive women who underwent a breast-multiparametric-MRI (mpMRI) with enhancing lesions on DCE-MRI (BI-RADS 2-5) were included in this IRB-approved retrospective study from September 2018 to March 2019. Three readers evaluated DW acquired b-800 and synthetic b-1000, b-1200, b-1500, and b-1800 s/mm 2 images for lesion visibility and preferred b-value based on lesion conspicuity. Image quality (1-3 scores) and breast composition (BI-RADS) were also recorded. Diagnostic parameters for DWI were determined using a 1-5 malignancy score based on qualitative imaging parameters (acquired + preferred synthetic b-values) and ADC values. BI-RADS classification was used for DCE-MRI and quantitative ADC values + BI-RADS were used for mpMRI. Results Sixty-four malignant (average = 23 mm) and 39 benign (average = 8 mm) lesions were found in 80 women. Although b-800 achieved the best image quality score, synthetic b-values 1200-1500 s/mm 2 were preferred for lesion conspicuity, especially in dense breast. b-800 and synthetic b-1000/b-1200 s/mm 2 values allowed the visualization of 84-90% of cancers visible with DCE-MRI performing better than b-1500/b-1800 s/mm 2. DWI was more specific (86.3% vs 65.7%, p < 0.001) but less sensitive (62.8% vs 90%, p < 0.001) and accurate (71% vs 80.7%, p = 0.003) than DCE-MRI for breast cancer detection, where mpMRI was the most accurate modality accounting for less false positive cases. Conclusion The addition of synthetic b-values enhances tumor conspicuity and could potentially improve tumor visualization particularly in dense breast. However, its supportive role for DWI breast cancer detection is still not definite. Key Points • The addition of synthetic b-values (1200-1500 s/mm 2) to acquired DWI afforded a better lesion conspicuity without increasing acquisition time and was particularly useful in dense breasts. • Despite the use of synthetic b-values, DWI was less sensitive and accurate than DCE-MRI for breast cancer detection. • A multiparametric MRI modality still remains the best approach having the highest accuracy for breast cancer detection and thus reducing the number of unnecessary biopsies.

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How to Improve the Conspicuity of Breast Tumors on Computed High <i>b</i>-value Diffusion-weighted Imaging

Abstract: To improve tumor conspicuity on cDWI, the quality of the source images must be improved. It may easily cause inferior conspicuity to aDWIs if high b-value cDWIs were generated from insufficient SNR images.

Cited by 11 publications

References 21 publications

High-Resolution, High b-Value Computed Diffusion-Weighted Imaging Improves Detection of Pancreatic Ductal Adenocarcinoma

High-Resolution, High b-Value Computed Diffusion-Weighted Imaging Improves Detection of Pancreatic Ductal Adenocarcinoma

Image quality and diagnostic value of diffusion-weighted breast magnetic resonance imaging: Comparison of acquired and computed images

Diagnostic value of diffusion-weighted imaging with synthetic b-values in breast tumors: comparison with dynamic contrast-enhanced and multiparametric MRI

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