Should less motion sensitive T2-weighted BLADE TSE replace Cartesian TSE for female pelvic MRI?

Abstract

ObjectivesTo prospectively compare the diagnostic performance of a non-Cartesian k-space sampling T2-weighted TSE BLADE sequence with a conventional T2-weighted TSE sequence in female pelvic organs.MethodsForty-seven patients with sonographically indeterminate adnexal masses or uterine lesions underwent sagittal BLADE and conventional TSE at 1.5 T after glucagon administration. Two radiologists independently determined their preferred sequence by rating: overall image diagnostic quality, conspicuity of the zonal anatomy and delineation of pathologies of the uterus and cervix, presence of artefacts, and of fluid in the pouch of Douglas (Wilcoxon signed rank test). Signal-to noise ratios (SNRs) and contrast-to-noise ratios (CNRs) were measured for the myometrium versus the rectus abdominis muscle (Student’s t-test).ResultsBLADE significantly (p < 0.0001) reduced motion and ghosting artefacts and showed improved conspicuity (p = 0.3/0.24), but overall image quality did not differ significantly (inter-observer agreement BLADE κ = 0.89; TSE κ = 0.84). In the majority of cases (53.2 % vs 59.6 %, respectively, κ = 0.82) radiologists preferred conventional TSE due to better image contrast (p < 0.0001) and visibility of free pelvic fluid (p ≤ 0.0001). SNR (TSE 57.5 ± 37.7; BLADE 16.6 ± 12.2) and CNR (TSE 40.4 ± 33.5; BLADE 7.2 ± 8.8) were significantly higher on conventional TSE (p < 0.0001).ConclusionsAlthough BLADE reduces motion artefacts and provides a clearer delineation of uterine zonal anatomy compared with conventional TSE, this comes at the expense of overall contrast.Main Messages• Use of BLADE may reduce T2 contrast and thus visibility of free pelvic fluid or cystic structures• Non-Cartesian sampling of k-space such as BLADE is beneficial due to less motion sensitivity• BLADE provides clearer delineation and conspicuity of uterine zonal anatomy on pelvic MRIs

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

“…However, the value of DWI in the detection and characterization of lymph nodes in GC remains controversial [ 48 , 49 , 64 ]. In the past, DWI of the abdomen and pelvis was easily distorted by respiratory motion and gastrointestinal peristalsis [ 67 , 68 ]. Recent technological developments in MRI, including new sequences (echo-planar imaging sequence, multichannel coils and parallel imaging), the high-field magnet and volumetric acquisition of T1-weighted images, allow the acquisition of DWI that is largely free of motion artifacts and provide excellent anatomical detail [ 23 , 69 , 70 ].…”

Update on multiparametric MRI of urinary bladder cancer

“…Bowel and abdominal wall motion can be mitigated wholly or in part by setting the phase‐encoding direction to direct motion away from the bladder (eg, on an axial T 2 W image, the phase‐encoding direction should be set left‐to‐right rather than anterior‐to‐posterior) and by increasing the number of excitations (NEX). T 2 W imaging can be acquired using periodically rotating overlapping parallel lines (PROPELLER, GE Healthcare; BLADE, Siemens Healthcare; MultiVane, Philips Healthcare), which has been shown to potentially improve image sharpness, overall image quality, and reduce artifact compared to conventional rectilinear filling of k ‐space in FSE/TSE, although at the cost of lower contrast . We consider the choice of using conventional FSE/TSE versus periodically rotating overlapping parallel lines sequences an institutional preference; however, in cases of severe motion artifact on FSE/TSE, periodically rotating overlapping parallel lines sequence T 2 W can be utilized as a backup to attempt to salvage an exam.…”

“…T 2 W imaging can be acquired using periodically rotating overlapping parallel lines (PROPELLER, GE Healthcare; BLADE, Siemens Healthcare; MultiVane, Philips Healthcare), which has been shown to potentially improve image sharpness, overall image quality, and reduce artifact compared to conventional rectilinear filling of k-space in FSE/TSE, 31,32 although at the cost of lower contrast. 33 We consider the choice of using conventional FSE/TSE versus periodically rotating overlapping parallel lines sequences an institutional preference; however, in cases of severe motion artifact on FSE/TSE, periodically rotating overlapping parallel lines sequence T 2 W can be utilized as a backup to attempt to salvage an exam. Half-Fourier single-shot FSE/TSE (ssFSE, GE Healthcare; HASTE, Siemens Healthcare; SSH-TSE/ UFSE, Philips Healthcare), which is ideal for imaging the kidneys and ureters, [34][35][36] can also be used to assess the bladder in cases of severe motion artifact on conventional FSE/TSE, but generally should not be utilized for bladder staging due to the lower spatial resolution and image blur compared to conventional FSE/TSE.…”

Diagnostic Performance of T2- weighted sequences in Upper Abdominal Magnetic Resonance Imaging: BLADE Technique or HASTE Technique?

“…One approach to overcoming this is to use non-Cartesian sampling [1,5]. As opposed to standard Cartesian sampling, non-Cartesian sampling confers better motion immunity and compensates for signal non-uniformity [4][5][6]. In particular, the Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) technique has shown to be highly valuable.…”