Fat suppression techniques for breast MRI: Dixon versus spectral fat saturation for 3D T1-weighted at 3 T

To compare two fat suppression techniques used for 3D T1-weighted sequence in breast MRI (magnetic resonance imaging), namely Dixon versus spectral fat saturation (fat sat).

All breast MRI examinations performed in a Philips 3 T unit between March 2013 and October 2015 including either a Dixon or a fat sat sequence were retrospectively analyzed. The examinations were subjectively evaluated by two independent experienced readers in a scale of 5 for overall quality of fat suppression, homogeneity of fat suppression, definition of anatomic structures and focal lesions, diagnostic confidence for axillary and internal mammary regions and the presence of artifacts, 1 corresponding to excellent and 5 to non-diagnostic quality. Contrast-to-noise-ratio (CNR) measurements for muscle and focal lesions were also performed.

Overall 161 women (mean age 51.6 ± 12.0 years) underwent 189 MR examinations, 113 with the fat saturation and 76 with the Dixon sequence. Interobserver variability was good (kappa = 0.757). In all subjectively evaluated parameters, the Dixon sequence was superior to the fat sat (p < 0.05). Mean values of CNR for muscle and focal lesions were 9.98 (±4.2), 17.9 (±7.53) for the fat sat and 18.3 (±10.4) and 29.3 (±14.1) for the Dixon sequence, respectively (p < 0.001).

3D T1 Dixon sequence is superior to fat sat for dedicated breast MRI at 3 T, in terms of efficiency of fat suppression and image quality with the added advantage of optimal exploration of the axillary areas.