Validation of Highly Accelerated Wave-CAIPI SWI Compared with Conventional SWI and T2*-Weighted Gradient...

Area of Science:

• Radiology
• Medical Imaging
• Neuroimaging

Background:

• Susceptibility-weighted imaging (SWI) is crucial for detecting intracranial hemorrhage and mineralization.
• Standard SWI sequences often involve long acquisition times, limiting their clinical utility.
• T2*-weighted gradient recalled-echo (T2*W GRE) is a common alternative for brain imaging.

Purpose of the Study:

• To compare a highly accelerated wave-controlled aliasing in parallel imaging (CAIPI) SWI sequence with standard SWI and T2*W GRE for routine 3T brain imaging.
• To evaluate the diagnostic performance, speed, and artifact levels of wave-CAIPI SWI.
• To assess the superiority of wave-CAIPI SWI over T2*W GRE and its noninferiority to standard SWI.

Main Methods:

• Prospective evaluation of 246 adult patients using conventional SWI/T2*W GRE and wave-CAIPI SWI.
• Wave-CAIPI SWI acquisition was 3-5 times faster than standard SWI.
• Two blinded radiologists assessed hemorrhage presence, microhemorrhage count, and motion artifact severity using forced-choice comparisons.

Main Results:

• Wave-CAIPI SWI detected significantly more hemorrhages and microhemorrhages than T2*W GRE (P < .001).
• Wave-CAIPI SWI demonstrated superior visualization of pathology, artifacts, and overall diagnostic quality compared to T2*W GRE (all P < .001).
• Wave-CAIPI SWI was noninferior to standard SWI for pathology visualization, artifact assessment, and diagnostic quality, with significantly reduced motion artifacts (P < .01).

Conclusions:

• Accelerated wave-CAIPI SWI provides superior diagnostic quality and pathology visualization compared to T2*W GRE.
• Wave-CAIPI SWI is noninferior to standard SWI, offering reduced scan times and motion artifacts.
• This advanced SWI technique enhances routine clinical brain imaging at 3T.