Diffusion-weighted double-echo steady-state with a three-dimensional cones trajectory for non-contrast-enhanced...

Area of Science:

• Magnetic Resonance Imaging
• Medical Imaging Physics
• Oncology Imaging

Background:

• Echo-planar diffusion-weighted imaging (DWI) has image quality limitations for breast MRI.
• Steady-state DWI offers better image quality but its contrast for breast cancer is not well-defined.

Purpose of the Study:

• To develop and evaluate diffusion-weighted double-echo steady-state imaging with a three-dimensional cones trajectory (DW-DESS-Cones).
• To assess DW-DESS-Cones as a non-contrast-enhanced alternative to conventional DWI for breast MRI.

Main Methods:

• Prospective study with 28 women and 6 volunteers at 3T.
• Acquisitions included DW-DESS-Cones, DW-DESS-Cartesian, DWI, and CE-MRI.
• Phantom experiments, simulations, and observer studies evaluated image quality, contrast, and motion artifacts.

Main Results:

• DW-DESS-Cones showed reduced motion artifacts compared to DW-DESS-Cartesian (p < 0.05).
• Lesion-to-fibroglandular tissue signal ratios were not correlated between DW-DESS-Cones and DWI (r = 0.25, p = 0.38).
• DW-DESS-Cones improved sharpness, distortion, and overall image quality versus DWI, with concordant hyperintensity/hypointensity in 11/14 lesions.

Conclusions:

• DW-DESS-Cones may eliminate motion artifacts in breast MRI, enabling higher diffusion weighting.
• Malignant breast lesions demonstrated hyperintensity on DW-DESS-Cones without contrast injection.
• DW-DESS-Cones shows promise as a non-contrast-enhanced technique for breast cancer imaging.