Diffusion-weighted Echo Planar Imaging with Compressed SENSE (EPICS-DWI) for Pancreas Assessment: A Multicenter Study

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Diffusion-Weighted Imaging

Background:

• Pancreatic ductal adenocarcinoma (PDAC) is a challenging diagnosis requiring advanced imaging techniques.
• Diffusion-weighted imaging (DWI) is crucial for pancreas assessment, but image quality can be limited.
• Compressed SENSE (EPICS-DWI) and parallel imaging (PI-DWI) are techniques to improve DWI acquisition speed and quality.

Purpose of the Study:

• To evaluate the feasibility and performance of single-shot echo planar diffusion-weighted imaging with compressed SENSE (EPICS-DWI) for pancreas assessment.
• To compare EPICS-DWI with conventional single-shot echo planar DWI with parallel imaging (PI-DWI) in patients with PDAC.

Main Methods:

• A multicenter prospective study included 27 participants with untreated PDAC.
• All participants underwent pancreatic protocol MRI including both PI-DWI and EPICS-DWI sequences.
• Radiologists qualitatively assessed image quality, noise, pancreas, and PDAC conspicuity. Quantitative measurements included PDAC-to-pancreas contrast-to-noise-ratio (CNR) and apparent diffusion coefficient (ADC) values.

Main Results:

• EPICS-DWI demonstrated significantly higher confidence scores for overall image quality and lower image noise compared to PI-DWI.
• PDAC-to-pancreas CNR was significantly higher with EPICS-DWI.
• PDAC conspicuity and ADC values were comparable between the two DWI techniques.

Conclusions:

• EPICS-DWI provides improved image quality and pancreas-to-tumor conspicuity in DWI for PDAC assessment.
• The diagnostic performance for PDAC conspicuity and ADC measurements is similar between EPICS-DWI and PI-DWI.
• EPICS-DWI is a feasible and potentially advantageous technique for pancreas MRI.