Echo-planar DWI variants: A comparative study in vertebral marrow pathology

Area of Science:

• Radiology
• Medical Imaging
• Spinal Diagnostics

Background:

• Single-shot echo-planar imaging (ss-EPI) is prone to artifacts in vertebral column imaging.
• Advanced imaging techniques are needed for accurate differential diagnosis of vertebral pathologies.

Purpose of the Study:

• To compare readout-segmented echo-planar imaging (rs-EPI) with ss-EPI.
• To evaluate rs-EPI's utility in differentiating vertebral infectious, tumoral infiltrative, and degenerative disorders.

Main Methods:

• Retrospective analysis of 66 adult patients with spondylodiscitis, tumoral infiltration, or Modic type I degeneration.
• Image quality, signal intensity (SI), apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were assessed by two radiologists.
• Patients were categorized into benign (degenerative/infectious) and malignant (tumoral) groups.

Main Results:

• rs-EPI demonstrated superior image quality, SNR, and CNR over ss-EPI (p < 0.05).
• Pathological ADC (ADCp) showed significant differences between sequences (p < 0.05) but not between benign and malignant groups in rs-EPI (p = 0.13).
• Pathological SI (SIp) and CNR were significantly higher in the malignant group with rs-EPI (p < 0.001).

Conclusions:

• rs-EPI provides enhanced image quality and reduces motion artifacts in vertebral DWI.
• Despite improved image quality, rs-EPI's ability to distinguish malignant from benign vertebral bone marrow pathologies was unsatisfactory compared to ss-EPI.