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Published on: July 28, 2013
Comparison of single shot and multishot diffusion-weighted imaging in 5-T magnetic resonance imaging for brain
Hao Chen1, Runyu Tang2, Xiaopeng Song2
1Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Background:
Diffusion-weighted imaging (DWI) with single-shot echo-planar imaging (ssEPI) is a valuable tool for detecting acute brain lesions but does suffer from image distortions. Multishot echo-planar imaging (msEPI) is a technique for reducing such distortions. This study aimed to compare the image quality and diagnostic efficacy of ssEPI- and msEPI-DWI at 5.0 T for brain disease detection.
Methods:
This study retrospectively reviewed images of 107 consecutive patients with suspected brain diseases who underwent ssEPI- and msEPI-DWI at 5.0 T at the First Affiliated Hospital of University of Science and Technology of China from August 2023 to September 2023. Two radiologists independently graded image quality and measured the image distortion. Signal-to-noise ratio, contrast-to-noise ratio, and apparent diffusion coefficient (ADC) were calculated and compared between ssEPI- and msEPI-DWI. Image quality scores were compared using the Wilcoxon test and other continuous variables by the paired t-test. The diagnostic accuracy of ADC values in distinguishing lesions from normal-appearing tissues was measured with the area under the curve (AUC).
Results:
Image quality evaluation and distortion analysis revealed that msEPI-DWI significantly outperformed ssEPI-DWI (two-sided P<0.001). No significant difference was observed in signal-to-noise ratio, contrast-to-noise ratio, or ADC values between msEPI- and ssEPI-DWI (two-sided P≥0.601). The ADC values of msEPI- and ssEPI-DWI showed strong correlations for both lesions (r=0.97) and contralateral normal tissues (r=0.91) (two-sided P<0.001). Compared to those of the contralateral white matter, ADC values of low-grade gliomas (LGGs) were significantly higher [ssEPI-DWI: 1,119.9±273.1 vs. 805.1±73.9; msEPI-DWI: 1,196.2±355.6 vs. 757.3±98.0 (unit: ×10-6 mm2/s)], while the ADC values of acute cerebral infarction (ACI) lesions were significantly lower [ssEPI-DWI: 603.9±273.2 vs. 888.9±212.0; msEPI-DWI: 538.0±281.2 vs. 905.0±188.9 (unit: ×10-6 mm2/s)] (two-sided P≤0.003). The AUCs for detecting LGGs were excellent for both ssEPI-DWI [AUC =0.934; 95% confidence interval (CI): 0.84-1.00] and msEPI-DWI (AUC =0.944; 95% CI: 0.86-1.00) (two-sided P<0.001; two-sided DeLong test: P=0.833).
Conclusions:
As compared to ssEPI-DWI, msEPI-DWI, when performed at 5.0 T, demonstrated superior image quality and less anatomical distortion in a wide spectrum of brain diseases and showed promising diagnostic performance for LGGs and ACI. In the future, msEPI-DWI at 5.0 T could become clinically routine in the diagnosis and grading of brain disorders.
Insights
Multishot echo-planar imaging (msEPI) offers superior image quality and reduced distortion compared to single-shot echo-planar imaging (ssEPI) for brain disease detection at 5.0 T. This advanced technique shows promise for routine clinical use in diagnosing brain disorders.
Area of Science:
- Radiology
- Neuroimaging
- Magnetic Resonance Imaging (MRI)
Background:
- Single-shot echo-planar imaging (ssEPI) is crucial for detecting acute brain lesions but suffers from image distortions.
- Multishot echo-planar imaging (msEPI) is an alternative technique designed to minimize these distortions.
- High-field MRI at 5.0 T offers enhanced signal but can exacerbate image artifacts.
Purpose of the Study:
- To compare the image quality and diagnostic performance of ssEPI-DWI and msEPI-DWI at 5.0 T for detecting brain diseases.
- To evaluate the impact of msEPI on image distortions and diagnostic accuracy compared to ssEPI.
- To assess the potential of msEPI-DWI at 5.0 T for clinical application in neuroimaging.
Main Methods:
- Retrospective review of 107 patients with suspected brain diseases who underwent both ssEPI-DWI and msEPI-DWI at 5.0 T.
- Independent assessment of image quality and distortion by two radiologists.
- Quantitative analysis of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) values.
- Statistical comparison using Wilcoxon and paired t-tests; diagnostic accuracy assessed using the area under the curve (AUC).
Main Results:
- msEPI-DWI demonstrated significantly superior image quality and reduced anatomical distortion compared to ssEPI-DWI (P<0.001).
- No significant differences were found in SNR, CNR, or ADC values between the two techniques (P≥0.601).
- ADC values from msEPI-DWI and ssEPI-DWI showed strong correlations (r=0.97 for lesions, r=0.91 for normal tissues).
- Both techniques achieved excellent AUCs for detecting low-grade gliomas (LGGs) (0.934 for ssEPI-DWI, 0.944 for msEPI-DWI).
- ADC values differed significantly between specific lesions (LGGs, acute cerebral infarction) and normal white matter for both techniques (P≤0.003).
Conclusions:
- Multishot echo-planar imaging (msEPI) at 5.0 T provides improved image quality and reduced distortion over single-shot echo-planar imaging (ssEPI) for various brain diseases.
- msEPI-DWI shows promising diagnostic performance for conditions like low-grade gliomas and acute cerebral infarction.
- The findings suggest that msEPI-DWI at 5.0 T could become a standard clinical tool for diagnosing and grading brain disorders.
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