Can a low b-value diffusion-weighted imaging sequence replace the standard T2-weighted fluid-sensitive sequence in...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• T2-weighted/fluid-sensitive short tau inversion recovery (STIR) sequences are standard in breast MRI.
• Diffusion-weighted imaging (DWI) offers complementary information but can increase scan time.

Purpose of the Study:

• To evaluate if a low b-value (b0) DWI sequence can replace T2-weighted/fluid-sensitive STIR sequences in breast MRI.
• To assess if DWI can be integrated without extending acquisition time.

Main Methods:

• Prospective study involving 72 women with 121 lesions evaluated on 3-T or 1.5-T breast MRI.
• Comparison of investigational DWI (rs-EPI, SMS) with standard T2-weighted/fluid-sensitive STIR sequences.
• Independent scoring by five radiologists on lesion conspicuity, signal characteristics, and artifacts.

Main Results:

• Lesion conspicuity on DWI was not inferior to STIR in 88.8% of assessments (p < 0.001).
• DWI followed lesion signal characteristics of STIR in 96.9% of assessments (p < 0.001).
• No or mild artifacts were reported for DWI in 98.3% of assessments (p < 0.001). Inter-reader agreement was substantial to moderate.

Conclusions:

• Low b-value DWI demonstrates similar diagnostic capabilities to T2-weighted/fluid-sensitive STIR for breast lesion evaluation.
• DWI can be incorporated into clinical breast MRI protocols without adding acquisition time.
• This integration may enhance cost-effectiveness and patient experience by reducing scan time and false-positives.