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Distortion-free diffusion-weighted imaging using echo planar time-resolved imaging with prospective motion

Haoran Bai1, Zhuqing Zhou2, Ke Dai1

  • 1School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.

Quantitative Imaging in Medicine and Surgery
|March 12, 2026
PubMed
Summary

Echo planar time-resolved imaging (EPTI) with prospective motion correction (PMC) significantly reduces distortions and artifacts in diffusion-weighted imaging (DWI). This technique offers improved image quality and feasibility for motion-sensitive patients.

Keywords:
Diffusion-weighted imaging (DWI)echo planar time-resolved imaging (EPTI)low-rank subspace reconstructionprospective motion correction (PMC)

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Area of Science:

  • Medical Imaging
  • Radiology
  • Neuroimaging

Background:

  • Diffusion-weighted imaging (DWI) using echo planar imaging (EPI) is standard but prone to geometric distortions and motion artifacts.
  • Motion sensitivity is a significant challenge in clinical DWI, particularly in patient populations like those with anxiety or Alzheimer's disease.

Purpose of the Study:

  • To evaluate the clinical feasibility and image quality of combining echo planar time-resolved imaging (EPTI) with markerless prospective motion correction (PMC).
  • To compare EPTI-DWI with PMC against conventional single-shot EPI-DWI in motion-sensitive individuals.

Main Methods:

  • A comparative study involving one healthy volunteer and 38 patients (24 with anxiety disorder, 14 with Alzheimer's disease).
  • Image quality was assessed by two radiologists using a five-point scale, with interreader agreement evaluated by ICC.
  • Apparent diffusion coefficients (ADC) were compared between EPTI-DWI and EPI-DWI using linear regression and Bland-Altman analysis.

Main Results:

  • EPTI-DWI with PMC significantly reduced geometric distortion and improved diagnostic confidence and overall image quality compared to EPI-DWI (P<0.001).
  • No significant difference in anatomical clarity was observed between the two methods (P=0.49).
  • ADC values showed a strong correlation (r=0.89) between EPTI-DWI and EPI-DWI, with a small positive bias for EPTI-DWI.

Conclusions:

  • EPTI-DWI with PMC provides high-resolution, distortion-free diffusion imaging with superior image quality compared to EPI-DWI.
  • The technique is clinically feasible and beneficial for motion-sensitive patients, suggesting potential for wider clinical adoption.