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Wang F, Sun YN, Zhang BT, Yang Q, He AD, Xu WY, Liu J, Liu MX, Li XH, Yu YQ, Zhu J. Value of fractional-order calculus (FROC) model diffusion-weighted imaging combined with simultaneous multi-slice (SMS) acceleration technology for evaluating benign and malignant breast lesions. BMC Med Imaging 2024; 24:190. [PMID: 39075336 PMCID: PMC11285176 DOI: 10.1186/s12880-024-01368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND This study explores the diagnostic value of combining fractional-order calculus (FROC) diffusion-weighted model with simultaneous multi-slice (SMS) acceleration technology in distinguishing benign and malignant breast lesions. METHODS 178 lesions (73 benign, 105 malignant) underwent magnetic resonance imaging with diffusion-weighted imaging using multiple b-values (14 b-values, highest 3000 s/mm2). Independent samples t-test or Mann-Whitney U test compared image quality scores, FROC model parameters (D,, ), and ADC values between two groups. Multivariate logistic regression analysis identified independent variables and constructed nomograms. Model discrimination ability was assessed with receiver operating characteristic (ROC) curve and calibration chart. Spearman correlation analysis and Bland-Altman plot evaluated parameter correlation and consistency. RESULTS Malignant lesions exhibited lower D, and ADC values than benign lesions (P < 0.05), with higher values (P < 0.05). In SSEPI-DWI and SMS-SSEPI-DWI sequences, the AUC and diagnostic accuracy of D value are maximal, with D value demonstrating the highest diagnostic sensitivity, while value exhibits the highest specificity. The D and combined model had the highest AUC and accuracy. D and ADC values showed high correlation between sequences, and moderate. Bland-Altman plot demonstrated unbiased parameter values. CONCLUSION SMS-SSEPI-DWI FROC model provides good image quality and lesion characteristic values within an acceptable time. It shows consistent diagnostic performance compared to SSEPI-DWI, particularly in D and values, and significantly reduces scanning time.
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Affiliation(s)
- Fei Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Hefei, 230032, China
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - Yi-Nan Sun
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - Bao-Ti Zhang
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - Qing Yang
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - An-Dong He
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - Wang-Yan Xu
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - Jun Liu
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China
| | - Meng-Xiao Liu
- MR Research & Marketing Department, Siemens Healthineers Co., Ltd, No.278, Zhouzugong Road, Shanghai, 201318, China
| | - Xiao-Hu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Hefei, 230032, China
| | - Yong-Qiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Hefei, 230032, China.
| | - Juan Zhu
- Department of Radiology, Anqing Municipal Hospital, No.352, Renmin Road, Anqing, 246003, China.
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Zhang Y, Ye Z, Xia C, Tan Y, Zhang M, Lv X, Tang J, Li Z. Clinical Applications and Recent Updates of Simultaneous Multi-slice Technique in Accelerated MRI. Acad Radiol 2024; 31:1976-1988. [PMID: 38220568 DOI: 10.1016/j.acra.2023.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/16/2024]
Abstract
Simultaneous multi-slice (SMS) is a magnetic resonance imaging (MRI) acceleration technique that utilizes multi-band radio-frequency pulses to simultaneously excite and encode multiple slices. Currently, SMS has been widely studied and applied in the MRI examination to reduce acquisition time, which can significantly improve the examination efficiency and patient throughput. Moreover, SMS technique can improve spatial resolution, which is of great value in disease diagnosis, treatment response monitoring, and prognosis prediction. This review will briefly introduce the technical principles of SMS, and summarize its current clinical applications. More importantly, we will discuss the recent technical progress and future research direction of SMS, hoping to highlight the clinical value and scientific potential of this technique.
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Affiliation(s)
- Yiteng Zhang
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zheng Ye
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yuqi Tan
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Meng Zhang
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Xinyang Lv
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Jing Tang
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zhenlin Li
- Department of Radiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Nissan N, Ochoa-Albiztegui RE, Fruchtman H, Gluskin J, Eskreis-Winkler S, Horvat JV, Kosmidou I, Meng A, Pinker K, Jochelson MS. Breast MRI in patients with implantable loop recorder: initial experience. Eur Radiol 2024; 34:155-164. [PMID: 37555957 PMCID: PMC11181953 DOI: 10.1007/s00330-023-10025-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/10/2023] [Accepted: 06/13/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES To investigate the feasibility of breast MRI exams and guided biopsies in patients with an implantable loop recorder (ILR) as well as the impact ILRs may have on image interpretation. MATERIALS AND METHODS This retrospective study examined breast MRIs of patients with ILR, from April 2008 to September 2022. Radiological reports and electronic medical records were reviewed for demographic characteristics, safety concerns, and imaging findings. MR images were analyzed and compared statistically for artifact quantification on the various pulse sequences. RESULTS Overall, 40/82,778 (0.049%) MRIs during the study period included ILR. All MRIs were completed without early termination. No patient-related or device-related adverse events occurred. ILRs were most commonly located in the left lower-inner quadrant (64.6%). The main artifact was a signal intensity (SI) void in a dipole formation in the ILR bed with or without areas of peripheral high SI. Artifacts appeared greatest in the cranio-caudal axis (p < 0.001), followed by the anterior-posterior axis (p < 0.001), and then the right-left axis. High peripheral rim-like SI artifacts appeared on the post-contrast and subtracted T1-weighted images, mimicking suspicious enhancement. Artifacts were most prominent on diffusion-weighted (p < 0.001), followed by T2-weighted and T1-weighted images. In eight patients, suspicious findings were found on MRI, resulting in four additional malignant lesions. Of six patients with left breast cancer, the tumor was completely visible in five cases and partially obscured in one. CONCLUSION Breast MRI is feasible and safe among patients with ILR and may provide a significant diagnostic value, albeit with localized, characteristic artifacts. CLINICAL RELEVANCE STATEMENT Indicated breast MRI exams and guided biopsies can be safely performed in patients with implantable loop recorder. Nevertheless, radiologists should be aware of associated limitations including limited assessment of the inner left breast and pseudo-enhancement artifacts. KEY POINTS • Breast MRI in patients with an implantable loop recorder is an infrequent, feasible, and safe procedure. • Despite limited breast visualization of the implantable loop recorder bed and characteristic artifacts, MRI depicted additional lesions in 8/40 (20%) of cases, half of which were malignant. • Breast MRI in patients with an implantable loop recorder should be performed when indicated, taking into consideration typical associated artifacts.
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Affiliation(s)
- Noam Nissan
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | | | - Hila Fruchtman
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Jill Gluskin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Sarah Eskreis-Winkler
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Joao V Horvat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ioanna Kosmidou
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Alicia Meng
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Maxine S Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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Effectiveness of simultaneous multislice accelerated readout-segmented echo planar imaging for the assessment of rectal cancer. Eur J Radiol 2023; 159:110649. [PMID: 36563564 DOI: 10.1016/j.ejrad.2022.110649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/17/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the effectiveness of simultaneous multislice (SMS) accelerated readout-segmented echo planar imaging (RESOLVE) DWI for assessing rectal cancer in the clinic. METHOD Sixty consecutive histologically proven rectal cancer patients were enrolled. They all received MRI examinations, including both SMS-RESOLVE and RESOLVE sequences. Two readers visually assessed the overall image quality, distinction of anatomical structures, lesion conspicuity, and artifacts of two sequences by using a qualitative 4-point Likert scale. The quantitative ADC value, lesion contrast, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and temporal SNR (tSNR) were independently calculated in rectal cancer on the largest slice of the tumor. RESULTS The scan time was shortened from 3 min and 50 s to 1 min and 47 s. The interobserver agreement of visual and quantitative assessments between the two readers was good overall. There were no differences in overall image quality, lesion conspicuity or artifact scores between the two sequences in both readers (all p > 0.05). The lesion contrast (p = 0.013) was significantly higher in SMS-RESOLVE, and the CNR was similar in the two DWIs. The scores of distinctions of anatomical structures in SMS-RESOLVE were lower (all p < 0.05) in both readers. The SNR of SMS-RESOLVE was lower than that of RESOLVE (p = 0.004), and the tSNR of SMS-RESOLVE was significantly higher (p < 0.001). The ADC value of the tumor was lower in SMS-RESOLVE (p = 0.001), but the ADC values of the normal rectal wall showed no difference between the two DWIs. CONCLUSION SMS-RESOLVE allowed a substantial reduction in acquisition time while maintaining overall image quality and lesion conspicuity in rectal cancer. It also had a higher contrast of the lesion and a higher temporal SNR.
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Stelzer P, Clauser P, Vatteroni G, Kapetas P, Helbich T, Baltzer P. How much can abbreviated protocols for breast MRI increase patient throughput? A multi-centric evaluation. Eur J Radiol 2022; 154:110436. [DOI: 10.1016/j.ejrad.2022.110436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022]
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Li X, Zhu H, Sun K, Chai W, Fu C, Yan F. Is simultaneous multi-slice readout-segmented echo-planar imaging valuable for predicting molecular subtypes of breast cancer? Eur J Radiol 2022; 150:110232. [DOI: 10.1016/j.ejrad.2022.110232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/15/2022] [Accepted: 02/25/2022] [Indexed: 11/03/2022]
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Nissan N, Bauer E, Moss Massasa EE, Sklair-Levy M. Breast MRI during pregnancy and lactation: clinical challenges and technical advances. Insights Imaging 2022; 13:71. [PMID: 35397082 PMCID: PMC8994812 DOI: 10.1186/s13244-022-01214-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022] Open
Abstract
The breast experiences substantial changes in morphology and function during pregnancy and lactation which affects its imaging properties and may reduce the visibility of a concurrent pathological process. The high incidence of benign gestational-related entities may further add complexity to the clinical and radiological evaluation of the breast during the period. Consequently, pregnancy-associated breast cancer (PABC) is often a delayed diagnosis and carries a poor prognosis. This state-of-the-art pictorial review illustrates how despite currently being underutilized, technical advances and new clinical evidence support the use of unenhanced breast MRI during pregnancy and both unenhanced and dynamic-contrast enhanced (DCE) during lactation, to serve as effective supplementary modalities in the diagnostic work-up of PABC.
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Affiliation(s)
- Noam Nissan
- Radiology Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel.
| | - Ethan Bauer
- Sackler Medicine School, New-York Program, Tel Aviv University, Tel Aviv, Israel
| | - Efi Efraim Moss Massasa
- Joint Medicine School Program of Sheba Medical Center, St. George's, University of London and the University of Nicosia, Sheba Medical Center, Tel Hashomer, Israel
| | - Miri Sklair-Levy
- Radiology Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Medicine School, Tel Aviv University, Tel Aviv, Israel
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Biswas D, Hippe DS, Wang Y, DelPriore MR, Zečević M, Scheel JR, Rahbar H, Partridge SC. Accelerated Breast Diffusion-weighted Imaging Using Multiband Sensitivity Encoding with the CAIPIRINHA Method: Clinical Experience at 3 T. Radiol Imaging Cancer 2022; 4:e210063. [PMID: 35029517 PMCID: PMC8830507 DOI: 10.1148/rycan.210063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 06/07/2023]
Abstract
Purpose To examine the clinical value of multiband (MB) sensitivity encoding (SENSE)-accelerated diffusion-weighted imaging (DWI) for breast imaging by performing quantitative and qualitative comparisons with conventional diffusion-weighted echo-planar imaging, or conventional DWI (cDWI). Materials and Methods In this prospective study (ClinicalTrials.gov identifier NCT03607552), women with breast cancer were recruited from July 2018 to July 2019 to undergo additional MB SENSE DWI during clinical 3-T breast MRI examinations. The cDWI and MB SENSE DWI acquisitions were assessed both quantitatively and qualitatively. Regions of interest were defined for tumorous and normal tissue, and the tumor apparent diffusion coefficient (ADC), contrast-to-noise ratio (CNR), and signal index (SI) were calculated for both DWI methods. Three readers independently reviewed the two acquisitions side by side and provided relative image quality scores. Tumor ADC, CNR, and SI measures were compared between cDWI and MB SENSE DWI acquisitions by using a paired t test, and reader preferences were evaluated by using the sign test. Results The study included 38 women (median age, 48 years; range, 28-83 years). Overall agreement was good between cDWI and MB SENSE DWI tumor ADC measures (intraclass correlation coefficient, 0.87 [95% CI: 0.75, 0.94]), and no differences were evident in the ADC (median, 0.93 × 10-3 mm2/sec vs 0.87 ×10-3 mm2/sec; P = .50), CNR (2.2 vs 2.3; P = .17), or SI (9.2 vs 9.2; P = .23) measurements. The image quality of cDWI and MB SENSE DWI acquisitions were considered equal for 51% of images (58 of 114), whereas MB SENSE DWI was preferred more often than cDWI (37% [42 of 114] vs 12% [14 of 114]; P < .001). The preference for MB SENSE DWI was most often attributed to better fat suppression. Conclusion MB SENSE can be used to accelerate breast DWI acquisition times without compromising the image quality or the fidelity of quantitative ADC measurements. Keywords: MR-Diffusion-weighted Imaging, Breast, Comparative Studies, Technology Assessment Clinical trial registration no. NCT03607552 © RSNA, 2022.
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