Simultaneous multi-slice accelerated diffusion-weighted imaging with higher spatial resolution for patients with liver metastases from neuroendocrine tumours

Clin Radiol. 2021 Jan;76(1):81.e11-81.e19. doi: 10.1016/j.crad.2020.08.024. Epub 2020 Sep 19.

Abstract

Aim: To evaluate the imaging characteristics of simultaneous multi-slice (SMS) accelerated diffusion-weighted imaging (DWI) with decreased section thickness, with and without motion correction, in comparison to conventional DWI (cDWI) for the detection of lesions in patients with neuroendocrine tumour (NET) liver metastases.

Materials and methods: Fifteen patients with NET liver metastases underwent cDWI (section thickness [SL]=4 mm) and SMS-DWI (SL=2 mm). Non-linear motion-corrected (Moco)-SMS-DWI was generated in addition to the original series. Qualitative imaging characteristics (five-point Likert scale), the number of high signal lesions, and the detectability and delineation of lesions were evaluated and compared using the Friedman and the Dunn-Bonferroni tests. The test-retest variability (TRV) of the cDWI and SMS-DWI techniques was investigated among 11 healthy volunteers who underwent cDWI (SL=4 mm) and SMS-DWI (SL=4 mm) twice. The Friedman and the Dunn-Bonferroni post-hoc tests were used to compare the mean apparent diffusion coefficient (ADC) and the TRV in different liver regions between the three series.

Results: Moco-SMS-DWI demonstrated significantly superior overall image quality (p<0.001) with significantly fewer artefacts (p=0.003) than cDWI. The number of lesions detected by cDWI, SMS-DWI, and Moco-SMS-DWI were 348, 504, and 523, respectively. The detectability and delineation of the lesions and the ADC values were significantly higher on the SMS-DWI and Moco-SMS-DWI images than on the cDWI images (all p<0.001). Moco-SMS-DWI showed significantly higher TRV than cDWI in regions near the liver edge (p=0.018).

Conclusions: SMS-DWI achieves higher spatial resolution than cDWI within the same acquisition time, detects more lesions, and provides better lesion delineation. By applying motion correction, the TRV of DWI could be enhanced in regions near the liver edge.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging / methods*
  • Edetic Acid
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / pathology*
  • Organometallic Compounds
  • Prospective Studies
  • Reproducibility of Results

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadolinium EDTA
  • Edetic Acid