Simultaneous Multislice Readout-Segmented Echo Planar Imaging for Diffusion-Weighted MRI in Patients With Invasive Breast Cancers

Background: In diffusion-weighted imaging (DWI) of breast MRI, simultaneous multislice acceleration techniques can be used for readout-segmented echo planar imaging (rs-EPI) to shorten the scan time. Purpose: To compare the image quality, apparent diffusion coefficient (ADC) value, and scan time of rs-EPI and simultaneous multislice rs-EPI (SMS rs-EPI) sequences. Study Type: Retrospective. Subjects: In all, 134 consecutive women (mean age: 55.3 years) with invasive breast cancer who underwent preoperative MRI. Field Strength/ Sequences: 3.0T; rs-EPI sequence, prototypic SMS rs-EPI sequence and dynamic contrast-enhanced MRI (DCE-MRI) sequence. Assessment: For quantitative comparison, two radiologists independently measured the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), lesion contrast, and apparent diffusion coefficient (ADC). For qualitative comparison, image quality, lesion conspicuity, and reader preference were assessed with a reference of DCE-MRI. Statistical Tests: Paired t-tests and Mann–Whitney tests were used. Results: For SNR and CNR, there were no differences between the sequences (P = 0.342 and 0.665 for reader 1; P = 0.606 and P = 0.116 for reader 2). Lesion contrast of SMS rs-EPI was higher than that of rs-EPI (P < 0.05 for both reader 1 and reader 2). Mean tumor ADC was similar in rs-EPI and SMS rs-EPI sequences (0.98 ± 0.22 vs. 1.00 ± 0.22; P = 0.291 for reader 1, 0.98 ± 0.21 vs. 1.00 ± 0.22; P = 0.418 for reader 2). Regarding qualitative comparison, image quality and lesion conspicuity were higher in SMS rs-EPI than in rs-EPI (both P < 0.05 for both readers). The two readers regarded SMS rs-EPI as superior or equal to rs-EPI in over 90% of cases. The acquisition time was 4:30 minutes for rs-EPI and 2:31 minutes for SMS rs-EPI. Data Conclusion: The SMS rs-EPI sequence resulted in a similar ADC value and better image quality than the rs-EPI sequence in a 44.1% reduced scan time. Level of Evidence: 4. Technical Efficacy: 3.