title: Improved focal liver lesion detection: comparison of single-shot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques.
abstract: The purpose of this study was to compare diffusion-weighted respiratory-triggered single-shot spin echo echoplanar imaging (SS SE-EPI) sequence using four b-values (b = 0, b = 20, b = 300, b = 800 s mm(-2)) and single-shot T2 weighted turbo spin echo (T2W SS TSE) in patients with focal liver lesions, with special interest in small (<10 mm) lesions. Twenty-four patients underwent routine MRI. The five sequences were compared qualitatively for image quality, lesion conspicuity and artefacts. Quantitative analysis was performed for lesion identification and lesion-to-liver contrast-to-noise ratio (CNR). Subgroup analyses were performed for different types of lesions with different sizes. Sequences were compared by rank order statistic (RIDIT) and Kruskal-Wallis test. The best image quality (p<0.05) was achieved with T2W TSE and the best lesion conspicuity (p<0.05) with T2W TSE for biliary cysts and SE-EPI diffusion-weighted imaging (DWI) (b = 20 s mm(-2)) for haemangiomas and metastases. Image artefacts were lowest (p<0.05) with T2W TSE. T2W TSE was found to be the best protocol (p<0.05) for the identification of biliary cysts and SE-EPI DWI (b = 20 s mm(-2)) for haemangiomas and metastases. The lesion-to-liver CNRs were highest on T2W TSE for biliary cysts and on SE-EPI diffusion-weighted imaging (DWI) for haemangiomas and metastases (p<0.05). This study shows the potential of SS SE-EPI DWI (especially with a b-value of 20 s mm(-2)) as a promising technique for detecting small (<10 mm) focal liver lesions.
authors.affiliation: Department of Radiology, AZ St-Jan AV, Bruges, Belgium. kenneth.coenegrachts@azbrugge.be
authors.forename: K
authors.initials: K
authors.lastname: Coenegrachts
authors.forename: J
authors.initials: J
authors.lastname: Delanote
authors.forename: L
authors.initials: L
authors.lastname: Ter Beek
authors.forename: M
authors.initials: M
authors.lastname: Haspeslagh
authors.forename: S
authors.initials: S
authors.lastname: Bipat
authors.forename: J
authors.initials: J
authors.lastname: Stoker
authors.forename: F
authors.initials: F
authors.lastname: Van Kerkhove
authors.forename: L
authors.initials: L
authors.lastname: Steyaert
authors.forename: H
authors.initials: H
authors.lastname: Rigauts
authors.forename: J W
authors.initials: JW
authors.lastname: Casselman
mesh_terms: D000368:Aged; D016477:Artifacts; D001649:Bile Duct Diseases / Q000175:diagnosis; D003560:Cysts / Q000175:diagnosis; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D006391:Hemangioma / Q000175:diagnosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011336:Probability; D013223:Statistics as Topic