title: Diffusion-weighted magnetic resonance imaging of breast lesions: the influence of different fat-suppression techniques on quantitative measurements and their reproducibility.
abstract: OBJECTIVE
  The aim of this study was to evaluate the influence of different fat-suppression techniques on quantitative measurements and their reproducibility when applied to diffusion-weighted imaging (DWI) of breast lesions.
  
  
  METHODS
  Twenty-five patients with different types of breast lesions were examined on a clinical 1.5-T magnetic resonance imaging (MRI) system. Two diffusion-weighted sequences with different fat-suppression methods were applied: one with spectral presaturation by inversion recovery (SPIR), and one with short-TI inversion recovery (STIR). The acquisition of both sequence variants was repeated with modified shim volume. Lesion-to-background contrast (LBC), apparent diffusion coefficients (ADC) ADC(0,1000) and ADC(50,1000), and their coefficients of variation (CV) were determined.
  
  
  RESULTS
  In four patients, the image quality of DWI with SPIR was insufficient. In the other 21 patients, 46 regions of interest (ROI), including 11 malignant and 35 benign lesions, were analysed. The LBC, ADC(0,1000) and ADC(50,1000) values, which did not differ between initial and repeated measurements, were significantly higher for STIR than for SPIR. The mean CV improved from 10.8 % to 4.0 % (P = 0.0047) for LBC, from 6.3 % to 2.9 % (P = 0.0041) for ADC(0,1000), and from 6.3 % to 2.6 % (P = 0.0049) for ADC(50,1000).
  
  
  CONCLUSIONS
  For STIR compared to SPIR fat suppression, improved lesion conspicuity, higher ADC values, and better measurement reproducibility were found in breast DWI.
  
  
  CONCLUSIONS
  • Quality of fat suppression influences quantitative DWI breast lesion measurements. • In breast DWI, STIR fat suppression worked more reliably than SPIR. • Lesion-to-background contrast and its reproducibility were significantly higher with STIR fat suppression. • Lesional ADCs and their reproducibility were significantly higher with STIR fat suppression.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105, Bonn, Germany, petra.muertz@ukb.uni-bonn.de.
authors.forename: P
authors.initials: P
authors.lastname: Mürtz
authors.forename: M
authors.initials: M
authors.lastname: Tsesarskiy
authors.forename: A
authors.initials: A
authors.lastname: Kowal
authors.forename: F
authors.initials: F
authors.lastname: Träber
authors.forename: J
authors.initials: J
authors.lastname: Gieseke
authors.forename: W A
authors.initials: WA
authors.lastname: Willinek
authors.forename: C C
authors.initials: CC
authors.lastname: Leutner
authors.forename: A
authors.initials: A
authors.lastname: Schmiedel
authors.forename: H H
authors.initials: HH
authors.lastname: Schild
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media