title: T2-adjusted computed diffusion-weighted imaging: A novel method to enhance tumour visualisation.
abstract: To introduce T2-adjusted computed DWI (T2-cDWI), a method that provides synthetic images at arbitrary b-values and echo times (TEs) that improve tissue contrast by removing or increasing T2contrast in diffusion-weighted images.
  
  
  
  In addition to the standard DWI acquisition protocol T2-weighted echo-planar images at multiple (≥2) echo times were acquired. This allows voxelwise estimation of apparent diffusion coefficient (ADC) and T2values, permitting synthetic images to be generated at any chosen b-value and echo time. An analytical model is derived for the noise properties in T2-cDWI, and validated using a diffusion test-object. Furthermore, we present T2-cDWI in two example clinical case studies: (i) a patient with mesothelioma demonstrating multiple disease tissue compartments and (ii) a patient with primary ovarian cancer demonstrating solid and cystic disease compartments.
  
  
  
  Measured image noise in T2-cDWI from phantom experiments conformed to the analytical model and demonstrated that T2-cDWI at high computed b-value/TE combinations achieves lower noise compared with conventional DWI. In patients, T2-cDWI with low b-value and long TE enhanced fluid signal while suppressing solid tumour components. Conversely, large b-values and short TEs overcome T2shine-through effects and increase the contrast between tumour and fluid compared with conventional high-b-value DW images.
  
  
  
  T2-cDWI is a promising clinical tool for improving image signal-to-noise, image contrast, and tumour detection through suppression of T2shine-through effects.
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
authors: Lin
authors: L
authors: Cheng
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK. Electronic address: matthew.blackledge@icr.ac.uk.
authors: Matthew D
authors: MD
authors: Blackledge
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
authors: David J
authors: DJ
authors: Collins
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
authors: Matthew R
authors: MR
authors: Orton
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
authors: Neil P
authors: NP
authors: Jerome
authors: Siemens Healthcare GmbH, Erlangen, Germany.
authors: Thorsten
authors: T
authors: Feiweier
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
authors: Mihaela
authors: M
authors: Rata
authors: Department of Radiology, Royal Marsden Hospital, Sutton, UK.
authors: Veronica
authors: V
authors: Morgan
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiology, Royal Marsden Hospital, Sutton, UK.
authors: Nina
authors: N
authors: Tunariu
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
authors: Martin O
authors: MO
authors: Leach
authors: Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK; Department of Radiology, Royal Marsden Hospital, Sutton, UK.
authors: Dow-Mu
authors: DM
authors: Koh
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging
keywords: Computed DWI; Diffusion-weighted imaging; T2 contrast; T2 shine-through effect; Tumour enhancement