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Evaluation of diffusion-weighted magnetic resonance imaging of the rectal cancers: comparison between modified reduced field-of-view single-shot echo-planar imaging with tilted two-dimensional radiofrequency excitation pulses and conventional full field-of-view readout-segmented echo-planar imaging

  • Abdominal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the image quality qualitatively and quantitatively, as well as apparent diffusion coefficient (ADC) values of modified reduced field-of-view diffusion-weighted magnetic resonance imaging (MRI) using spatially tailored two-dimensional radiofrequency pulses with tilted excitation plane (tilted r-DWI) based on single-shot echo planar imaging (SS-EPI) compared with full-size field-of-view DWI (f-DWI) using readout segmented (RS)-EPI in patients with rectal cancer.

Materials and methods

Twenty-two patients who underwent an MRI for further evaluation of rectal cancer were included in this retrospective study. All MR images were analyzed to compare image quality, lesion conspicuity, and artifacts between f-DWI with RS-EPI and tilted r-DWI with SS-EPI. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and ADC values were also compared. The Wilcoxon signed-rank test or paired t test was performed to compare the qualitative and quantitative assessments.

Results

All image quality scores, except aliasing artifacts, were significantly higher (p < 0.01 for all) in tilted r-DWI than f-DWI with RS-EPI. CNR in tilted r-DWI was significantly higher than in f-DWI with RS-EPI (p < 0.01), while SNR was not significantly different. Regarding the ADC values, no significant difference was observed between tilted r-DWI and f-DWI with RS-EPI (p = 0.27).

Conclusion

Tilted r-DWI provides a better image quality with fewer artifacts and higher rectal lesion conspicuity than f-DWI with RS-EPI, indicating the feasibility of this MR sequence in evaluating rectal cancer in clinical practice.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan

    Atsuo Inoue, Masahiro Tanabe, Kenichiro Ihara, Keiko Hideura, Mayumi Higashi, Takaaki Ueda & Katsuyoshi Ito

  2. MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

    Thomas Benkert

  3. MR Research and Collaboration, Siemens Healthcare K.K., Tokyo, Japan

    Hiroshi Imai

  4. Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, Japan

    Masatoshi Yamane & Takahiro Yamaguchi

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Contributions

MT, MY, TY, TU and KI contributed to the study conception and design. Material preparation, data collection and analysis were performed by AI, MT, KI, KH, MH and KI. The first draft of the manuscript was written by AI and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masahiro Tanabe.

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Conflict of interest

Two authors (Thomas Benkert and Hiroshi Imai) were employees of Siemens Healthcare, but the other authors, who are not Siemens Healthcare employees, had control of inclusion of any data and information. Atsuo Inoue, Masahiro Tanabe, Kenichiro Ihara, Keiko Hideura, Mayumi Higashi, Masatoshi Yamane, Takahiro Yamaguchi, Takaaki Ueda, and Katsuyoshi Ito declare they have no financial interests.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board of Yamaguchi University Hospital (September 5, 2022/No 2022–094).”

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Written informed consent was waived by the Institutional Review Board.

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Inoue, A., Tanabe, M., Ihara, K. et al. Evaluation of diffusion-weighted magnetic resonance imaging of the rectal cancers: comparison between modified reduced field-of-view single-shot echo-planar imaging with tilted two-dimensional radiofrequency excitation pulses and conventional full field-of-view readout-segmented echo-planar imaging. Radiol med 128, 1192–1198 (2023). https://doi.org/10.1007/s11547-023-01699-2

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