Korean J Radiol.  2015 Dec;16(6):1216-1225. 10.3348/kjr.2015.16.6.1216.

Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging of the Pancreas: Comparison with Conventional Single-Shot Echo-Planar Imaging

Affiliations
  • 1Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea. jmsh@snu.ac.kr
  • 2Aerospace Medical Group, Air Force Education and Training Command, Jinju 52634, Korea.
  • 3Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
  • 4Department of Surgery, Seoul National University Hospital, Seoul 03080, Korea.
  • 5Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
  • 6Siemens Healthcare, Erlangen, Germany.

Abstract


OBJECTIVE
To investigate the image quality (IQ) and apparent diffusion coefficient (ADC) of reduced field-of-view (FOV) di-ffusion-weighted imaging (DWI) of pancreas in comparison with full FOV DWI.
MATERIALS AND METHODS
In this retrospective study, 2 readers independently performed qualitative analysis of full FOV DWI (FOV, 38 × 38 cm; b-value, 0 and 500 s/mm²) and reduced FOV DWI (FOV, 28 × 8.5 cm; b-value, 0 and 400 s/mm²). Both procedures were conducted with a two-dimensional spatially selective radiofrequency excitation pulse, in 102 patients with benign or malignant pancreatic diseases (mean size, 27.5 ± 14.4 mm). The study parameters included 1) anatomic structure visualization, 2) lesion conspicuity, 3) artifacts, 4) IQ score, and 5) subjective clinical utility for confirming or excluding initially considered differential diagnosis on conventional imaging. Another reader performed quantitative ADC measurements of focal pancreatic lesions and parenchyma. Wilcoxon signed-rank test was used to compare qualitative scores and ADCs between DWI sequences. Mann Whitney U-test was used to compare ADCs between the lesions and parenchyma.
RESULTS
On qualitative analysis, reduced FOV DWI showed better anatomic structure visualization (2.76 ± 0.79 at b = 0 s/mm² and 2.81 ± 0.64 at b = 400 s/mm²), lesion conspicuity (3.11 ± 0.99 at b = 0 s/mm² and 3.15 ± 0.79 at b = 400 s/mm²), IQ score (8.51 ± 2.05 at b = 0 s/mm² and 8.79 ± 1.60 at b = 400 s/mm²), and higher clinical utility (3.41 ± 0.64), as compared to full FOV DWI (anatomic structure, 2.18 ± 0.59 at b = 0 s/mm² and 2.56 ± 0.47 at b = 500 s/mm²; lesion conspicuity, 2.55 ± 1.07 at b = 0 s/mm² and 2.89 ± 0.86 at b = 500 s/mm²; IQ score, 7.13 ± 1.83 at b = 0 s/mm² and 8.17 ± 1.31 at b = 500 s/mm²; clinical utility, 3.14 ± 0.70) (p < 0.05). Artifacts were significantly improved on reduced FOV DWI (2.65 ± 0.68) at b = 0 s/mm² (full FOV DWI, 2.41 ± 0.63) (p < 0.001). On quantitative analysis, there were no significant differences between the 2 DWI sequences in ADCs of various pancreatic lesions and parenchyma (p > 0.05). ADCs of adenocarcinomas (1.061 × 10⁻³ mm²/s ± 0.133 at reduced FOV and 1.079 × 10⁻³ mm²/s ± 0.135 at full FOV) and neuroendocrine tumors (0.983 × 10⁻³ mm²/s ± 0.152 at reduced FOV and 1.004 × 10⁻³ mm²/s ± 0.153 at full FOV) were significantly lower than those of parenchyma (1.191 × 10⁻³ mm²/s ± 0.125 at reduced FOV and 1.218 × 10⁻³ mm²/s ± 0.103 at full FOV) (p < 0.05).
CONCLUSION
Reduced FOV DWI of the pancreas provides better overall IQ including better anatomic detail, lesion conspicuity and subjective clinical utility.

Keyword

Reduced field-of-view; Image quality; Apparent diffusion coefficient; Diffusion-weighted imaging; Magnetic resonance imaging; Pancreas

MeSH Terms

Adult
Aged
Artifacts
Diagnosis, Differential
*Diffusion Magnetic Resonance Imaging
*Echo-Planar Imaging
Female
Humans
Male
Middle Aged
Pancreas/*radiography
Pancreatic Diseases/pathology/*radiography
Pancreatic Neoplasms/pathology/radiography
Retrospective Studies

Figure

  • Fig. 1 58-year-old woman with 1.5 cm sized neuroendocrine tumor (arrow) in pancreas uncinate process. A. Mass shows rim enhancement on enhanced T1-weighted image. B. Full field-of-view (FOV) diffusion-weighted imaging (DWI) sequence at b = 0 s/mm2. Lesion shows ill-defined hyperintensity. C. Full FOV DWI at b = 500 s/mm2. Note that margin of lesion is severely blurred and barely delineable from background. D. Corresponding apparent diffusion coefficient (ADC) map of full FOV DWI. E. Reduced FOV DWI at b = 0 s/mm2. F. Reduced FOV DWI at b = 400 s/mm2. Lesion is more clearly visualized on reduced FOV image. G. Corresponding ADC map of reduced FOV DWI.

  • Fig. 2 38-year-old man with neuroendocrine tumor (not shown) in pancreas tail. Images are cropped to focus on pancreas. A. Full field-of-view (FOV) diffusion-weighted imaging (DWI) sequence at b = 0 s/mm2. Margin of pancreas is blurred and duct is not visible. Normal lobulated appearance of pancreas is hardly recognizable. B. Full FOV DWI at b = 500 s/mm2. C. Corresponding apparent diffusion coefficient (ADC) map of full FOV DWI. D. Reduced FOV DWI at b = 0 s/mm2. Note that lobulated appearance of pancreas border and pancreatic duct are more clearly visualized on reduced FOV image. E. Reduced FOV DWI at b = 400 s/mm2. F. Corresponding ADC map of reduced FOV DWI.


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Jianjun Zheng, Jing Wang, Jianqing Zhao, Xianyun Meng
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