Korean J Radiol.  2020 Jan;21(1):77-87. 10.3348/kjr.2019.0406.

Feasibility of Simultaneous Multislice Acceleration Technique in Diffusion-Weighted Magnetic Resonance Imaging of the Rectum

• Park JH
• Seo N
• Lim JS
• Hahm J
• Kim MJ

• KMID: 2467044
• DOI: http://doi.org/10.3348/kjr.2019.0406

Abstract

OBJECTIVE
To assess the feasibility of simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) of the rectum in comparison with conventional DWI (C-DWI) in rectal cancer patients.
MATERIALS AND METHODS
This study included 65 patients with initially-diagnosed rectal cancer. All patients underwent C-DWI and SMS-DWI with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) using a 3T scanner. Acquisition times of the three DWI sequences were measured. Image quality in the three DWI sequences was reviewed by two independent radiologists using a 4-point Likert scale and subsequently compared using the Friedman test. Apparent diffusion coefficient (ADC) values for rectal cancer and the normal rectal wall were compared among the three sequences using repeated measures analysis of variance.
RESULTS
Acquisition times using C-DWI, SMS2-DWI, and SMS3-DWI were 173 seconds, 107 seconds, (38.2% shorter than C-DWI), and 77 seconds (55.5% shorter than C-DWI), respectively. For all image quality parameters other than distortion (margin sharpness, artifact, lesion conspicuity, and overall image quality), C-DWI and SMS2-DWI yielded better results than did SMS3-DWI (Ps < 0.001), with no significant differences observed between C-DWI and SMS2-DWI (Ps ≥ 0.054). ADC values of rectal cancer (p = 0.943) and normal rectal wall (p = 0.360) were not significantly different among C-DWI, SMS2-DWI, and SMS3-DWI.
CONCLUSION
SMS-DWI using an acceleration factor of 2 is feasible for rectal MRI resulting in substantial reductions in acquisition time while maintaining diagnostic image quality and similar ADC values to those of C-DWI.

Keyword

Diffusion-weighted imaging; Rectum; Rectal cancer; Simultaneous multislice

MeSH Terms

Acceleration*
Artifacts
Diffusion
Humans
Magnetic Resonance Imaging*
Rectal Neoplasms
Rectum*

Figure

• 

  Fig. 1 Flow diagram of study population.

• 

  Fig. 2 C-DWI and SMS2-DWI and SMS3-DWI in 41-year-old female with rectal cancer. Image set consists of b0, b300, b1000, and ADC map. Image quality and lesion conspicuity for rectal cancer (arrows) in SMS2-DWI (overall image quality score: 4 by both readers) are not significantly different from those in C-DWI (score: 4 by both readers). However, SMS3-DWI (score: 3 in both readers) shows significant aliasing artifacts (arrowheads) and worse image quality in comparison with C-DWI and SMS2-DWI. b0, b = 0 s/mm2; b300, b = 300 s/mm2; b1000, b = 1000 s/mm2. ADC = apparent diffusion coefficient, C-DWI = conventional DWI, DWI = diffusion-weighted imaging, SMS = simultaneous multislice, SMS2-DWI = SMS accelerated DWI with acceleration factor of 2, SMS3-DWI = SMS accelerated DWI with acceleration factor of 3

• 

  Fig. 3 C-DWI and SMS2-DWI and SMS3-DWI in 66-year-old female with rectal cancer. Image set consists of b0, b300, b1000, and ADC map. Image quality and lesion conspicuity for rectal cancer (arrows) in SMS2-DWI are not significantly different from those in C-DWI. However, SMS3-DWI shows decreased lesion conspicuity (arrow) and significant aliasing artifacts (arrowheads) in comparison with C-DWI and SMS2-DWI. Overall image quality scores were 3, 4, and 2 for C-DWI, SMS2-DWI, and SMS3-DWI by both readers. b0, b = 0 s/mm2; b300, b = 300 s/mm2; b1000, b = 1000 s/mm2.

• 

  Fig. 4 Bland-Altman plots comparing ADC values of rectal cancer between C-DWI and SMS2-DWI (A) and between C-DWI and SMS3-DWI (B) and comparing ADC values of normal rectal wall between C-DWI and SMS2-DWI (C) and C-DWI and SMS3-DWI (D). ADC values are given in × 10−3 mm2/s. Solid line indicates mean absolute difference between two sequences, and dashed lines indicate 95% confidence interval of mean difference. SD = standard deviation

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