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Simultaneous multislice diffusion-weighted imaging versus standard diffusion-weighted imaging in whole-body PET/MRI

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare standard (STD-DWI) single-shot echo-planar imaging DWI and simultaneous multislice (SMS) DWI during whole-body positron emission tomography (PET)/MRI regarding acquisition time, image quality, and lesion detection.

Methods

Eighty-three adults (47 females, 57%), median age of 64 years (IQR 52–71), were prospectively enrolled from August 2018 to March 2020. Inclusion criteria were (a) abdominal or pelvic tumors and (b) PET/MRI referral from a clinician. Patients were excluded if whole-body acquisition of STD-DWI and SMS-DWI sequences was not completed. The evaluated sequences were axial STD-DWI at b-values 50–400–800 s/mm2 and the apparent diffusion coefficient (ADC), and axial SMS-DWI at b-values 50–300–800 s/mm2 and ADC, acquired with a 3-T PET/MRI scanner. Three radiologists rated each sequence’s quality on a five-point scale. Lesion detection was quantified using the anatomic MRI sequences and PET as the reference standard. Regression models were constructed to quantify the association between all imaging outcomes/scores and sequence type.

Results

The median whole-body STD-DWI acquisition time was 14.8 min (IQR 14.1–16.0) versus 7.0 min (IQR 6.7–7.2) for whole-body SMS-DWI, p < 0.001. SMS-DWI image quality scores were higher than STD-DWI in the abdomen (OR 5.31, 95% CI 2.76–10.22, p < 0.001), but lower in the cervicothoracic junction (OR 0.21, 95% CI 0.10–0.43, p < 0.001). There was no significant difference in the chest, mediastinum, pelvis, and rectum. STD-DWI detected 276/352 (78%) lesions while SMS-DWI located 296/352 (84%, OR 1.46, 95% CI 1.02–2.07, p = 0.038).

Conclusions

In cancer staging and restaging, SMS-DWI abbreviates acquisition while maintaining or improving the diagnostic yield in most anatomic regions.

Key Points

• Simultaneous multislice diffusion-weighted imaging enables faster whole-body image acquisition.

• Simultaneous multislice diffusion-weighted imaging maintains or improves image quality when compared to single-shot echo-planar diffusion-weighted imaging in most anatomical regions.

• Simultaneous multislice diffusion-weighted imaging leads to superior lesion detection.

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Abbreviations

ADC:

Apparent diffusion coefficient

CI:

Confidence interval

DWI:

Diffusion-weighted imaging

IQR:

Interquartile range

OR:

Odds ratio

PET:

Positron emission tomography

SMS:

Simultaneous multislice

STD:

Standard

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Acknowledgements

We would like to thank Robin Striar for coordinating this research study.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Felipe S. Furtado, Nathaniel D. Mercaldo, William R. Bradley, Mukesh G. Harisinghani, Susanna Lee, Ciprian Catana & Onofrio Antonio Catalano

  2. Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA

    Felipe S. Furtado, Ravi Teja Seethamraju, Ciprian Catana, Bruse R. Rosen & Onofrio Antonio Catalano

  3. MR Application Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany

    Thomas Vahle & Thomas Benkert

  4. Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA

    Lisa Ratanaprasatporn & Krista Suarez-Weiss

  5. MR Collaborations, Siemens Medical Solutions USA, Inc., 30 Jonathan Ln, Malden, MA, 02148, USA

    Ravi Teja Seethamraju

  6. Universitätsmedizin Essen, Hufelandstraße 55, 45147, Essen, Germany

    Lale Umutlu & Kelsey L. Pomykala

  7. Sheba Medical Center, Derech Sheba 2, Ramat Gan, Israel

    Liran Domachevsky

  8. Tel Aviv University, 6997801, Tel Aviv-Yafo, Israel

    Liran Domachevsky, Hanna Bernstine & David Groshar

  9. Assuta Medical Center, HaBarzel 20 St, Ramat Hahayal, Tel Aviv, Israel

    Hanna Bernstine & David Groshar

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  1. Felipe S. Furtado
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The authors T.V., T.B., and R. S. declare relationships with Siemens GmbH.

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Furtado, F.S., Mercaldo, N.D., Vahle, T. et al. Simultaneous multislice diffusion-weighted imaging versus standard diffusion-weighted imaging in whole-body PET/MRI. Eur Radiol 33, 2536–2547 (2023). https://doi.org/10.1007/s00330-022-09275-4

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