Tags

Type your tag names separated by a space and hit enter

Diffusion-weighted imaging in patients with acute brain ischemia at 3 T: current possibilities and future perspectives comparing conventional echoplanar diffusion-weighted imaging and fast spin echo diffusion-weighted imaging sequences using BLADE (PROPELLER).
Invest Radiol. 2009 Jun; 44(6):351-9.IR

Abstract

OBJECTIVES

To compare diffusion-weighted imaging (DWI) based on a fast spin echo (FSE) sequence using BLADE (PROPELLER) with conventional DWI-echoplanar imaging (EPI) techniques at 3 T and to demonstrate the influence of hardware developments on signal-to-noise ratio (SNR) with these techniques using 12- and 32-channel head coils.

MATERIALS AND METHODS

Fourteen patients with brain ischemia were evaluated with DWI using EPI and FSE BLADE sequences, with a 12-channel head coil, in the axial plane and 1 additional plane (either sagittal or coronal). SNR and CNR were calculated from region-of-interest measurements. Scans were evaluated in a blinded fashion by 2 experienced neuroradiologists. SNR of both DWI techniques was evaluated in 12 healthy volunteers using different parallel imaging (PI) factors (for the EPI sequence) and both the 12- and 32-channel coils.

RESULTS

DWI-BLADE sequences acquired with the 12-channel coil revealed a significant reduction in SNR (mean +/- SD) of ischemic lesions (SNR(lesion) [5.0 +/- 2.5]), normal brain (SNR(brain) [3.0 +/- 1.9]), and subsequently in CNR (3.0 +/- 1.8) as compared with the DWI-EPI sequence (SNR(lesion) [9.3 +/- 5.2], SNR(brain) [7.7 +/- 3.5], CNR [6.1 +/- 2.8], P < 0.001). Despite this reduction in SNR and CNR, the blinded read revealed a marked preference for the DWI-BLADE sequence, or equality between the sequences, in the majority of patients because lesion detection was degraded by susceptibility artifacts on axial DWI-EPI scans in 14% to 43% of cases (but in no instance with the DWI-BLADE sequence). In particular, preference for the DWI-BLADE sequence or equality between the 2 techniques for lesion detection in the brainstem and cerebellum was observed. On some DWI-BLADE scans, in the additional plane, radial-like artifacts degraded lesion detection.In volunteers, SNR was significantly improved using the 32-channel coil, irrespective of scan technique. Comparing DWI-EPI acquired with the 12-channel coil (iPAT = 2) to DWI-BLADE acquired with the 32-channel coil, comparable SNR values were obtained. The 32-channel coil also makes feasible, with DWI-EPI, an increase in the PI factor to 4, which allows for a further reduction of bulk susceptibility artifacts. However, still DWI-BLADE sequences performed better because of absence of bulk susceptibility artifacts at comparable SNR values.

CONCLUSION

Despite lower SNR at comparable PI factors, DWI-BLADE sequences acquired using the 12-channel coil are preferable in most instances, as compared with DWI-EPI sequences, because of the absence of susceptibility artifacts and subsequently improved depiction of ischemic lesions in the brainstem and cerebellum. With the 32-channel coil, recently FDA approved, DWI-BLADE acquired with an iPAT = 2 provides comparable SNR without bulk susceptibility artifacts as compared with the DWI-EPI sequences acquired for clinical routine to date and has the potential to replace the standard DWI technique for special indications like DWI of the cerebellum and the brainstem or in presence of metallic implants or hemorrhage.

Authors+Show Affiliations

Clinic of Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg, Germany. peterfries@uks.euNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

19363447

Citation

Fries, Peter, et al. "Diffusion-weighted Imaging in Patients With Acute Brain Ischemia at 3 T: Current Possibilities and Future Perspectives Comparing Conventional Echoplanar Diffusion-weighted Imaging and Fast Spin Echo Diffusion-weighted Imaging Sequences Using BLADE (PROPELLER)." Investigative Radiology, vol. 44, no. 6, 2009, pp. 351-9.
Fries P, Runge VM, Kirchin MA, et al. Diffusion-weighted imaging in patients with acute brain ischemia at 3 T: current possibilities and future perspectives comparing conventional echoplanar diffusion-weighted imaging and fast spin echo diffusion-weighted imaging sequences using BLADE (PROPELLER). Invest Radiol. 2009;44(6):351-9.
Fries, P., Runge, V. M., Kirchin, M. A., Stemmer, A., Naul, L. G., Wiliams, K. D., Reith, W., Bücker, A., & Schneider, G. (2009). Diffusion-weighted imaging in patients with acute brain ischemia at 3 T: current possibilities and future perspectives comparing conventional echoplanar diffusion-weighted imaging and fast spin echo diffusion-weighted imaging sequences using BLADE (PROPELLER). Investigative Radiology, 44(6), 351-9. https://doi.org/10.1097/RLI.0b013e3181a00d09
Fries P, et al. Diffusion-weighted Imaging in Patients With Acute Brain Ischemia at 3 T: Current Possibilities and Future Perspectives Comparing Conventional Echoplanar Diffusion-weighted Imaging and Fast Spin Echo Diffusion-weighted Imaging Sequences Using BLADE (PROPELLER). Invest Radiol. 2009;44(6):351-9. PubMed PMID: 19363447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diffusion-weighted imaging in patients with acute brain ischemia at 3 T: current possibilities and future perspectives comparing conventional echoplanar diffusion-weighted imaging and fast spin echo diffusion-weighted imaging sequences using BLADE (PROPELLER). AU - Fries,Peter, AU - Runge,Val M, AU - Kirchin,Miles A, AU - Stemmer,Alto, AU - Naul,L Gill, AU - Wiliams,Kenneth D, AU - Reith,Wolfgang, AU - Bücker,Arno, AU - Schneider,Günther, PY - 2009/4/14/entrez PY - 2009/4/14/pubmed PY - 2009/8/6/medline SP - 351 EP - 9 JF - Investigative radiology JO - Invest Radiol VL - 44 IS - 6 N2 - OBJECTIVES: To compare diffusion-weighted imaging (DWI) based on a fast spin echo (FSE) sequence using BLADE (PROPELLER) with conventional DWI-echoplanar imaging (EPI) techniques at 3 T and to demonstrate the influence of hardware developments on signal-to-noise ratio (SNR) with these techniques using 12- and 32-channel head coils. MATERIALS AND METHODS: Fourteen patients with brain ischemia were evaluated with DWI using EPI and FSE BLADE sequences, with a 12-channel head coil, in the axial plane and 1 additional plane (either sagittal or coronal). SNR and CNR were calculated from region-of-interest measurements. Scans were evaluated in a blinded fashion by 2 experienced neuroradiologists. SNR of both DWI techniques was evaluated in 12 healthy volunteers using different parallel imaging (PI) factors (for the EPI sequence) and both the 12- and 32-channel coils. RESULTS: DWI-BLADE sequences acquired with the 12-channel coil revealed a significant reduction in SNR (mean +/- SD) of ischemic lesions (SNR(lesion) [5.0 +/- 2.5]), normal brain (SNR(brain) [3.0 +/- 1.9]), and subsequently in CNR (3.0 +/- 1.8) as compared with the DWI-EPI sequence (SNR(lesion) [9.3 +/- 5.2], SNR(brain) [7.7 +/- 3.5], CNR [6.1 +/- 2.8], P < 0.001). Despite this reduction in SNR and CNR, the blinded read revealed a marked preference for the DWI-BLADE sequence, or equality between the sequences, in the majority of patients because lesion detection was degraded by susceptibility artifacts on axial DWI-EPI scans in 14% to 43% of cases (but in no instance with the DWI-BLADE sequence). In particular, preference for the DWI-BLADE sequence or equality between the 2 techniques for lesion detection in the brainstem and cerebellum was observed. On some DWI-BLADE scans, in the additional plane, radial-like artifacts degraded lesion detection.In volunteers, SNR was significantly improved using the 32-channel coil, irrespective of scan technique. Comparing DWI-EPI acquired with the 12-channel coil (iPAT = 2) to DWI-BLADE acquired with the 32-channel coil, comparable SNR values were obtained. The 32-channel coil also makes feasible, with DWI-EPI, an increase in the PI factor to 4, which allows for a further reduction of bulk susceptibility artifacts. However, still DWI-BLADE sequences performed better because of absence of bulk susceptibility artifacts at comparable SNR values. CONCLUSION: Despite lower SNR at comparable PI factors, DWI-BLADE sequences acquired using the 12-channel coil are preferable in most instances, as compared with DWI-EPI sequences, because of the absence of susceptibility artifacts and subsequently improved depiction of ischemic lesions in the brainstem and cerebellum. With the 32-channel coil, recently FDA approved, DWI-BLADE acquired with an iPAT = 2 provides comparable SNR without bulk susceptibility artifacts as compared with the DWI-EPI sequences acquired for clinical routine to date and has the potential to replace the standard DWI technique for special indications like DWI of the cerebellum and the brainstem or in presence of metallic implants or hemorrhage. SN - 1536-0210 UR - https://www.unboundmedicine.com/medline/citation/19363447/Diffusion_weighted_imaging_in_patients_with_acute_brain_ischemia_at_3_T:_current_possibilities_and_future_perspectives_comparing_conventional_echoplanar_diffusion_weighted_imaging_and_fast_spin_echo_diffusion_weighted_imaging_sequences_using_BLADE__PROPELLER__ L2 - https://doi.org/10.1097/RLI.0b013e3181a00d09 DB - PRIME DP - Unbound Medicine ER -