Fat suppression strategies in MR imaging of breast cancer at 3.0 T: comparison of the two-point Dixon technique and the frequency selective inversion method

Use of Dixon in magnetic resonance breast contrast-enhanced T1 weighted high-resolution imaging for mastectomy patients at 3T: A prospective study in single center

BACKGROUND

For patients with complete breast resection, conventional contrast-enhanced T1-weighted imaging (CE-T1WI) with frequency-selective spectral attenuated inversion recovery (SPAIR) provides limited fat suppression on the postoperative side due to the uneven skin surface, inhomogeneous tissue environment, and frequency-selective feature of the SPAIR scheme, leading to difficulties in precise diagnosis. This study aimed to investigate the image quality and performance of the Dixon method compared with SPAIR in breast high-resolution CE-T1WI for mastectomy patients.

MATERIALS AND METHODS

Sixty female patients who had not performed any breast surgeries were randomly selected retrospectively as the control group. Postmastectomy female patients were enrolled to undergone high-resolution CE-T1WI with SPAIR and Dixon breast scans. Subjective scores were rated using a 5-point scale. Objective parameters, including contrast-to-noise ratio (CNR), edge sharpness, and signal uniformity were measured and calculated. The Wilcoxon rank-sum test and Kappa statistic were used.

RESULTS

A total of 114 consecutive postmastectomy patients were included. Subjective scores of T1WI-SPAIR in the control group were all significantly better than those with SPAIR on the postoperative side of mastectomy patients (P < 0.01). Dixon outperformed SPAIR with significantly better subjective scores in regards to uniformity and degree of fat-suppression, anatomical structures depiction, lesion conspicuity, and axillary visibility (p < 0.05) in both post- and non-operative sides and bilateral axillary areas through the paired comparison. The objective parameters of Dixon were significantly better than those of SPAIR.

CONCLUSION

The Dixon method provided better image uniformity and higher fat suppression efficiency, and showed significant advantages in delineating the anatomical structures, with better axillary and lesion visibilities, especially on the completely removed breast side.

A novel spectrally selective fat saturation pulse design with robustness to B0 and B1 inhomogeneities: A demonstration on 3D T1-weighted breast MRI at 3 T

PURPOSE

Spectrally selective fat saturation (FatSat) sequence is commonly used to suppress signal from adipose tissue. Conventional SINC-shaped pulses are sensitive to B₀ off-resonance and B₁⁺ offset. Uniform fat saturation with large spatial coverage is especially challenging for the body and breast MRI. The aim of this study is to develop spectrally selective FatSat pulses that offer more immunity to B₀/B₁⁺ field inhomogeneities than SINC pulses and evaluate them in bilateral breast imaging at 3 T.

MATERIALS AND METHODS

Optimized composite pulses (OCP) were designed based on the optimal control theory with robustness to a targeted B₀/ B₁⁺ conditions. OCP pulses also allows flexible flip angles to meet different requirements. Comparisons with the vendor-provided SINC pulses were conducted by numerical simulation and in vivo scans using a 3D T₁-weighted (T₁w) gradient-echo (GRE) sequence with coverage of the whole-breast.

RESULTS

Simulation revealed that OCP pulses yielded almost half of the transition band and much less sensitivity to B₁⁺ inhomogeneity compared to SINC pulses with B₀ off-resonance within ±200 Hz and B₁⁺ scale error within ±0.3 (P < 0.001). Across five normal subjects, OCP FatSat pulses produced 25-41% lower residual fat signals (P < 0.05) with 27-36% less spatial variation (P < 0.05) than SINC.

CONCLUSION

In contrast to conventional SINC-shaped pulses, the newly designed OCP FatSat pulses mitigated challenges of wide range of B₀/ B₁⁺ field inhomogeneities and achieved more uniform fat suppression in bilateral breast T₁w imaging at 3 T.

Fat suppression in magnetic resonance imaging of the head and neck region: is the two-point DIXON technique superior to spectral fat suppression?

OBJECTIVE

The aim of our study was to systematically compare two-point Dixon fat suppression (FS) and spectral FS techniques in contrast enhanced imaging of the head and neck region.

METHODS

Three independent readers analysed coronal T₁ weighted images recorded after contrast medium injection with Dixon and spectral FS techniques with regard to FS homogeneity, motion artefacts, lesion contrast, image sharpness and overall image quality.

RESULTS

85 patients were prospectively enrolled in the study. Images generated with Dixon-FS technique were of higher overall image quality and had a more homogenous FS over the whole field of view compared with the standard spectral fat-suppressed images (p < 0.001). Concerning motion artefacts, flow artefacts, lesion contrast and image sharpness no statistically significant difference was observed.

CONCLUSION

The Dixon-FS technique is superior to the spectral technique due to improved homogeneity of FS and overall image quality while maintaining lesion contrast. Advances in knowledge: T₁ with Dixon FS technique offers, compared to spectral FS, significantly improved FS homogeneity and over all image quality in imaging of the head and neck region.

Fat suppression techniques for breast MRI: Dixon versus spectral fat saturation for 3D T1-weighted at 3 T

OBJECTIVE

To compare two fat suppression techniques used for 3D T1-weighted sequence in breast MRI (magnetic resonance imaging), namely Dixon versus spectral fat saturation (fat sat).

MATERIALS AND METHODS

All breast MRI examinations performed in a Philips 3 T unit between March 2013 and October 2015 including either a Dixon or a fat sat sequence were retrospectively analyzed. The examinations were subjectively evaluated by two independent experienced readers in a scale of 5 for overall quality of fat suppression, homogeneity of fat suppression, definition of anatomic structures and focal lesions, diagnostic confidence for axillary and internal mammary regions and the presence of artifacts, 1 corresponding to excellent and 5 to non-diagnostic quality. Contrast-to-noise-ratio (CNR) measurements for muscle and focal lesions were also performed.

RESULTS

Overall 161 women (mean age 51.6 ± 12.0 years) underwent 189 MR examinations, 113 with the fat saturation and 76 with the Dixon sequence. Interobserver variability was good (kappa = 0.757). In all subjectively evaluated parameters, the Dixon sequence was superior to the fat sat (p < 0.05). Mean values of CNR for muscle and focal lesions were 9.98 (±4.2), 17.9 (±7.53) for the fat sat and 18.3 (±10.4) and 29.3 (±14.1) for the Dixon sequence, respectively (p < 0.001).

CONCLUSION

3D T1 Dixon sequence is superior to fat sat for dedicated breast MRI at 3 T, in terms of efficiency of fat suppression and image quality with the added advantage of optimal exploration of the axillary areas.