Diffusion-Weighted DESS with a 3D Cones Trajectory for Non-Contrast-Enhanced Breast MRI

In this work a novel diffusion-weighted method, DW-DESS-Cones, is developed and characterized in vivo for the MRI of breast cancer without a contrast injection.

Diffusion-weighted (DW) MRI can distinguish breast cancers from surrounding normal tissue without an injection of contrast. However, conventional DW MRI has limitations in terms of image quality that can be particularly problematic for detecting small breast cancers during screening. The method developed in this work, Diffusion-Weighted Double-Echo Steady-State Cones (DW-DESS-Cones) combines an alternative DW MRI method, steady-state diffusion-weighting, with a three-dimensional cones trajectory. Steady-state DWI acquisitions should provide more robust image quality in comparison to conventional DWI but their contrast in the breast is not well-characterized. The cones trajectory is used with the goal of reducing motion artifact. In volunteer and patient studies, the DW-DESS-Cones method reduced motion artifacts with respect to DW-DESS-Cartesian and improved image sharpness, distortion and overall image quality with respect to conventional DWI. In 11/14 lesions the hyperintensity/hypointensity of the lesion signal versus the surrounding tissue signal was concordant between DW-DESS-Cones and conventional DWI, demonstrating the potential of DW-DESS-Cones to distinguish breast cancers from normal tissue without a contrast injection. Finally, simulations of DW-DESS-Cones contrast between malignant lesions and surrounding fibroglandular tissue provided a broader representation of the potential contrast of steady-state DWI in the breast.

Moran CJ, Cheng JY, Sandino CM, Carl M, Alley MT, Rosenberg J, Daniel BL, Pittman SM, Rosen EL, Hargreaves BA. Diffusion-weighted double-echo steady-state with a three-dimensional cones trajectory for non-contrast-enhanced breast MRI. J Magn Reson Imaging. 2020 Dec 31. doi: 10.1002/jmri.27492. Online ahead of print.

Online Journal Article

Four malignant lesions (a-d) and two benign lesions (e-f) are visible with a contrast-injection on contrast-enhanced (CE) MRI in column 1 (solid arrows). All lesions are also visible without a contrast injection on conventional DWI (column 2) and DW-DESS-Cones (column 3). DW-DESS-Cones also achieves improved image sharpness and reduced distortion.

Senior Research Scientist - Physical, Rad/Radiological Sciences Laboratory
Senior Research Scientist - Physical, Rad/Radiological Sciences Laboratory
Professor of Radiology (Body Imaging) and, by courtesy, of Bioengineering
Clinical Associate Professor, Radiology
Clinical Professor, Radiology
Professor of Radiology (Radiological Sciences Laboratory) and, by courtesy, of Electrical Engineering and of Bioengineering