Breast MRI at very short TE (minTE): image analysis of minTE sequences on non-fat-saturated, subtracted T1-weighted images

Abstract

Purpose The aim was to evaluate a minimum echo time (minTE) protocol for breast magnetic resonance imaging (MRI) in patients with breast lesions compared to a standard TE (nTE) time protocol.

Methods Breasts of 144 women were examined with a 1.5 Tesla MRI scanner. Additionally to the standard gradient-echo sequence with nTE (4.8 ms), a variant with minimum TE (1.2 ms) was used in an interleaved fashion which leads to a better temporal resolution and should reduce the scan time by approximately 50 %. Lesion sizes were measured and the signal-to-noise ratio (SNR) as well as the contrast-to-noise ratio (CNR) were calculated. Subjective confidence was evaluated using a 3-point scale before looking at the nTE sequences (1 = very sure that I can identify a lesion and classify it, 2 = quite sure that I can identify a lesion and classify it, 3 = definitely want to see nTE for final assessment) and the subjective image quality of all examinations was evaluated using a four-grade scale (1 = sharp, 2 = slight blur, 3 = moderate blur and 4 = severe blur/not evaluable) for lesion and skin sharpness. Lesion morphology and contrast enhancement were also evaluated.

Results With minTE sequences, no lesion was rated with “definitely want to see nTE sequences for final assessment”. The difference of the longitudinal and transverse diameter did not differ significantly (p > 0.05). With minTE, lesions and skin were rated to be significantly more blurry (p < 0.01 for lesions and p < 0.05 for skin). There was no difference between both sequences with respect to SNR, CNR, lesion morphology, contrast enhancement and detection of multifocal disease.

Conclusion Dynamic breast MRI with a minTE protocol is feasible without a major loss of information (SNR, CNR, lesion morphology, contrast enhancement and lesion sizes) and the temporal resolution can be increased by a factor of 2 using minTE sequences.

Key points 

• Increase of temporal resolution for a better in-flow curve.

• Dynamic breast MRI with a shorter TE time is possible without relevant loss of information.

• Possible decrease of the overall scan time.

Zusammenfassung

Einleitung Das Ziel war es in der Brustmagnetresonanztomografie einen Vergleich zwischen zwei Sequenzen mit einer minimalen TE-Zeit (minTE) und mit einer Standard TE Zeit (nTE) bei Patienten mit Brustläsionen anzustellen.

Methoden 144 Frauen wurden mit einem 1,5-Tesla-MRT untersucht. Zusätzlich zu den Standard-Gradienten-Echo-Sequenzen mit normaler TE (4,8 ms) wurde eine Variante mit minimaler TE (1,2 ms) verwendet was zu einer besseren zeitlichen Auflösung führt und die Scanzeit um ca. 50 % reduzieren sollte. Die Läsionsgrößen wurden gemessen und das Signal-Rausch-Verhältnis (SNR) sowie das Kontrast-Rausch-Verhältnis (CNR) wurden berechnet. Die subjektive Diagnosesicherheit wurde mit Hilfe einer 3-Punkte-Skala (1 = sehr sicher, dass ich eine Läsion identifizieren und klassifizieren kann, 2 = ziemlich sicher, dass ich eine Läsion identifizieren und klassifizieren kann, 3 = auf jeden Fall benötigt man eine nTE Sequenz zur abschließenden Bewertung) und die subjektive Bildqualität aller Untersuchungen wurde unter Verwendung einer vierstufigen Skala (1 = scharf, 2 = leichte Unschärfe, 3 = mäßige Unschärfe und 4 = starke Unschärfe / nicht auswertbar) sowohl für die Läsion als auch die Schärfe der Haut evaluiert. Ebenso wurden die Herdbeschaffenheit und die KM-Aufnahme evaluiert.

Ergebnisse Mit minTE Sequenzen wurde keine Läsion mit „auf jeden Fall benötigt man eine nTE Sequenz zur abschließenden Bewertung“ bewertet. Der Längs- und Querdurchmessers unterschied sich nicht signifikant (p > 0,05). Mit minTE Sequenzen wurden Läsionen und Haut deutlich verschwommener bewertet (p < 0,01 für Läsionen und p < 0,05 für Haut). Es gab keinen signifikanten Unterschied zwischen den beiden Sequenzen in SNR, CNR, Herdbeschaffenheit, KM-Aufnahme und in der Erkennung von Multifokalität.

Zusammenfassung Ein dynamisches Brust-MRT ist mit minTE Sequenzen ohne größeren Informationsverlust durchführbar (SNR, CNR, Herdbeschaffenheit, KM-Aufnahme und Läsionsgröße) und die zeitliche Auflösung kann durch minTE Sequenzen um einen Faktor 2 erhöht werden.

Kernaussagen 

• Erhöhung der zeitlichen Auflösung für eine bessere KM-Anflutungskurve.

• Dynamische Brust-MRT mit einer kurzen TE Zeit ist ohne relevanten Informationsverlust möglich.

• Mögliche Reduktion der gesamten Scandauer.

Key words

breast - technology assessment - MR imaging

• References

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