{"doi":"10.1148/radiol.2020200221","title":"A Comparison of Methods for High-Spatial-Resolution Diffusion-weighted Imaging in Breast MRI","abstract":"Background Diffusion-weighted imaging (DWI) shows promise in detecting and monitoring breast cancer, but standard spin-echo (SE) echo-planar DWI methods often have poor image quality and low spatial resolution. Proposed alternatives include readout-segmented (RS) echo-planar imaging and axially reformatted (AR)–simultaneous multislice (SMS) imaging. Purpose To compare the resolution and image quality of standard SE echo-planar imaging DWI with two high-spatial-resolution alternatives, RS echo-planar and AR-SMS imaging, for breast imaging. Materials and Methods In a prospective study (2016–2018), three 5-minute DWI protocols were acquired at 3.0 T, including standard SE echo-planar imaging, RS echo-planar imaging with five segments, and AR-SMS imaging with four times slice acceleration. Participants were women undergoing breast MRI either as part of a treatment response clinical trial or undergoing breast MRI for screening or suspected cancer. A commercial breast phantom was imaged for resolution comparison. Three breast radiologists reviewed images in random order, including clinical images indicating the lesion, images with b value of 800 sec/mm2, and apparent diffusion coefficient (ADC) maps from the three randomly labeled DWI methods. Readers measured the longest dimension and lesion-average ADC on three DWI methods, reported measurement confidence, and rated or ranked the quality of each image. The scores were fit to a linear mixed-effects model with intercepts for reader and subject. Results The smallest feature (1 mm) was only detectible in a phantom on images from AR-SMS DWI. Thirty lesions from 28 women (mean age, 50 years ± 13 [standard deviation]) were evaluated. On the five-point Likert scale for image quality, AR-SMS imaging scored 1.31 points higher than SE echo-planar imaging and 0.74 points higher than RS echo-planar imaging, whereas RS echo-planar imaging scored 0.57 points higher than SE echo-planar imaging (all P < .001). Conclusion The axially reformatted simultaneous multislice protocol was rated highest for image quality, followed by the readout-segmented echo-planar imaging protocol. Both were rated higher than the standard spin-echo echo-planar imaging. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Partridge in this issue.","journal":"Radiology","year":2020,"id":63937,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":40,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9569,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":295246,"name":"An Church","orcid":"0000-0002-9544-8638","position":1,"is_corresponding":false},{"id":334865,"name":"Nathan Rubin","orcid":"0000-0001-7162-5225","position":2,"is_corresponding":false},{"id":337943,"name":"Tim H. Emory","orcid":"0000-0001-9604-3563","position":3,"is_corresponding":false},{"id":337944,"name":"Noelle Hoven","orcid":"0000-0001-6991-3033","position":4,"is_corresponding":false},{"id":338623,"name":"Jessica Kuehn-Hajder","orcid":null,"position":5,"is_corresponding":false},{"id":295245,"name":"Michael T. Nelson","orcid":"0000-0001-5797-623X","position":6,"is_corresponding":false},{"id":257403,"name":"Sudhir Ramanna","orcid":null,"position":7,"is_corresponding":false},{"id":320266,"name":"Edward J. Auerbach","orcid":"0000-0003-4553-1545","position":8,"is_corresponding":false},{"id":256594,"name":"Steen Moeller","orcid":"0000-0003-1698-7260","position":9,"is_corresponding":false},{"id":295247,"name":"Patrick J. Bolan","orcid":"0000-0002-4194-3975","position":10,"is_corresponding":false},{"id":337942,"name":"Jessica A. McKay","orcid":"0000-0003-3377-0346","position":0,"is_corresponding":true}],"reference_count":17,"raw_metadata":null,"created_at":"2026-07-18T21:11:24.000992Z","pmid":"32840468","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}