Artifact-Robust Diffusion-Weighted Whole-Body Imaging With Background Suppression At 3 T Using Improved Turbo Spin-Echo Diffusion-Weighted Imaging

Objective: To compare single-shot turbo spin-echo (TSE) diffusion-weighted whole-body imaging with background suppression (DWIBS) and echo-planar imaging (EPI) DWIBS to determine the feasibility of direct-coronal TSE-DWIBS.Methods: All measurements were performed using a 3.0 T MRI scanner. In the phantom study, we compared the contrast ratios (CRs) of tumor-mimicking phantom (tumor) to muscle-mimicking phantom (muscle) and water to muscle and the signal-to-noise ratio (SNR) between TSE-DWIBS and EPI-DWIBS. In the volunteer study, 10 healthy volunteers were whole-body scanned with direct-coronal TSE-DWIBS, direct-coronal EPI-DWIBS (corEPl-DWIBS), and transverse EPI-DWIBS (traEPI-DWIBS). Two radiologists assessed the image distortion, uniformity of fat suppression, overall artifacts, and overall image quality in maximum intensity projection (MIP) images from each DWIBS image using a 5-point scale.Results: In the phantom study, the CR of tumor to muscle was found to be lower for TSE-DWIBS (10.57 +/- 0.45) than for EPI-DWIBS (15.38 +/- 0.27), and the CR of water to muscle was higher for TSE-DWIBS (9.61 +/- 0.66) than for EPI-DWIBS (2.52 +/- 0.60). The volunteer study revealed good inter observer agreement between TSE-DWIBS and EPI-DWIBS with respect to image distortion, uniformity of fat suppression, overall artifacts, and overall image quality, with weighted Cohen's k coefficients of 0.91, 0.74, 0.87, and 0.72, respectively. Qualitative analysis scores for image distortion, uniformity of fat suppression, overall artifacts, and overall image quality were significantly higher for TSE-DWIBS than for corEPl-DWIBS or traEPI-DWIBS (p < 0.05).Conclusion: Direct-coronal TSE-DWIBS is robust against magnetic field inhomogeneity. High-quality images without distortion or fat suppression inhomogeneity were obtained.Advances In knowledge: Many studies on DWIBS have been previously reported; however, these studies used EPI read-out. To the best of our knowledge, no studies using TSE read-out have been reported. In this study, we examined the feasibility of TSE-DWIBS with lesser artifacts than EPI-DWIBS.