Application of Time-Resolved Angiography With Stochastic Trajectories (TWIST)-Dixon in Dynamic Contrast-Enhanced (DCE) Breast MRI

PurposeTo evaluate a magnetic resonance imaging (MRI) technique that integrates time-resolved angiography with stochastic trajectories (TWIST) view sharing and Dixon for a breast dynamic contrast-enhanced (DCE)-MRI application. Materials and MethodsSimulation study: K-space data at six timepoints (1 pre-, 5 postcontrast) were generated by performing Fourier transform on a digital phantom with 3-9 mm enhancing lesions and three types of enhancement curves (persistent, plateau, washout). Images were reconstructed with and without TWIST. Clinical study: Six TWIST-Dixon image sets (one pre-, five postcontrast) were acquired in 18 patients on a 3T scanner, followed by one conventional image set. The last TWIST-Dixon and the conventional images were scored for seven criteria: perceived signal-to-noise ratio (P.SNR), visualization of anatomy, fat suppression (FS) accuracy, FS uniformity, ghosting artifact, edge ringing artifact, and overall image quality (IQ). ResultsSimulation study: With proper TWIST parameters (pA 33%, pB 50%), the enhancement underestimation was 5% or less for tumor size 5 mm. Clinical study: TWIST-Dixon images have significantly better scores in all criteria except for ghosting artifacts, where the difference was not significant. ConclusionWith proper parameters, TWIST-Dixon provides higher perceived SNR, more accurate fat suppression, and better overall image quality for breast DCE-MRI without sacrificing accuracy in the enhancement estimation. J. Magn. Reson. Imaging 2013;38:1033-1042. (c) 2013 Wiley Periodicals, Inc.