Apparent Diffusion Coefficient Reproducibility Across 3 T Scanners in a Breast Diffusion Phantom

Background To date, the accuracy and variability of diffusion-weighted MRI (DW-MRI) metrics have been reported in a limited number of scanner/protocol/coil combinations. Purpose To evaluate the reproducibility of DW-MRI estimates across multiple scanners and DW-MRI protocols and to assess the effects of using an 8-channel vs. 16-channel breast coil in a breast phantom. Study Type Prospective. Phantom Breast phantom containing tubes of water and differing polyvinylpyrrolidone (PVP) concentrations with apparent diffusion coefficients (ADCs) matching breast tissue. Field Strength/Sequence 3 T (three standard and one wide bore), three DW-MRI single-shot echo planar imaging protocols of varying acquired spatial resolution. Assessment Accuracy of estimated ADCs was assessed using percent differences (PD) relative to nuclear magnetic resonance spectroscopy-derived reference values. Coefficients of variation (CV) were calculated to determine variation across scanners. CVs based on the median standard deviation (CVM) were used to evaluate tube-specific dispersion using 8- or 16-channel coils at a single scanner. ADCs of PVP-containing tubes were additionally normalized by the median water tube ADC to account for temperature effects. Statistical Tests Two-way repeated measures analysis of variance and post hoc tests were used to evaluate differences in ADC, CV, and CVM across scanners and protocols (alpha = 0.05). Results ADCs were within 11% (interquartile range [IQR] 7%) of reference values and significantly improved to 2% (IQR 7%) after normalization to an internal water reference. Normalization significantly reduced interscanner variability of ADC estimates from 7% to 4%. DW-MRI protocol did not affect ADC accuracy; however, the clinical and higher-resolution clinical protocols resulted in the greatest (9%) and least (6%) interscanner variability, respectively. The 8- and 16-channel receive coils yielded similar accuracy (PD: 12% vs. 16%) and precision (CVM: 2.7% vs. 2.9%). Data Conclusion Normalization by an internal reference improved interscanner ADC reproducibility. High-resolution protocols yielded comparably accurate and significantly less variable ADCs compared to a clinical standard protocol. Evidence Level 2 Technical Efficacy Stage 1

Automated summary

This study aimed to evaluate the reproducibility of DW-MRI estimates across multiple scanners and protocols, and compare the effects of using 8-channel versus 16-channel breast coils. The results showed that normalization by an internal reference improved interscanner ADC reproducibility, and high-resolution protocols yielded comparably accurate and less variable ADCs.