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Fat saturation in dynamic breast MRI at 3 Tesla: is the Dixon technique superior to spectral fat saturation? A visual grading characteristics study

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Abstract

Purpose

To intra-individually compare the diagnostic image quality of Dixon and spectral fat suppression at 3 T.

Methods

Fifty consecutive patients (mean age 55.1 years) undergoing 3 T breast MRI were recruited for this prospective study. The image protocol included pre-contrast and delayed post-contrast spectral and Dixon fat-suppressed T1w series. Two independent blinded readers compared spectral and Dixon fat-suppressed series by evaluating six ordinal (1 worst to 5 best) image quality criteria (image quality, delineation of anatomical structures, fat suppression in the breast and axilla, lesion delineation and internal enhancement). Breast density and size were assessed. Data analysis included Spearman’s rank correlation coefficient and visual grading characteristics (VGC) analysis.

Results

Four examinations were excluded; 48 examinations in 46 patients were evaluated. In VGC analysis, the Dixon technique was superior regarding image quality criteria analysed (P < 0.01). Smaller breast size and lower breast density were significantly (P < 0.01) correlated with impaired spectral fat suppression quality. No such correlation was identified for the Dixon technique, which showed reconstruction-based water-fat mixups leading to insufficient image quality in 20.8 %.

Conclusions

The Dixon technique outperformed spectral fat suppression in all evaluated criteria (P < 0.01). Non-diagnostic examinations can be avoided by fat and water image reconstruction. The superior image quality of the Dixon technique can improve breast MRI interpretation.

Key Points

• Optimal fat suppression quality is necessary for optimal image interpretation

• Superior fat suppression quality is achieved using the Dixon technique

• Lesion margin and internal enhancement evaluation improves using the Dixon technique

• Superior image quality of the Dixon technique improves breast MRI interpretation

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Acknowledgments

The scientific guarantor of this publication is Pascal A.T. Baltzer. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution

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Authors and Affiliations

  1. Institute of Diagnostic Radiology, University of Udine, Azienda Ospedaliero-Universitaria “S.Maria della Misericordia”, Udine, Italy

    P. Clauser

  2. Department of Biomedical Imaging and Image-guided interventions, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria

    P. Clauser, K. Pinker, T. H. Helbich, P. Kapetas, M. Bernathova & P. A. T. Baltzer

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  1. P. Clauser
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  2. K. Pinker
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  3. T. H. Helbich
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  4. P. Kapetas
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  5. M. Bernathova
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  6. P. A. T. Baltzer
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Corresponding author

Correspondence to K. Pinker.

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Clauser, P., Pinker, K., Helbich, T.H. et al. Fat saturation in dynamic breast MRI at 3 Tesla: is the Dixon technique superior to spectral fat saturation? A visual grading characteristics study. Eur Radiol 24, 2213–2219 (2014). https://doi.org/10.1007/s00330-014-3189-7

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  • DOI: https://doi.org/10.1007/s00330-014-3189-7

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