Simultaneous Multislice Readout-Segmented Echo Planar Imaging for Diffusion-Weighted MRI in Patients With Invasive Breast Cancers

Sung Eun Song, Ok Hee Woo, Kyu Ran Cho, Bo Kyoung Seo, Yo Han Son, Robert Grimm, Wei Liu, Woo Kyung Moon

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: In diffusion-weighted imaging (DWI) of breast MRI, simultaneous multislice acceleration techniques can be used for readout-segmented echo planar imaging (rs-EPI) to shorten the scan time. Purpose: To compare the image quality, apparent diffusion coefficient (ADC) value, and scan time of rs-EPI and simultaneous multislice rs-EPI (SMS rs-EPI) sequences. Study Type: Retrospective. Subjects: In all, 134 consecutive women (mean age: 55.3 years) with invasive breast cancer who underwent preoperative MRI. Field Strength/ Sequences: 3.0T; rs-EPI sequence, prototypic SMS rs-EPI sequence and dynamic contrast-enhanced MRI (DCE-MRI) sequence. Assessment: For quantitative comparison, two radiologists independently measured the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), lesion contrast, and apparent diffusion coefficient (ADC). For qualitative comparison, image quality, lesion conspicuity, and reader preference were assessed with a reference of DCE-MRI. Statistical Tests: Paired t-tests and Mann–Whitney tests were used. Results: For SNR and CNR, there were no differences between the sequences (P = 0.342 and 0.665 for reader 1; P = 0.606 and P = 0.116 for reader 2). Lesion contrast of SMS rs-EPI was higher than that of rs-EPI (P < 0.05 for both reader 1 and reader 2). Mean tumor ADC was similar in rs-EPI and SMS rs-EPI sequences (0.98 ± 0.22 vs. 1.00 ± 0.22; P = 0.291 for reader 1, 0.98 ± 0.21 vs. 1.00 ± 0.22; P = 0.418 for reader 2). Regarding qualitative comparison, image quality and lesion conspicuity were higher in SMS rs-EPI than in rs-EPI (both P < 0.05 for both readers). The two readers regarded SMS rs-EPI as superior or equal to rs-EPI in over 90% of cases. The acquisition time was 4:30 minutes for rs-EPI and 2:31 minutes for SMS rs-EPI. Data Conclusion: The SMS rs-EPI sequence resulted in a similar ADC value and better image quality than the rs-EPI sequence in a 44.1% reduced scan time. Level of Evidence: 4. Technical Efficacy: 3.

Original languageEnglish
Pages (from-to)1108-1115
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Issue number4
StatePublished - Apr 2021


  • breast cancer
  • diffusion-weighted imaging
  • magnetic resonance imaging
  • simultaneous excitation

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