Optimizing Image Quality with High-Resolution, Deep-Learning-Based Diffusion-Weighted Imaging in Breast Cancer Patients at 1.5 T

The objective of this study was to evaluate a high-resolution deep-learning (DL)-based diffusion-weighted imaging (DWI) sequence for breast magnetic resonance imaging (MRI) in comparison to a standard DWI sequence (DWI_Std) at 1.5 T. It is a prospective study of 38 breast cancer patients, who were scanned with DWI_Std and DWI_DL. Both DWI sequences were scored for image quality, sharpness, artifacts, contrast, noise, and diagnostic confidence with a Likert-scale from 1 (non-diagnostic) to 5 (excellent). The lesion diameter was evaluated on b 800 DWI, apparent diffusion coefficient (ADC), and the second subtraction (SUB) of the contrast-enhanced T1 VIBE. SNR was also calculated. Statistics included correlation analyses and paired <i>t</i>-tests. High-resolution DWI_DL offered significantly superior image quality, sharpness, noise, contrast, and diagnostic confidence (each <i>p</i> < 0.02)). Artifacts were significantly higher in DWI_DL by one reader (M = 4.62 vs. 4.36 Likert scale, <i>p</i> < 0.01) without affecting the diagnostic confidence. SNR was higher in DWI_DL for b 50 and ADC maps (each <i>p</i> = 0.07). Acquisition time was reduced by 22% in DWI_DL. The lesion diameters in DWI b 800_DL and _Std and ADC_DL and _Std were respectively 6% lower compared to the 2nd SUB. A DL-based diffusion sequence at 1.5 T in breast MRI offers a higher resolution and a faster acquisition, including only minimally more artefacts without affecting the diagnostic confidence.