High-resolution, three-dimensional diffusion-weighted breast imaging using DESS

Purpose: To evaluate the use of the double-echo steady-state (DESS) sequence for acquiring high-resolution breast images with diffusion and T2 weighting. Materials and Methods: Phantom scans were used to verify the T2 and diffusion weighting of the DESS sequence. Image distortion was evaluated in volunteers by comparing DESS images and conventional diffusion-weighted images (DWI) to spoiled gradient-echo images. The DESS sequence was added to a standard clinical protocol, and the resulting patient images were used to evaluate overall image quality and image contrast in lesions. Results: The diffusion weighting of the DESS sequence can be easily modulated by changing the spoiler gradient area and flip angle. Radiologists rated DESS images as having higher resolution and less distortion than conventional DWI. Lesion-to-tissue contrast ratios are strongly correlated between DWI and DESS images (R = 0.83) and between T2-weighted fast spin-echo and DESS images (R = 0.80). Conclusion: The DESS sequence is able to acquire high-resolution 3D diffusion- and 12-weighted images in short scan times, with image quality that facilitates morphological assessment of lesions. (C) 2014 Elsevier Inc. All rights reserved.