Intraobserver and Interobserver Reproducibility of Breast Diffusion‐Weighted Imaging Quantitative Parameters: Readout‐Segmented vs. Single‐Shot Echo‐Planar Imaging

Abstract

BackgroundThe recommended technique for breast diffusion‐weighted imaging (DWI) acquisitions is not sufficiently standardized in clinical practice.PurposeTo investigate the intraobserver and interobserver reproducibility of DWI measurements, diffusion‐kurtosis imaging (DKI) parameters, and image quality evaluation in breast lesions between single‐shot echo‐planar imaging (ss‐EPI) and readout‐segmented echo‐planar imaging (rs‐EPI).Study TypeProspective.PopulationA total of 295 women with 209 malignant and 86 benign breast lesions.Field Strength/SequenceA 3‐T; fat‐saturated T2‐weighted MR imaging (T2WI); multi‐b‐value DWI with both ss‐EPI and rs‐EPI readouts; T1‐weighted dynamic contrast‐enhanced MRI (DCE‐MRI).AssessmentMean kurtosis (MK), mean diffusion (MD), and apparent diffusion coefficient (ADC) values were measured for each lesion on ss‐EPI and rs‐EPI, respectively. Image quality was visually evaluated regarding image sharpness, geometric distortion, lesion conspicuity, visualization of anatomic structures, and overall quality. Quantitative and qualitative analyses were performed twice with a time interval of 2 weeks.Statistical TestsIntraobserver and interobserver reproducibility were evaluated using intra‐class correlation coefficients (ICC), within‐subject coefficient of variation (wCV), and Bland–Altman plots.ResultsMK, MD, and ADC quantitative parameters for breast lesions showed excellent intraobserver and interobserver reproducibility, with ICCs >0.75 and wCV values ranging from 2.51% to 7.08% for both sequences. The wCV values in both intraobserver and interobserver measurements were higher in the ss‐EPI sequence (3.63%–7.08%) than that of the rs‐EPI sequence (2.51%–3.62%). The wCV values differed in subgroups with different histopathological types of lesions, breast density, lesion morphology, and lesion sizes, respectively. Furthermore, rs‐EPI (ICCs, 0.76–0.97; wCV values, 2.41%–6.04%) had better intraobserver and interobserver reproducibility than ss‐EPI (ICCs, 0.54–0.90; wCV values, 6.18%–13.69%) with regard to image quality.Data ConclusionCompared to the ss‐EPI, the rs‐EPI sequence showed higher intraobserver and interobserver reproducibility for quantitative diffusion‐related parameters and image quality assessments measured in breast DWI and DKI.Evidence Level2.Technical EfficacyStage 2.