Initial Experience of Applying TWIST Dixon with Flexible View Sharing in Breast DCE-MRI

Introduction We developed a new fast imaging technique with flexible time-resolved angiography with stochastic trajectories (TWIST) view sharing to achieve variable temporal resolution and with flexible echo time Dixon to achieve robust fat suppression and to evaluate its application in breast dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI). Materials and Methods The TWIST-Dixon technique was improved with more flexible view sharing and echo times (TWIST-Dixon-Flex). In a dynamic series, each measurement can be separately prescribed as “full,” “partial,” or “center-only.” The spatial and temporal resolution can then be adjusted throughout the measurements to match the dynamic characteristics of contrast enhancement at different phases. The potential advantages of TWIST-Dixon-Flex were evaluated with 18 clinical breast DCE MRI cases. A mixed-effects analysis of variance (ANOVA) was performed to compare the image quality with that of the conventional images. Results The ANOVA showed that the quality of postcontrast TWIST-Dixon-Flex images was significantly higher than that of the conventional images. The TWIST-Dixon-Flex technique also provided the capability to detect differences in rapid contrast uptake from different regions of the breast tumor, which is not possible with conventional breast DCE-MRI. Conclusion The new TWIST-Dixon-Flex technique provides potentially valuable information about early tumor enhancement, and maintains excellent image quality at peak and postcontrast enhancement. This technique could help overcome the compromise on spatial over temporal resolution in clinical breast imaging