Multiplexed sensitivity-encoding diffusion-weighted imaging (MUSE) in diffusion-weighted imaging for rectal MRI: a quantitative and qualitative analysis at multiple b-values

Purpose To compare four diffusion-weighted imaging (DWI) sequences for image quality, rectal contour, and lesion conspicuity, and to assess the difference in their signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC). Methods In this retrospective study of 36 consecutive patients who underwent 3.0 T rectal MRI from January–June 2020, DWI was performed with single-shot echo planar imaging (ss-EPI) (b800 s/mm 2 ), multiplexed sensitivity encoding (MUSE) (b800 s/mm 2 ), MUSE (b1500 s/mm 2 ), and field-of-view optimized and constrained undistorted single-shot (FOCUS) (b1500 s/mm 2 ). Two radiologists independently scored image quality using a 5-point Likert scale. Inter-reader agreement was assessed using the weighted Cohen’s к. SNR, CNR, and ADC measurements were compared using the paired t -test. Results For both readers, MUSE b800 scored significantly higher for image quality, rectal contour, and lesion conspicuity compared to ss-EPI; MUSE b800 also scored significantly higher for image quality and rectal contour compared to all other sequences. Lesion conspicuity was equally superior for MUSE b800 and MUSE b1500 compared to the other two sequences. There was good to excellent inter-reader agreement for all qualitative features ( к = 0.72–0.88). MUSE b800 had the highest SNR; MUSE b1500 had the highest CNR. A significant difference in ADC was observed between ss-EPI compared to the other sequences ( p < 0.001) and between MUSE b800 and FOCUS. No significant difference in ADC was found between MUSE b1500 and FOCUS b1500. Conclusion MUSE b800 improved image quality over ss-EPI and both MUSE b800 and b1500 showed better tumor conspicuity compared to conventional ss-EPI.