Influence of fat-water separation and spatial resolution on automated volumetric MRI measurements of fibroglandular breast tissue

The aim of this study was to investigate the influence of fat-water separation and spatial resolution in MRI on the results of automated quantitative measurements of fibroglandular breast tissue (FGT). Ten healthy volunteers (age range, 28-71years; mean, 39.9years) were included in this Institutional Review Board-approved prospective study. All measurements were performed on a 1.5-T scanner (Siemens, AvantoFit) using an 18-channel breast coil. The protocols included isotropic (Di) [TR/TE1/TE2=6.00ms/2.45ms/2.67ms; flip angle, 6.0° 256 slices; matrix, 360×360; 1mm isotropic; field of view, 360° acquisition time (TA)=3min 38s] and anisotropic (Da) (TR/TE1/TE2=10.00ms/2.39ms/4.77ms; flip angle, 24.9° 80 slices; matrix 360×360; voxel size, 0.7×0.7×2.0mm3; field of view, 360° TA=1min 25s) T1 three-dimensional (3D) fast low-angle shot (FLASH) Dixon sequences, and a T1 3D FLASH sequence with the same resolution (T1) without (TR/TE=11.00ms/4.76ms; flip angle, 25.0° 80 slices; matrix, 360×360; voxel size, 0.7×0.7×2.0mm3; field of view, 360° TA=50s) and with (TR/TE=29.00ms/4.76ms; flip angle, 25.0° 80 slices; matrix, 360×360; voxel size, 0.7×0.7×2.0mm3; field of view, 360° TA=2min 35s) fat saturation. Repeating volunteer measurements after 20min and repositioning were used to assess reproducibility. An automated and quantitative volumetric breast density measurement system was used for FGT calculation. FGT with Di, Da and T1 measured 4.6-63.0% (mean, 30.6%), 3.2-65.3% (mean, 32.5%) and 1.7-66.5% (mean, 33.7%), respectively. The highest correlation between different MRI sequences was found with the Di and Da sequences (R2=0.976). Coefficients of variation (CVs) for FGT calculation were higher in T1 (CV=21.5%) compared with Dixon (Di, CV=5.1%; Da, CV=4.2%) sequences. Dixon-type sequences worked well for FGT measurements, even at lower resolution, whereas the conventional T1-weighted sequence was more sensitive to decreasing resolution. The Dixon fat-water separation technique showed superior repeatability of FGT measurements compared with conventional sequences. A standard dynamic protocol using Dixon fat-water separation is best suited for combined diagnostic purposes and prognostic measurements of FGT