Abstract
OBJECTIVES: This study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b value diffusion-weighted images (rFOV-syDWIs) in the clinical application of cervical cancer based on image quality and diagnostic efficacy. METHODS: We retrospectively evaluated the data of 35 patients with cervical cancer and 35 healthy volunteers from May to November 2021. All patients and volunteers underwent rFOV-DWI scans, including a 13b-protocol: b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, and 1500 s/mm(2) and a 5b-protocol: b = 0, 100, 400, 800,1500 s/mm(2). rFOV-syDWIs with b values of 1200 (rFOV-syDWI(b=1200)) and 1500 (rFOV-syDWI(b=1500)) were generated from two different multiple-b-value image datasets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by the Levene's test and Shapiro-Wilk test, the inter-modality differences of quantitative measurements were, respectively, examined by Wilcoxon signed-rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann-Whitney U test. RESULTS: A higher inter-reader agreement between SNRs and CNRs was found in 13b-protocol and 5b-protocol rFOV-syDWI(b=1200/1500) compared to 13b-protocol rFOV-sDWI(b=1200/1500) (p < 0.05). AUC of 5b-protocol syADC(mean,b=1200/1500) and syADC(minimum,b=1200/1500) was equal or higher than that of 13b-protocol sADC(mean,b=1200/1500) and sADC(minimum,b=1200/1500). CONCLUSIONS: rFOV-syDWIs provide better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shorten scan time, and synthetic ADCs offer reliable diagnosis value as scanned 13b-protocol DWIs.