Optimisation of B-values for the Accurate Estimation of the Apparent Diffusion Coefficient (ADC) in Whole-body Diffusion-weighted MRI in Patients with Metastatic Melanoma

Objective: To establish optimised diffusion weightings ('b-values') for acquisition of whole-body diffusion-weighted MRI (WB-DWI) for estimation of the apparent diffusion coefficient (ADC) in patients with metastatic melanoma (MM). Existing recommendations for WB-DWI have not been optimised for the tumour properties in MM; therefore, evaluation of acquisition parameters is essential before embarking on larger studies.

Methods: Retrospective clinical data and phantom experiments were used. Clinical data comprised 125 lesions from 14 examinations in 11 patients with multifocal MM, imaged before and/or after treatment with immunotherapy at a single institution. ADC estimates from these data were applied to a model to estimate the optimum b-value. A large non-diffusing phantom was used to assess eddy current-induced geometric distortion.

Results: Considering all tumour sites from pre- and post-treatment examinations together, metastases exhibited a large range of mean ADC values, [0.67-1.49] × 10 mm/s, and the optimum high b-value (b) for ADC estimation was 1100 (10th-90th percentile: 740-1790) s/mm. At higher b-values, geometric distortion increased, and longer echo times were required, leading to reduced signal.

Conclusions: Theoretical optimisation gave an optimum b of 1100 (10th-90th percentile: 740-1790) s/mm for ADC estimation in MM, with the large range of optimum b-values reflecting the wide range of ADC values in these tumours. Geometric distortion and minimum echo time increase at higher b-values and are not included in the theoretical optimisation; b in the range 750-1100 s/mm should be adopted to maintain acceptable image quality but performance should be evaluated for a specific scanner.

Key Points: • Theoretical optimisation gave an optimum high b-value of 1100 (10th-90th percentile: 740-1790) s/mm for ADC estimation in metastatic melanoma. • Considering geometric distortion and minimum echo time (TE), a b-value in the range 750-1100 s/mm is recommended. • Sites should evaluate the performance of specific scanners to assess the effect of geometric distortion and minimum TE.