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Prospective Comparison of FOCUS MUSE and Single-Shot Echo-Planar Imaging for Diffusion-Weighted Imaging in Evaluating Thyroid-Associated Ophthalmopathy

  • YunMeng Wang (Graduate School of Bengbu Medical University) ;
  • YuanYuan Cui (Department of Radiology, Second Affiliated Hospital of Naval Medical University) ;
  • JianKun Dai (GE Healthcare) ;
  • ShuangShuang Ni (Department of Radiology, Second Affiliated Hospital of Naval Medical University) ;
  • TianRan Zhang (Department of Radiology, Second Affiliated Hospital of Naval Medical University) ;
  • Xin Chen (Department of Radiology, Second Affiliated Hospital of Naval Medical University) ;
  • QinLing Jiang (Department of Radiology, Second Affiliated Hospital of Naval Medical University) ;
  • YuXin Cheng (Department of Radiology, Second Affiliated Hospital of Naval Medical University) ;
  • YiChuan Ma (Department of Radiology, The First Affiliated Hospital of Bengbu Medical University) ;
  • Tuo Li (Department of Endocrinology, Changzheng Hospital) ;
  • Yi Xiao (Department of Radiology, Second Affiliated Hospital of Naval Medical University)
  • Received : 2024.02.20
  • Accepted : 2024.08.02
  • Published : 2024.10.01

Abstract

Objective: To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO). Materials and Methods: SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation. Results: Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores (P < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) (P < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs (P < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC: 0.925 vs. 0.779; P = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI (r = 0.391, P < 0.001) and FOCUS MUSE DWI (r = 0.645, P < 0.001). Conclusion: FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.

Keywords

Acknowledgement

First of all, I would like to give my heartfelt thanks to all the people who have ever helped me in this paper. My sincere and hearty thanks and appreciations go firstly to my supervisor, Mrs. Xiao Yi, whose suggestions and encouragement have given me much insight into these translation studies. It has been a great privilege and joy to study under her guidance and supervision. My gratitude to her knows no bounds. I am also extremely grateful to all my teachers and classmates who have kindly provided me assistance and companionship in the course of preparing this paper. Finally, I am really grateful to all those who devote much time to reading this thesis and give me much advice, which will benefit me in my later study.

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