Evaluation of image quality of pituitary dynamic contrast-enhanced MRI using time-resolved angiography with interleaved stochastic trajectories (TWIST) and iterative reconstruction TWIST (IT-TWIST)

Background Time-resolved angiography with interleaved stochastic trajectories (TWIST) is a keyhole imaging with frequent sampling of central k-space data and view-sharing for the peripheral k-space of dynamic phases. IT-TWIST is a technique to reconstruct images with a smaller temporal footprint using the same raw data obtained with TWIST by iterative reconstruction. Purpose To compare image quality between TWIST and IT-TWIST in 3D pituitary DCE-MRI. Study Type Retrospective observation study. Population Fifty-one patients (23 men, 28 women) who underwent 3D pituitary DCE-MRI using TWIST between July 2016 and April 2017. Field Strength/Sequence 3T/TWIST and IT-TWIST. Assessment Visual evaluation was conducted for image quality of delineation of the pituitary stalk and posterior lobe during the early arterial phase, cerebral white matter near the sella turcica, and the mass lesion. Bolus sharpness of the pituitary stalk, posterior lobe, and bilateral cavernous sinus was evaluated on the enhancement slope map calculated from TWIST and IT-TWIST. Temporal stability of intensity of the nonenhanced area was evaluated on temporal standard deviation (SD) maps calculated from TWIST and IT-TWIST. Statistical Tests Paired t-test or Wilcoxon rank-sum test was used to test the differences between TWIST and IT-TWIST in both visual evaluation and region of interest evaluation. Results Scores of visual evaluations for IT-TWIST were significantly better than those for TWIST (P < 0.001) in all items. Enhancement slope for IT-TWIST was significantly higher than that for TWIST in posterior lobe, and right and left cavernous sinus (P < 0.001). Temporal SD for IT-TWIST was significantly lower than that for TWIST in all items, with statistical significance (P < 0.001). Data Conclusion IT-TWIST yielded better visualization, and better enhancement slope, and less temporal SD compared with TWIST in 3D pituitary DCE-MRI. Evidence Level: 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1497-1506.