Whole-body MRI for metastatic cancer detection using T2-weighted imaging with fat and fluid suppression

Purpose: To develop a whole-body MRI technique at 3T with improved lesion conspicuity for metastatic cancer detection using fast, high-resolution and high SNR T-2-weighted (T2W) imaging with simultaneous fat and fluid suppression. Theory and Methods: The proposed dual-echo T-2-weighted acquisition for enhanced conspicuity of tumors (DETECT) acquires 4 images, in-phase (IP) and out-of-phase (OP) at a short and a long TE using single-shot turbo spin echo. The IP/OP images at the short and long TEs are reconstructed using the standard Dixon and shared-field-map Dixon reconstruction respectively, for robust fat-water separation. An adaptive complex subtraction between the 2 TE water-only images achieves fluid attenuation. DETECT imaging was optimized and evaluated in whole-body imaging of 5 healthy volunteers, and compared against diffusion-weighted imaging with background suppression (DWIBS) in 5 patients with known metastatic renal cell carcinoma. Results: Robust fat-water separation and fluid attenuation were achieved using the shared-field-map Dixon reconstruction and adaptive complex subtraction, respectively. DETECT imaging technique generated co-registered T2W images with and without fat suppression, heavily T2W, and fat and fluid suppressed T2W whole-body images in < 7 min. Compared to DWIBS acquired in 17 min, the DETECT imaging achieved better detection and localization of lesions in patients with metastatic cancer. Conclusion: DETECT imaging technique generates T2W images with high resolution, high SNR, minimal geometric distortions, and provides good lesion conspicuity with robust fat and fluid suppression in < 7 min for whole-body imaging, demonstrating efficient and reliable metastatic cancer detection at 3T.