Diagonal DWI: A Time-efficient Alternative to 3-scan Trace DWI for Breast Lesion Evaluation at 3.0T - Phantom Study and Clinical Assessment

Motivation: Diffusion-weighted imaging (DWI) optimization in breast MRI protocols faces challenges between image quality and acquisition efficiency. Diagonal DWI (dDWI) potentially offers advantages over traditional 3-scan trace DWI (tDWI). Goal(s): Compare traditional tDWI and dDWI for breast lesion evaluation at 3.0T MRI, focusing on image quality metrics. Approach: Seventy consecutive patients underwent both tDWI and dDWI protocols at 3.0T MRI. Comparative analysis included phantom ADC measurements, quantitative metrics (SNR and CNR), and independent qualitative scoring by two board-certified radiologists. Results: dDWI achieved 38% faster acquisition time with tendency of slightly better conspicuity, while tDWI showed superior SNR/CNR. ADC measurements demonstrated strong agreement between techniques. Impact: This study demonstrates diagonal DWI as a time-efficient alternative to traditional DWI in breast imaging protocols, potentially improving clinical workflow while maintaining diagnostic accuracy.