The Zoom diffusion-weighted imaging sequence is used in gastric tumors: clinical utility, image quality, ADC value, and entropy value evaluation

Abstract Objective To evaluate the clinical utility, image quality, apparent diffusion coefficient (ADC) value, and entropy value of diffusion weighted imaging (DWI) using echo planar imaging (EPI) with zonally oblique multi-slice (Zoom-DWI) of the gastric tumors. In addition, these values were compared with those obtained from general single-shot EPI with parallel imaging technique (General-DWI). Materials and Methods This retrospective study included 70 participants with histologically confirmed gastric tumors who underwent MRI. DWI acquisition was performed using free-breathing two-dimensional fat-suppressed General-DWI and Zoom-DWI. The image quality was qualitatively evaluated using a five-point Likert scale. Three reviewers evaluated the diagnostic performance regarding the structural conspicuity and boundary delineation of gastric tumors. Furthermore, quantitative analysis included measurement of the mean ADC and entropy values with the tumor regions. Qualitative, quantitative and diagnostic performance parameters were compared between General-DWI and Zoom-DWI using paired t test. The mean ADC and entropy values were correlation analysis between General-DWI and Zoom-DWI using the linear regression. Results The mean image quality scores for imaging noise and the mean ADC values in gastric tumors were higher in General-DWI compared with Zoom-DWI (p 0.05). Conversely, the tumors’ boundaries scores and sharpness scores were higher in Zoom-DWI compared with General-DWI (p = 0.0001). However, no significant difference was observed in the mean entropy values of the gastric tumors between General-DWI and Zoom-DWI (p = 0.788). Correlation analysis demonstrated an extremely strong correlation for both mean ADC and entropy values between the two techniques (R = 0.906 and 0.776, respectively). Additionally, the performance of Zoom-DWI images in identifying structural conspicuity of gastric tumors (p 0.05) and boundaries delineation (p 0.05) surpassed that of General-DWI. Conclusion Zoom-DWI outperformed General-DWI in tumor diagnostic performance analysis and visualization despite higher ADC values in General-DWI, with strong inter-technique correlations validating Zoom-DWI's clinical utility for gastric tumors.