Marco Palombo, Benedetta Bodini, Francesco Grussu, Denis Le Bihan, Markus Nilsson, Raquel Perez-Lopez, Edwin H G Oei, Ivo G Schoots, Marion Smits, Ileana O Jelescu
{"title":"ESR Essentials: diffusion-weighted MRI-practice recommendations by the European Society for Magnetic Resonance in Medicine and Biology.","authors":"Marco Palombo, Benedetta Bodini, Francesco Grussu, Denis Le Bihan, Markus Nilsson, Raquel Perez-Lopez, Edwin H G Oei, Ivo G Schoots, Marion Smits, Ileana O Jelescu","doi":"10.1007/s00330-025-12033-x","DOIUrl":null,"url":null,"abstract":"<p><p>Diffusion-weighted imaging (DWI) offers critical insights into tissue microstructure through the assessment of water molecule random displacements and plays a central role in the assessment of neoplastic and non-neoplastic diseases. To successfully implement and use DWI in clinical practice, guidelines for acquisition, interpretation of image contrast and of artefacts should be followed, taking the disease process and body part into account. We recommend covering a b-value range of 0-1000 s/mm<sup>2</sup> in the brain (along at least six directions for white matter), and 50-800 s/mm<sup>2</sup> in the body. Available acquisition acceleration options should be used to reduce repetition time (TR), echo time (TE), and echo-planar imaging (EPI) distortions, while considering the penalty in signal-to-noise ratio (SNR) and image sharpness. DW images and the apparent diffusion coefficient (ADC) map should be read jointly for the clinical interpretation. Areas of slower diffusion are hyperintense on DW images and hypointense on the ADC map, and vice versa. Magnetic susceptibility distortions and signal drop-outs or pile-ups are particularly pronounced at air-tissue or metal-tissue interfaces and may obscure areas of interest or hinder the co-localisation with structural scans. By following these guidelines and recommendations, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications. KEY POINTS: This article provides an overview of DWI principles, clinical applications, potential pitfalls, and emerging advances, alongside expert recommendations for optimal implementation. We provide key considerations tailored to specific applications (neuro and whole-body imaging), including protocol optimisation, adherence to established guidelines, and quality assurance measures to minimise artefacts and ensure reproducibility. By following the guidelines and recommendations summarised in this work, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-025-12033-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Diffusion-weighted imaging (DWI) offers critical insights into tissue microstructure through the assessment of water molecule random displacements and plays a central role in the assessment of neoplastic and non-neoplastic diseases. To successfully implement and use DWI in clinical practice, guidelines for acquisition, interpretation of image contrast and of artefacts should be followed, taking the disease process and body part into account. We recommend covering a b-value range of 0-1000 s/mm2 in the brain (along at least six directions for white matter), and 50-800 s/mm2 in the body. Available acquisition acceleration options should be used to reduce repetition time (TR), echo time (TE), and echo-planar imaging (EPI) distortions, while considering the penalty in signal-to-noise ratio (SNR) and image sharpness. DW images and the apparent diffusion coefficient (ADC) map should be read jointly for the clinical interpretation. Areas of slower diffusion are hyperintense on DW images and hypointense on the ADC map, and vice versa. Magnetic susceptibility distortions and signal drop-outs or pile-ups are particularly pronounced at air-tissue or metal-tissue interfaces and may obscure areas of interest or hinder the co-localisation with structural scans. By following these guidelines and recommendations, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications. KEY POINTS: This article provides an overview of DWI principles, clinical applications, potential pitfalls, and emerging advances, alongside expert recommendations for optimal implementation. We provide key considerations tailored to specific applications (neuro and whole-body imaging), including protocol optimisation, adherence to established guidelines, and quality assurance measures to minimise artefacts and ensure reproducibility. By following the guidelines and recommendations summarised in this work, radiologists and imaging professionals can enhance diagnostic accuracy, reduce variability, and maximise the clinical value of DWI across diverse applications.
期刊介绍:
European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field.
This is the Journal of the European Society of Radiology, and the official journal of a number of societies.
From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.