Application of the new optimized sequence HASTE-TSE-Separated in gastric cancer MR scanning: comparison with HASTE-GRE-Separated, TSE-BLADE, and TSE Sequences
Authors: xu xiao sheng , wei jia , shi qing lei , yang li 
Published: June 2023

Abstract
Objective To compare the image quality of HASTE-GRE-Separated, HASTE-TSE-Separated, TSE-BLADE, and TSE sequences in gastric T2WI, and explore the optimal imaging scheme for gastric T2WI.Method 25 patients with gastric cancer (17 males and 8 females) were included and scanned using HASTE-GRE-Separated, HASTE-TSE-Separated, TSE-BLADE, and TSE sequences on 3.0T magnetic resonance imaging. Calculate the SNR of the lesion, the signal intensity ratio of the lesion to water, and the CNR. Two abdominal diagnostic physicians (with 15 and 5 years of diagnostic experience, respectively) rated the image quality according to the 5-point method. The criteria were as follows: 5 = excellent (clear display of gastric wall and perigastric fat spaces, clear display of cancer margins, clear boundary between gastric blood vessels and lymph nodes), 4 = good (slight artifacts in gastric wall and perigastric fat spaces, and cancer lesion boundaries can be determined), 3 = Moderate (gastric wall display is fair, perigastric fat spaces are not clear, and cancer margins are blurry), 2 = Poor (gastric wall display is not clear, but cancer location is difficult to determine boundaries), and 1 = Poor (gastric wall and cancer location are not clear, making it difficult to determine cancer location and boundaries). All quantitative and qualitative parameters were analyzed using One way ANOVA and Kruskal Wallis one-way ANOVA, with Bonferroni correction used for pairwise comparisons between groups. Apply Kappa analysis to analyze the consistency of scores between two physicians.Results Objective quantitative parameter analysis showed that there were statistical differences in SNR and CNR among the four types of T2WI in the stomach (F = 4.709, P < 0.05; F = 4.164, P < 0.05). The SNR of the HASTE-TSE-Separated sequence was higher than that of the TSE sequence (P < 0.05). The CNR of the HASTE-GRE-Separated sequence was higher than that of the TSE sequence (P < 0.05). The signal strength ratio of the HASTE-GRE-Separated sequence is not as good as that of the TSE-BLADE sequence (P < 0.05). The signal intensity ratio of HASTE-GRE-Separated and HASTE-TSE-Separated sequences showed no significant difference (P > 0.05), but the HASTE-TSE-Separated sequence showed a slightly higher tissue CNR. The subjective evaluation scores of HASTE-GRE-Separated and HASTE-TSE-Separated sequences [(4.52 ± 0.59) and (4.64 ± 0.49) scores] were significantly higher than those of TSE-BLADE and TSE [(3.16 ± 0.80) and (3.04 ± 1.02) scores, (F = 32.47, P < 0.001)]. The HASTE-TSE-Separated sequence image has the highest score. The subjective scores of both physicians for the four sequences showed good consistency.Conclusion Although the signal strength of the HASTE sequence is not as strong as that of the TSE-BLADE and TSE sequences, the HASTE sequence has a faster imaging speed and fewer motion artifacts, especially the appearance of the HASTE-TSE-Separated imaging sequence, which further improves the imaging quality of traditional HASTE and has great potential for application in gastric MR T2WI imaging.