{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T08:57:12Z","timestamp":1776070632128,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: To evaluate the influence of different DIXON contrasts on the quality of subtraction images in dynamic breast MRI using maximum intensity projections (MIPs). Methods: This retrospective study included n = 40 women (median age: 53.5 years, range 23\u201383) undergoing clinically indicated breast MRI (3T). For each MRI examination, two independent readers individually evaluated GBCA-enhanced subtraction MIPS for different timepoints (n = 5) and DIXON contrasts (n = 4) per breast, resulting in a total of 800 individual evaluations. Evaluations comprised (a) qualitative measures, using Likert-scores for artefact strength, breast parenchyma visibility, lesion visibility and reading confidence; and (b) signal intensity, measured in three regions of interest with the apparent signal-to-noise ratio (aSNR) and apparent contrast-to-noise ratio (aCNR) calculated. The evaluation results were analysed to identify differences between DIXON contrasts. Results: The \u201conly water\u201d DIXON contrast at ~120s after GBCA injection achieved the highest lesion conspicuity and reading confidence scores and lowest artefact scores; however, its performance was not statistically significant (p &gt; 0.05) compared to the \u201cin-phase\u201d and \u201copposed-phase\u201d subtractions. The aCNR at the second timepoint was slightly, but not significantly (p &gt; 0.05), lower than the first timepoint, whilst aSNR increased significantly from the first to second timepoint in all contrasts. Conclusions: Subtraction MIPs derived from the \u201conly water\u201d DIXON contrast achieved the highest qualitative scoring for lesion conspicuity and confidence, with the aSNR increasing and aCNR decreasing between the first and second timepoints.<\/jats:p>","DOI":"10.3390\/diagnostics16081145","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T07:29:29Z","timestamp":1776065369000},"page":"1145","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Individual T1w-DIXON Contrasts for Subtraction Generation in Dynamic Contrast-Enhanced Breast MRI"],"prefix":"10.3390","volume":"16","author":[{"given":"Shirley-Maria","family":"Christian","sequence":"first","affiliation":[{"name":"Gynecology Department, Klinikum Darmstadt, 64283 Darmstadt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Bickelhaupt","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Hadler","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1866-860X","authenticated-orcid":false,"given":"Lorenz A.","family":"Kapsner","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Medical Informatics, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Uder","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9269-5609","authenticated-orcid":false,"given":"Frederik B.","family":"Laun","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9163-8840","authenticated-orcid":false,"given":"Sabine","family":"Ohlmeyer","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.breast.2022.08.010","article-title":"Current and future burden of breast cancer: Global statistics for 2020 and 2040","volume":"66","author":"Arnold","year":"2022","journal-title":"Breast"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.6004\/jnccn.2018.0083","article-title":"Breast Cancer Screening and Diagnosis, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology","volume":"16","author":"Bevers","year":"2018","journal-title":"J. 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