{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T09:46:20Z","timestamp":1782294380033,"version":"3.54.5"},"reference-count":38,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"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>Objectives: This study evaluates the protocol-level image quality and quantitative diffusion metrics of a clinically implemented deep-learning\u2013reconstructed readout-segmented echo-planar imaging protocol with water-excitation spectral fat saturation (DL-rs-EPI with WEXfs) compared with conventional rs-EPI using spectral attenuated inversion recovery (SPAIR) at 3 T. Methods: Overall, 80 patients underwent breast magnetic resonance imaging (MRI) with both conventional rs-EPI with SPAIR and DL-rs-EPI with WEXfs protocols (b-values: 0, 800, and 1200 s\/mm2). ROI-based relative image-quality metrics, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and lesion contrast, were assessed at b = 800 and b = 1200 s\/mm2; apparent diffusion coefficient (ADC) values were calculated using multi-b-value data. Fat suppression, background diffusion signal, lesion conspicuity, and artifact severity were qualitatively evaluated. A temperature-controlled diffusion phantom (CaliberMRI) was scanned; ADC values were compared with reference values at 24 \u00b0C. Results: DL-rs-EPI with WEXfs demonstrated higher ROI-based relative SNR estimates (b800: 5.79 vs. 5.28; b1200: 5.41 vs. 4.94; p &lt; 0.001) and CNR estimates (b800: 3.35 vs. 3.12, p = 0.024; b1200: 3.67 vs. 3.37, p = 0.001), with unchanged lesion contrast. Tumor ADC values were comparable between protocols, whereas normal fibroglandular tissue ADC values were slightly higher, and ADC contrast increased with DL-rs-EPI with WEXfs. Phantom ADC values from both protocols closely matched reference values at 24 \u00b0C, without significant differences. DL-rs-EPI with WEXfs demonstrated more homogeneous fat suppression and reduced background diffusion signal, with comparable lesion conspicuity and artifact severity. Conclusions: The combined DL-rs-EPI with WEXfs protocol demonstrated improved qualitative and relative quantitative image quality while preserving tumor ADC measurements. As a protocol-level evaluation, these composite improvements support its clinical feasibility for high-quality breast DWI without implying the isolated effect of DL reconstruction alone.<\/jats:p>","DOI":"10.3390\/diagnostics16131958","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:57:24Z","timestamp":1782287844000},"page":"1958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Evaluation of a Combined Deep Learning\u2013Reconstructed Readout-Segmented Echo-Planar Imaging and Water-Excitation Spectral Fat-Saturation Protocol for Breast Diffusion-Weighted Imaging at 3T Breast MRI"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7163-2084","authenticated-orcid":false,"given":"Jung Min","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0922-6677","authenticated-orcid":false,"given":"Soyeoun","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Jung","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea"},{"name":"Research Institute of Clinical Medicine, Jeonbuk National University\u2013Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9198-775X","authenticated-orcid":false,"given":"MunYoung","family":"Paek","sequence":"additional","affiliation":[{"name":"Siemens Healthineers Ltd., Seoul 06620, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8072-7116","authenticated-orcid":false,"given":"Wei","family":"Liu","sequence":"additional","affiliation":[{"name":"Siemens Healthineers AG, 91052 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8933-1444","authenticated-orcid":false,"given":"Minseo","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5139-552X","authenticated-orcid":false,"given":"Jung Hee","family":"Byon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"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":"2091","DOI":"10.1056\/NEJMoa1903986","article-title":"Supplemental MRI screening for women with extremely dense breast tissue","volume":"381","author":"Bakker","year":"2019","journal-title":"N. 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