ArticleSkeletal radiology2026
Efficient and complete fat suppression in two-point Dixon MR imaging: sequence considerations and assessment in lumbar plexus imaging.
Article in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTwo-point Dixon MRI is widely used for lumbar plexus imaging but often yields incomplete fat suppression due to neglecting fat's multi-peak spectrum. This study developed and evaluated a post-processing algorithm that accounts for the multi-peak fat spectrum to achieve more effective fat suppression.
methodsA novel Dark-fat processing algorithm was developed to enhance fat suppression in water-only MR images from standard two-point Dixon reconstruction. It was evaluated using a custom fat/water phantom, prospectively in a healthy volunteer, and retrospectively in 30 patients who underwent clinical lumbar plexus imaging between March and October 2023. Imaging was done using FFE (or GRE)-Dixon, TSE (or FSE)-Dixon, and mDixon-Quant. Quantitative metrics (SNR, apparent SNR (aSNR), and apparent CNR (aCNR)) and qualitative assessments by two radiologists were analyzed. Statistical significance was determined using Welch's t-test (p < 0.05) and Wilcoxon signed-rank test with Benjamini-Krieger-Yekutieli correction (q < 0.05).
resultsThe Dark-fat processing (i) substantially decreased fat signal in water-only images (84% reduction) in phantom from two-point TSE-Dixon and was statistically not different from the reference standard, multi-echo mDixon-Quant (p = 0.58); (ii) improved overall fat suppression (q < 0.05, effect size = 0.67 and 0.92), while there was no significant difference in the anatomical visualization; (iii) significantly reduced aSNR in the subcutaneous fat (p < 0.0001, effect size > 1) and muscle (p < 0.01, effect size = 0.81); and (iv) did not alter aCNR between nerve and muscle tissue (p = 0.27, effect size = 0.29).
conclusionDark-fat processing enables efficient and complete fat suppression in two-point Dixon acquisitions, especially TSE-Dixon, significantly enhancing lumbar plexus image quality. When implemented offline and as a retrospective method, it requires no change to scan time and can be applied to any two-point Dixon dataset.
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