Iterative Decomposition of Water and Fat with Echo Asymmetric and Least-Squares Estimation (IDEAL) Compared to T1-Weighted Spin Echo in the Evaluation of Vertebral Body Lesions

Behroze Adi Vachha¹, Subhendra Sarkar¹, Robert Greenman¹, David Hackney¹

We compared the effectiveness of Iterative Decomposition with Echo Asymmetric and Least-Squares Estimation (IDEAL) fat-selective images to conventional T1-weighted spin-echo (SE) images for depiction of vertebral body lesions with reduced or increased fat content. We computed signal intensity ratios of lesions to adjacent vertebrae with both sequences. IDEAL showed significantly higher contrast between vertebral lesions and adjacent vertebral bodies than T1 SE images, ratios were 0.58 (T1 weighted), and 0.25 (IDEAL fat-selective) for reduced fat lesions and 1.47 (T1 weighted) and 1.83 (IDEAL fat-selective) for increased fat lesions; p<0.05 for both lesion types. IDEAL also displays significantly higher fat/water contrast, p<0.001.