Objective To compare the image quality and diagnostic value of ZOOMit diffusion-weighted imaging(ZOOMit DWI)and the conventional full field of view DWI(fFOV-DWI)in gastric cancer(GC).Methods Consecu-tive patients who were confirmed to have gastric cancer by endoscopy and pathological biopsy and underwent 3.0 T gastric MR scanning at the First Affiliated Hospital of Nanjing Medical University from November 2021 to August 2022 were pro-spectively included.Axial fFOV-DWI and ZOOMit DWI were performed.Two radiologists with more than 5 years of MRI di-agnostic experience quantitatively analyzed the measurable lesions on images of two sequences independently,including sig-nal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR),using interclass correlation coefficient(ICC)and paired sam-ple t-test for consistency evaluation and difference analysis.The two diagnostic radiologists subjectively scored the images of fFOV-DWI and ZOOMit DWI using a 5-scale Likert scales,and Kendall's concordance coefficient and paired sample non-parametric test were used for statistical analysis.In addition,T staging was evaluated by the same two radiologists based on the results of both sequences according to the 8th edition of the American Joint Committee on Cancer(AJCC)TNM staging standard for gastric cancer,and kappa test and paired chi-square test were used for statistical analysis.Results Among the 177 patients,144 had measurable lesion sizes,and quantitative analysis of these images showed that ZOOMit DWI had higher SNR and CNR than fFOV-DWI(P＜0.05),with good consistency(ICC=0.730～0.840,P＜0.01).Furthermore,the subjective scores of the ZOOMit DWI images by the two diagnostic radiologists were better than those of the fFOV-DWI images(4.01±1.00 vs.3.60±1.01,4.25±0.95 vs.3.86±0.87),and the difference in image quality subjective scores between the two was statistically significant(P＜0.01).With the postoperative pathological T staging as the golden stand-ard,the overall accuracy of T staging evaluation using ZOOMit DWI by the two radiologists was higher than that of fFOV-DWI(0.644 vs.0.441,0.718 vs.0.435,P＜0.05).Further subgroup analysis showed that ZOOMit DWI was superior to fFOV-DWI in differentiating early gastric cancer(≤T2)from advanced gastric cancer(≥T3)and distinguishing serosa breakthrough(≥T4a)of advanced gastric cancer.Conclusion Compared with fFOV-DWI,ZOOMit DWI scanning has better image quality.Additionally,ZOOMit DWI can provide additional diagnostic value by improving the accuracy of preop-erative T staging of GC,which is of great significance for the diagnosis and treatment of GC patients.
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