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Barrett T, Lee KL, de Rooij M, Giganti F. Update on Optimization of Prostate MR Imaging Technique and Image Quality. Radiol Clin North Am 2024; 62:1-15. [PMID: 37973236 DOI: 10.1016/j.rcl.2023.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Prostate MR imaging quality has improved dramatically over recent times, driven by advances in hardware, software, and improved functional imaging techniques. MRI now plays a key role in prostate cancer diagnostic work-up, but outcomes of the MRI-directed pathway are heavily dependent on image quality and optimization. MR sequences can be affected by patient-related degradations relating to motion and susceptibility artifacts which may enable only partial mitigation. In this Review, we explore issues relating to prostate MRI acquisition and interpretation, mitigation strategies at a patient and scanner level, PI-QUAL reporting, and future directions in image quality, including artificial intelligence solutions.
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Affiliation(s)
- Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
| | - Kang-Lung Lee
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Maarten de Rooij
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands
| | - Francesco Giganti
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK; Division of Surgery and Interventional Science, University College London, London, UK
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Han Q, Lu Y, Wang D, Li X, Ruan Z, Mei N, Ji X, Geng D, Yin B. Glioblastomas with and without peritumoral fluid-attenuated inversion recovery (FLAIR) hyperintensity present morphological and microstructural differences on conventional MR images. Eur Radiol 2023; 33:9139-9151. [PMID: 37495706 DOI: 10.1007/s00330-023-09924-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 05/04/2023] [Accepted: 05/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Glioblastoma (GB) without peritumoral fluid-attenuated inversion recovery (FLAIR) hyperintensity is atypical and its characteristics are barely known. The aim of this study was to explore the differences in pathological and MRI-based intrinsic features (including morphologic and first-order features) between GBs with peritumoral FLAIR hyperintensity (PFH-bearing GBs) and GBs without peritumoral FLAIR hyperintensity (PFH-free GBs). METHODS In total, 155 patients with pathologically diagnosed GBs were retrospectively collected, which included 110 PFH-bearing GBs and 45 PFH-free GBs. The pathological and imaging data were collected. The Visually AcceSAble Rembrandt Images (VASARI) features were carefully evaluated. The first-order radiomics features from the tumor region were extracted from FLAIR, apparent diffusion coefficient (ADC), and T1CE (T1-contrast enhanced) images. All parameters were compared between the two groups of GBs. RESULTS The pathological data showed more alpha thalassemia/mental retardation syndrome X-linked (ATRX)-loss in PFH-free GBs compared to PFH-bearing ones (p < 0.001). Based on VASARI evaluation, PFH-free GBs had larger intra-tumoral enhancing proportion and smaller necrotic proportion (both, p < 0.001), more common non-enhancing tumor (p < 0.001), mild/minimal enhancement (p = 0.003), expansive T1/FLAIR ratio (p < 0.001) and solid enhancement (p = 0.009), and less pial invasion (p = 0.010). Moreover, multiple ADC- and T1CE-based first-order radiomics features demonstrated differences, especially the lower intensity heterogeneity in PFH-free GBs (for all, adjusted p < 0.05). CONCLUSIONS Compared to PFH-bearing GBs, PFH-free ones demonstrated less immature neovascularization and lower intra-tumoral heterogeneity, which would be helpful in clinical treatment stratification. CLINICAL RELEVANCE STATEMENT Glioblastomas without peritumoral FLAIR hyperintensity show less immature neovascularization and lower heterogeneity leading to potential higher treatment benefits due to less drug resistance and treatment failure. KEY POINTS • The study explored the differences between glioblastomas with and without peritumoral FLAIR hyperintensity. • Glioblastomas without peritumoral FLAIR hyperintensity showed less necrosis and contrast enhancement and lower intensity heterogeneity. • Glioblastomas without peritumoral FLAIR hyperintensity had less immature neovascularization and lower tumor heterogeneity.
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Affiliation(s)
- Qiuyue Han
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Yiping Lu
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China
| | - Dongdong Wang
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China
| | - Xuanxuan Li
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China
| | - Zhuoying Ruan
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China
| | - Nan Mei
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China
| | - Xiong Ji
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China.
- Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Research, Shanghai, China.
| | - Bo Yin
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, 200040, Shanghai, China.
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Dependence of apparent diffusion coefficient on slice position in magnetic resonance diffusion imaging. Magn Reson Imaging 2023; 99:41-47. [PMID: 36682397 DOI: 10.1016/j.mri.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE The position dependence of the apparent diffusion coefficient (ADC) in magnetic resonance imaging (MRI) by echo-planar imaging (EPI)- and turbo spin echo (TSE)-diffusion-weighted imaging (DWI) was assessed using phantoms. METHODS Six pure water-filled containers were placed parallel to the direction of the static magnetic field from the center of the magnetic field to the foot direction (five containers) and the head direction (one container). Six slice positions were set, and a cross-section image was scanned at the center of each container using a 1.5-T MRI scanner. Diffusion times for both EPI- and TSE-DWI were matched as much as possible. The slice thickness was adjusted to match the signal-to-noise ratio (SNR) at the center of the magnetic field for both sequences. A B1 map was analyzed. The ADC and SNR at each position of both sequences were tested using the Wilcoxon signed-rank test (P = 0.05) and compared using Friedman and Steel-Dwass multiple comparison tests (P = 0.05). Pearson correlation coefficients between ADC and SNR and between ADC and flip angle (FA) were calculated. RESULTS ADC decreased significantly with distance from the center of the magnetic field for both EPI-DWI and TSE-DWI (P < 0.05). TSE-ADC was significantly higher than EPI-ADC for all combinations (P < 0.01). Based on the Friedman test, the SNR of EPI- and TSE-DWI was significantly different and depended on the slice position (P < 0.01). The Pearson correlation coefficient between ADC and SNR was 0.78 in EPI-DWI and 0.60 in TSE-DWI, whereas that between ADC and FA was 0.97 in EPI-DWI and 0.94 in TSE-DWI. The FA decreased by 0.048 and 0.047° per mm from the center of the magnetic field to head and foot directions, respectively. CONCLUSION ADC depends on the slice position and decreases with an increase in distance from the magnetic field center. Caution should be taken when comparing and quantitatively evaluating the ADC at sites shifted in the long-axis direction.
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Lin Y, Yilmaz EC, Belue MJ, Turkbey B. Prostate MRI and image Quality: It is time to take stock. Eur J Radiol 2023; 161:110757. [PMID: 36870241 PMCID: PMC10493032 DOI: 10.1016/j.ejrad.2023.110757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023]
Abstract
Multiparametric magnetic resonance imaging (mpMRI) plays a vital role in prostate cancer diagnosis and management. With the increase in use of mpMRI, obtaining the best possible quality images has become a priority. The Prostate Imaging Reporting and Data System (PI-RADS) was introduced to standardize and optimize patient preparation, scanning techniques, and interpretation. However, the quality of the MRI sequences depends not only on the hardware/software and scanning parameters, but also on patient-related factors. Common patient-related factors include bowel peristalsis, rectal distension, and patient motion. There is currently no consensus regarding the best approaches to address these issues and improve the quality of mpMRI. New evidence has been accrued since the release of PI-RADS, and this review aims to explore the key strategies which aim to improve prostate MRI quality, such as imaging techniques, patient preparation methods, the new Prostate Imaging Quality (PI-QUAL) criteria, and artificial intelligence on prostate MRI quality.
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Affiliation(s)
- Yue Lin
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Enis C Yilmaz
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Mason J Belue
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Baris Turkbey
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
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Lee G, Oto A, Giurcanu M. Prostate MRI: Is Endorectal Coil Necessary?—A Review. Life (Basel) 2022; 12:life12040569. [PMID: 35455060 PMCID: PMC9030903 DOI: 10.3390/life12040569] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
To assess the necessity of endorectal coil use in 3 Tesla (T) prostate magnetic resonance imaging (MRI), a literature review comparing the image quality and diagnostic performance with an endorectal coil (ERC) and a without endorectal coil (NERC), with a phased array coil or a wearable perineal coil (WPC), was performed. A PubMed search of 3T prostate MRI using an endorectal coil for studies published until 31 July 2021 was performed. A total of 14 studies comparing 3T prostate MRI with and without endorectal coil use were identified. The quality scores and diagnostic performances were recorded for each study. In total, five studies compared image quality; five studies compared quality and performance; and four studies compared performance of detection, size of detected lesions, accuracy of cancer localization, and aggressiveness/staging. The use of an endorectal coil improved image quality with a higher overall signal to noise ratio, posterior and peripheral zone signal to noise ratio, high b-value attenuation diffusion coefficient (ADC) signal to noise ratio, and contrast to noise ratio. Endorectal coil use improved subjective image quality for anatomic detail on T2 weighted images (T2WI) and diffusion weighted images (DWI). Endorectal coil use had less motion artifact on DWI than non-endorectal coil use, but produced a higher occurrence of other artifacts on DWI. Endorectal coils had higher sensitivity, specificity, and positive predictive value (PPV) in the detection of overall and index lesions, as well as smaller and less aggressive lesions, missing fewer and smaller lesions than non-endorectal coils. Endorectal coils had higher sensitivity than non-endorectal coils in localizing and staging lesions. Endorectal coils improved quantitative and qualitative image quality and diagnostic performance in the detection of smaller and less aggressive cancers in 3T prostate MRI.
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Affiliation(s)
- Grace Lee
- Department of Radiology, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA;
- Correspondence:
| | - Aytekin Oto
- Department of Radiology, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA;
| | - Mihai Giurcanu
- Department of Public Health Sciences, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA;
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Prostate MRI using a rigid two-channel phased-array endorectal coil: comparison with phased array coil acquisition at 3 T. Cancer Imaging 2022; 22:15. [PMID: 35296357 PMCID: PMC8925156 DOI: 10.1186/s40644-022-00453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 02/27/2022] [Indexed: 11/27/2022] Open
Abstract
Background To compare image quality, lesion detection and patient comfort of 3T prostate MRI using a combined rigid two-channel phased-array endorectal coil and an external phased-array coil (ERC-PAC) compared to external PAC acquisition in the same patients. Methods Thirty three men (mean age 65.3y) with suspected (n = 15) or biopsy-proven prostate cancer (PCa, n = 18) were prospectively enrolled in this exploratory study. 3T prostate MRI including T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) was performed using an ERC-PAC versus PAC alone, in random order. Image quality, lesion detection and characterization (biparametric PI-RADSv2.1) were evaluated by 2 independent observers. Estimated signal-to-noise ratio (eSNR) was measured in identified lesions and the peripheral zone (PZ). Patient comfort was assessed using a questionnaire. Data were compared between sequences and acquisitions. Inter/intra-observer agreement for PI-RADS scores was evaluated. Results Twenty four prostate lesions (22 PCa) were identified in 20/33 men. Superior image quality was found for ERC-PAC compared to PAC for T2WI for one observer (Obs.1, p < 0.03) and high b-value DWI for both observers (p < 0.05). The sensitivity of PI-RADS for lesion detection for ERC-PAC and PAC acquisitions was 79.2 and 75% for Obs.1, and 79.1 and 66.7%, for Obs.2, without significant difference for each observer (McNemar p-values ≥0.08). Inter−/intra-observer agreement for PI-RADS scores was moderate-to-substantial (kappa = 0.52–0.84). Higher eSNR was observed for lesions and PZ for T2WI and PZ for DWI using ERC-PAC (p < 0.013). Most patients (21/33) reported discomfort at ERC insertion. Conclusion Despite improved image quality and eSNR using the rigid ERC-PAC combination, no significant improvement in lesion detection was observed, therefore not supporting the routine use of ERC for prostate MRI. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-022-00453-7.
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Takatsu Y, Nakamura M, Sagawa H, Suzuki Y, Mori N, Motegi S, Miyati T. Differences in apparent diffusion coefficients between normal brain echo-planar images and turbo spin-echo diffusion-weighted images with distortion correction. Eur J Radiol 2022; 149:110202. [DOI: 10.1016/j.ejrad.2022.110202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/17/2022] [Accepted: 02/07/2022] [Indexed: 11/03/2022]
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Alipour A, Viswanathan AN, Watkins RD, Elahi H, Loew W, Meyer E, Morcos M, Halperin HR, Schmidt EJ. An endovaginal MRI array with a forward-looking coil for advanced gynecological cancer brachytherapy procedures: Design and initial results. Med Phys 2021; 48:7283-7298. [PMID: 34520574 PMCID: PMC8817785 DOI: 10.1002/mp.15228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 08/20/2021] [Accepted: 09/04/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To develop an endovaginal MRI array that provides signal enhancement forward into the posterior parametrium and sideways into the vaginal wall, accelerating multiple-contrast detection of residual tumors that survive external beam radiation. The array's enclosure should form an obturator for cervical cancer brachytherapy, allowing integration with MRI-guided catheter placement, CT, and interstitial radiation dose delivery. METHODS The endovaginal array consisted of forward-looking and sideways-looking components. The forward-looking element imaged the cervix and posterior endometrium, and the sideways-looking elements imaged the vaginal wall. Electromagnetic simulation was performed to optimize the geometry of a forward-looking coil placed on a conductive-metallic substrate, extending the forward penetration above the coil's tip. Thereafter, an endovaginal array with one forward-looking coil and four sideways-looking elements was constructed and tested at 1.5 Tesla in saline and gel phantoms, and three sexually mature swine. Each coil's tuning, matching, and decoupling were optimized theoretically, implemented with electronic circuits, and validated with network-analyzer measurements. The array enclosure emulates a conventional brachytherapy obturator, allowing use of the internal imaging array together with tandem coils and interstitial catheters, as well as use of the enclosure alone during CT and radiation delivery. To evaluate the receive magnetic field ( B 1 - ) spatial profile, the endovaginal array's specific absorption-rate (SAR) distribution was simulated inside a gel ASTM phantom to determine extreme heating locations in advance of a heating test. Heating tests were then performed during high SAR imaging in a gel phantom at the predetermined locations, testing compliance with MRI safety standards. To assess array imaging performance, signal-to-noise-ratios (SNR) were calculated in a saline phantom and in vivo. Swine images were acquired with the endovaginal array combined with the scanner's body and spine arrays. RESULTS Simulated B 1 - profiles for the forward-looking lobe pattern, obtained while varying several geometric parameters, disclosed that a forward-looking coil placed on a metal-backed substrate could double the effective forward penetration from approximately 25 to ∼40 mm. An endovaginal array, enclosed in an obturator enclosure was then constructed, with all coils tuned, matched, and decoupled. The ASTM gel-phantom SAR test showed that peak local SAR was 1.2 W/kg in the forward-looking coil and 0.3 W/kg in the sideways-looking elements, well within ASTM/FDA/IEC guidelines. A 15-min 4 W/kg average SAR imaging experiment resulted in less than 2o C temperature increase, also within ASTM/FDA/IEC heating limits. In a saline phantom, the forward-looking coil and sideways-looking array's SNR was four to eight times, over a 20-30 mm field-of-view (FOV), and five to eight times, over a 15-25 mm FOV, relative to the spine array's SNR, respectively. In three sexually mature swine, the forward-looking coil provided a 5 + 0.2 SNR enhancement factor within the cervix and posterior endometrium, and the sideways-looking array provided a 4 + 0.2 SNR gain factor in the vaginal wall, relative to the Siemens spine array, demonstrating that the array could significantly reduce imaging time. CONCLUSIONS Higher SNR gynecological imaging is supported by forward-looking and sideways-looking coils. A forward-looking endovaginal coil for cervix and parametrium imaging was built with optimized metal backing. Array placement within an obturator enhanced integration with the brachytherapy procedure and accelerated imaging for detecting postexternal-beam residual tumors.
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Affiliation(s)
- Akbar Alipour
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA,Department of Radiology, Mount Sinai School of Medicine, New York, New York, USA
| | - Akila N. Viswanathan
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ronald D. Watkins
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Hassan Elahi
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wolfgang Loew
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Eric Meyer
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marc Morcos
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Henry R. Halperin
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ehud J. Schmidt
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA,Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA
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Parsai A, Zerizer I, Jan H, Kastler A, Subhan S, Balogh P, Nowosinska E, Thaha M, Miquel ME. Assessment of Apparent Diffusion Coefficients and SUVs as Predicators of Histological Differentiation in Anal Squamous Cell Carcinoma. Clin Nucl Med 2021; 46:783-789. [PMID: 34238797 DOI: 10.1097/rlu.0000000000003795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The study aims to assess minimal apparent diffusion coefficient (ADCmin) and SUVmax as predictors of histological differentiation in patients with anal squamous cell carcinoma (ASCC) and to determine cutoff values for each histopathological tumor grade. PATIENTS AND METHODS A retrospective study of 41 ASCC patients (14 males, 27 females; mean age, 65 ± 13 years) staged with FDG PET/CT and MRI (mean scan time interval, 21 ± 11 days). SUVmax and ADCmin values were measured and compared with histopathological tumor grading obtained from biopsy. RESULTS The mean size and tumor volume were 3 ± 2 cm and 16.5 ± 27.3 cm3, respectively. The mean ADCmin values for well-, moderately, and poorly differentiated ASCC were 935 ± 179, 896 ± 123, and 637 ± 114, respectively. The mean SUVmax for well-, moderately, and poorly differentiated ASCC were 6.9 ± 1.8, 11.5 ± 4.1, and 13.4 ± 2.6, respectively. The difference in mean ADCmin values between poorly and moderately/well-differentiated tumors was statistically significant, whereas this was not significant between moderately and well-differentiated tumors. Differences in SUVmax values were statistically significant between poorly/moderately and well-differentiated tumors, whereas there was no statistical significance between poorly and moderately differentiated tumors. By combining the 2 modalities using cutoff values of 675 × 10-6 mm2·s-1 for ADCmin and 8.5 for SUVmax, it was possible to differentiate the tumor categories with a sensitivity, specificity, positive predictive value, and negative predictive value, respectively, of 84.6%, 96.4%, 91.7%, and 93.1% for well-differentiated ASCC, 76.5%, 87.5%, 81.3%, and 84% for moderately, and 90.9%, 89.3%, 76.9%, and 96.2% for poorly differentiated ASCC, respectively. CONCLUSIONS ADCmin and SUVmax values correlated with the degree of differentiation in ASCC and can be used as predictors of tumor grading and aggressiveness. Combined ADCmin and SUVmax cutoff values can therefore be used for early patient risk stratification and treatment decision making.
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Affiliation(s)
| | | | - Hikmat Jan
- Barts Health NHS Trust, London, United Kingdom
| | | | - Sana Subhan
- Barts Health NHS Trust, London, United Kingdom
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Hu L, Zhou DW, Fu CX, Benkert T, Xiao YF, Wei LM, Zhao JG. Calculation of Apparent Diffusion Coefficients in Prostate Cancer Using Deep Learning Algorithms: A Pilot Study. Front Oncol 2021; 11:697721. [PMID: 34568027 PMCID: PMC8458902 DOI: 10.3389/fonc.2021.697721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background Apparent diffusion coefficients (ADCs) obtained with diffusion-weighted imaging (DWI) are highly valuable for the detection and staging of prostate cancer and for assessing the response to treatment. However, DWI suffers from significant anatomic distortions and susceptibility artifacts, resulting in reduced accuracy and reproducibility of the ADC calculations. The current methods for improving the DWI quality are heavily dependent on software, hardware, and additional scan time. Therefore, their clinical application is limited. An accelerated ADC generation method that maintains calculation accuracy and repeatability without heavy dependence on magnetic resonance imaging scanners is of great clinical value. Objectives We aimed to establish and evaluate a supervised learning framework for synthesizing ADC images using generative adversarial networks. Methods This prospective study included 200 patients with suspected prostate cancer (training set: 150 patients; test set #1: 50 patients) and 10 healthy volunteers (test set #2) who underwent both full field-of-view (FOV) diffusion-weighted imaging (f-DWI) and zoomed-FOV DWI (z-DWI) with b-values of 50, 1,000, and 1,500 s/mm2. ADC values based on f-DWI and z-DWI (f-ADC and z-ADC) were calculated. Herein we propose an ADC synthesis method based on generative adversarial networks that uses f-DWI with a single b-value to generate synthesized ADC (s-ADC) values using z-ADC as a reference. The image quality of the s-ADC sets was evaluated using the peak signal-to-noise ratio (PSNR), root mean squared error (RMSE), structural similarity (SSIM), and feature similarity (FSIM). The distortions of each ADC set were evaluated using the T2-weighted image reference. The calculation reproducibility of the different ADC sets was compared using the intraclass correlation coefficient. The tumor detection and classification abilities of each ADC set were evaluated using a receiver operating characteristic curve analysis and a Spearman correlation coefficient. Results The s-ADCb1000 had a significantly lower RMSE score and higher PSNR, SSIM, and FSIM scores than the s-ADCb50 and s-ADCb1500 (all P < 0.001). Both z-ADC and s-ADCb1000 had less distortion and better quantitative ADC value reproducibility for all the evaluated tissues, and they demonstrated better tumor detection and classification performance than f-ADC. Conclusion The deep learning algorithm might be a feasible method for generating ADC maps, as an alternative to z-ADC maps, without depending on hardware systems and additional scan time requirements.
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Affiliation(s)
- Lei Hu
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Da Wei Zhou
- State Key Laboratory of Integrated Services Networks, School of Telecommunications Engineering, Xidian University, Xi'an, China
| | - Cai Xia Fu
- Magnetic Resonance (MR) Application Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Yun Feng Xiao
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Li Ming Wei
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jun Gong Zhao
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Ullrich T, Kohli MD, Ohliger MA, Magudia K, Arora SS, Barrett T, Bittencourt LK, Margolis DJ, Schimmöller L, Turkbey B, Westphalen AC. Quality Comparison of 3 Tesla multiparametric MRI of the prostate using a flexible surface receiver coil versus conventional surface coil plus endorectal coil setup. Abdom Radiol (NY) 2020; 45:4260-4270. [PMID: 32696213 PMCID: PMC7716937 DOI: 10.1007/s00261-020-02641-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/21/2020] [Accepted: 07/04/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To subjectively and quantitatively compare the quality of 3 Tesla magnetic resonance imaging of the prostate acquired with a novel flexible surface coil (FSC) and with a conventional endorectal coil (ERC). METHODS Six radiologists independently reviewed 200 pairs of axial, high-resolution T2-weighted and diffusion-weighted image data sets, each containing one examination acquired with the FSC and one with the ERC, respectively. Readers selected their preferred examination from each pair and assessed every single examination using six quality criteria on 4-point scales. Signal-to-noise ratios were measured and compared. RESULTS Two readers preferred FSC acquisition (36.5-45%) over ERC acquisition (13.5-15%) for both sequences combined, and four readers preferred ERC acquisition (41-46%). Analysis of pooled responses for both sequences from all readers shows no significant preference for FSC or ERC. Analysis of the individual sequences revealed a pooled preference for the FSC in T2WI (38.7% vs 17.8%) and for the ERC in DWI (50.9% vs 19.6%). Patients' weight was the only weak predictor of a preference for the ERC acquisition (p = 0.04). SNR and CNR were significantly higher in the ERC acquisitions (p<0.001) except CNR differentiating tumor lesions from benign prostate (p=0.1). CONCLUSION Although readers have strong individual preferences, comparable subjective image quality can be obtained for prostate MRI with an ERC and the novel FSC. ERC imaging might be particularly valuable for sequences with inherently lower SNR as DWI and larger patients whereas the FSC is generally preferred in T2WI. FSC imaging generates a lower SNR than with an ERC.
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Affiliation(s)
- T Ullrich
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225, Dusseldorf, Germany.
| | - M D Kohli
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - M A Ohliger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - K Magudia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - S S Arora
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - T Barrett
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- CamPARI Prostate Cancer Group, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - L K Bittencourt
- DASA Company, São Paulo, Brazil
- Department of Radiology, Fluminense Federal University (UFF), Niterói, Rio De Janeiro, Brazil
| | - D J Margolis
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - L Schimmöller
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225, Dusseldorf, Germany
| | - B Turkbey
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - A C Westphalen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, CA, USA
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12
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Kaye EA, Aherne EA, Duzgol C, Häggström I, Kobler E, Mazaheri Y, Fung MM, Zhang Z, Otazo R, Vargas HA, Akin O. Accelerating Prostate Diffusion-weighted MRI Using a Guided Denoising Convolutional Neural Network: Retrospective Feasibility Study. Radiol Artif Intell 2020; 2:e200007. [PMID: 33033804 DOI: 10.1148/ryai.2020200007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/29/2020] [Accepted: 05/06/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the feasibility of accelerating prostate diffusion-weighted imaging (DWI) by reducing the number of acquired averages and denoising the resulting image using a proposed guided denoising convolutional neural network (DnCNN). MATERIALS AND METHODS Raw data from the prostate DWI scans were retrospectively gathered between July 2018 and July 2019 from six single-vendor MRI scanners. There were 103 datasets used for training (median age, 64 years; interquartile range [IQR], 11), 15 for validation (median age, 68 years; IQR, 12), and 37 for testing (median age, 64 years; IQR, 12). High b-value diffusion-weighted (hb DW) data were reconstructed into noisy images using two averages and reference images using all 16 averages. A conventional DnCNN was modified into a guided DnCNN, which uses the low b-value DW image as a guidance input. Quantitative and qualitative reader evaluations were performed on the denoised hb DW images. A cumulative link mixed regression model was used to compare the readers' scores. The agreement between the apparent diffusion coefficient (ADC) maps (denoised vs reference) was analyzed using Bland-Altman analysis. RESULTS Compared with the original DnCNN, the guided DnCNN produced denoised hb DW images with higher peak signal-to-noise ratio (32.79 ± 3.64 [standard deviation] vs 33.74 ± 3.64), higher structural similarity index (0.92 ± 0.05 vs 0.93 ± 0.04), and lower normalized mean square error (3.9% ± 10 vs 1.6% ± 1.5) (P < .001 for all). Compared with the reference images, the denoised images received higher image quality scores from the readers (P < .0001). The ADC values based on the denoised hb DW images were in good agreement with the reference ADC values (mean ADC difference ranged from -0.04 to 0.02 × 10-3 mm2/sec). CONCLUSION Accelerating prostate DWI by reducing the number of acquired averages and denoising the resulting image using the proposed guided DnCNN is technically feasible. Supplemental material is available for this article. © RSNA, 2020.
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Affiliation(s)
- Elena A Kaye
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Emily A Aherne
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Cihan Duzgol
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Ida Häggström
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Erich Kobler
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Yousef Mazaheri
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Maggie M Fung
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Zhigang Zhang
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Ricardo Otazo
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Hebert A Vargas
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
| | - Oguz Akin
- Departments of Medical Physics (E.A.K., I.H., Y.M., R.O.), Radiology (E.A.A., C.D., R.O., H.A.V., O.A.), and Epidemiology and Biostatistics (Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S1212B, New York, NY 10065; Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria (E.K.); and MR Applications & Workflow Team, GE Healthcare, Chicago, Ill (M.M.F.)
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Bjurlin MA, Carroll PR, Eggener S, Fulgham PF, Margolis DJ, Pinto PA, Rosenkrantz AB, Rubenstein JN, Rukstalis DB, Taneja SS, Turkbey B. Update of the Standard Operating Procedure on the Use of Multiparametric Magnetic Resonance Imaging for the Diagnosis, Staging and Management of Prostate Cancer. J Urol 2020; 203:706-712. [PMID: 31642740 PMCID: PMC8274953 DOI: 10.1097/ju.0000000000000617] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE We update the prior standard operating procedure for magnetic resonance imaging of the prostate, and summarize the available data about the technique and clinical use for the diagnosis and management of prostate cancer. This update includes practical recommendations on the use of magnetic resonance imaging for screening, diagnosis, staging, treatment and surveillance of prostate cancer. MATERIALS AND METHODS A panel of clinicians from the American Urological Association and Society of Abdominal Radiology with expertise in the diagnosis and management of prostate cancer evaluated the current published literature on the use and technique of magnetic resonance imaging for this disease. When adequate studies were available for analysis, recommendations were made on the basis of data and when adequate studies were not available, recommendations were made on the basis of expert consensus. RESULTS Prostate magnetic resonance imaging should be performed according to technical specifications and standards, and interpreted according to standard reporting. Data support its use in men with a previous negative biopsy and ongoing concerns about increased risk of prostate cancer. Sufficient data now exist to support the recommendation of magnetic resonance imaging before prostate biopsy in all men who have no history of biopsy. Currently, the evidence is insufficient to recommend magnetic resonance imaging for screening, staging or surveillance of prostate cancer. CONCLUSIONS Use of prostate magnetic resonance imaging in the risk stratification, diagnosis and treatment pathway of men with prostate cancer is expanding. When quality prostate imaging is obtained, current evidence now supports its use in men at risk of harboring prostate cancer and who have not undergone a previous biopsy, as well as in men with an increasing prostate specific antigen following an initial negative standard prostate biopsy procedure.
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Affiliation(s)
- Marc A Bjurlin
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Peter R Carroll
- University of California San Francisco, San Francisco, California
| | - Scott Eggener
- University of Chicago Medical Center, Chicago, Illinois
| | - Pat F Fulgham
- Texas Health Presbyterian Hospital of Dallas, Dallas, Texas
| | | | - Peter A Pinto
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | - Baris Turkbey
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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MRI of the Prostate With and Without Endorectal Coil at 3 T: Correlation With Whole-Mount Histopathologic Gleason Score. AJR Am J Roentgenol 2020; 215:133-141. [PMID: 32160050 DOI: 10.2214/ajr.19.22094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this article is to prospectively compare image quality and diagnostic accuracy of clinically significant prostate cancer with and without endorectal coil (ERC) at 3 T using a combination of T2-weighted and diffusion-weighted MRI. SUBJECTS AND METHODS. Twenty-three patients with biopsy-proven prostate cancer underwent MRI with and without ERC at the same visit. Patients subsequently underwent radical prostatectomy. Specimens were assessed by whole-mount histopathologic examination. Two radiologists reviewed MR images for image quality (5-point scale) and disease using Prostate Imaging Reporting and Data Systems version 2 (PI-RADSv2). Sensitivity, specificity, and area under the ROC curve (AUC) were calculated with and without ERC. Additionally, apparent diffusion coefficient (ADC) was correlated with Gleason score and ADC values of each lesion were compared with and without ERC. RESULTS. Image quality was comparable with and without ERC (3.8 vs 3.5). Twenty-nine cancer foci larger than 0.5 cm in diameter were found in 23 patients on histopathologic examination; 18 tumors had a Gleason score of 7 or greater. Two radiologists recorded AUC for tumors with a Gleason score of 7 or greater as 0.96 and 0.96 with ERC and 0.88 and 0.91 without ERC. All 13 tumors with a Gleason score of 3 + 4 were detected with ERC, but only 9 were detected without ERC. One of five tumors with Gleason scores less than 3 + 4 was missed with and without ERC. ADC significantly correlated with Gleason score. There was no significant difference in the ADC of a lesion on MRI with and without an ERC. CONCLUSION. MRI with and without ERC was equally accurate at showing prostate cancers with Gleason scores of 4 + 3 or greater. However, MRI with ERC was superior at showing cancer with a Gleason score of 3 + 4. There was no significant difference in ADC values between scores acquired with or without an ERC.
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15
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Hectors SJ, Said D, Gnerre J, Tewari A, Taouli B. Luminal Water Imaging: Comparison With Diffusion-Weighted Imaging (DWI) and PI-RADS for Characterization of Prostate Cancer Aggressiveness. J Magn Reson Imaging 2020; 52:271-279. [PMID: 31961049 DOI: 10.1002/jmri.27050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Luminal water imaging (LWI), a multicomponent T2 mapping technique, has shown promise for prostate cancer (PCa) detection and characterization. PURPOSE To 1) quantify LWI parameters and apparent diffusion coefficient (ADC) in PCa and benign peripheral zone (PZ) tissues; and 2) evaluate the diagnostic performance of LWI, ADC, and PI-RADS parameters for differentiation between low- and high-grade PCa lesions. STUDY TYPE Prospective. SUBJECTS Twenty-six PCa patients undergoing prostatectomy (mean age 59 years, range 46-72 years). FIELD STRENGTH/SEQUENCE Multiparametric MRI at 3.0T, including diffusion-weighted imaging (DWI) and LWI T2 mapping. ASSESSMENT LWI parameters and ADC were quantified in index PCa lesions and benign PZ. STATISTICAL TESTS Differences in MRI parameters between PCa and benign PZ were assessed using Wilcoxon signed tests. Spearman correlation of pathological grade group (GG) with LWI parameters, ADC, and PI-RADS was evaluated. The utility of each of the parameters for differentiation between low-grade (GG ≤2) and high-grade (GG ≥3) PCa was determined by Mann-Whitney U tests and ROC analyses. RESULTS Twenty-six index lesions were analyzed (mean size 1.7 ± 0.8 cm, GG: 1 [n = 1; 4%], 2 [n = 14, 54%], 3 [n = 8, 31%], 5 [n = 3, 12%]). LWI parameters and ADC both showed high diagnostic performance for differentiation between benign PZ and PCa (highest area under the curve [AUC] for LWI parameter T2,short [AUC = 0.98, P < 0.001]). The LWI parameters luminal water fraction (LWF) and amplitude of long T2 component Along significantly correlated with GG (r = -0.441, P = 0.024 and r = -0.414, P = 0.036, respectively), while PI-RADS, ADC, and the other LWI parameters did not (P = 0.132-0.869). LWF and Along also showed significant differences between low-grade and high-grade PCa (AUC = 0.776, P = 0.008 and AUC = 0.758, P = 0.027, respectively). Maximum diagnostic performance for discrimination of high-grade PCa was found with combined LWI parameters (AUC 0.891, P = 0.001). DATA CONCLUSION LWI parameters, in particular in combination, showed superior diagnostic performance for differentiation between low-grade and high-grade PCa compared to ADC and PI-RADS assessment. J. Magn. Reson. Imaging 2020;52:271-279.
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Affiliation(s)
- Stefanie J Hectors
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Daniela Said
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Universidad de los Andes, Santiago, Chile
| | - Jeffrey Gnerre
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashutosh Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bachir Taouli
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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16
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Sumikawa T, Yabuuchi H, Sumikawa C, Nakashima Y, Miura G. Influence of blade width and magnetic field strength on the ADC on PROPELLER DWI in head and neck. Neuroradiol J 2019; 33:39-47. [PMID: 31407966 DOI: 10.1177/1971400919870178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the influence of blade width and magnetic field strength on apparent diffusion coefficient values of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted imaging in the head and neck at 1.5 and 3.0 T magnetic resonance imaging. METHODS Fifteen healthy volunteers (eight men and seven women; mean age 36.4 ± 10.1 years) underwent PROPELLER diffusion-weighted imaging using four blade widths at 3.0 T and three blade widths at 1.5 T. For the multigroup comparison of apparent diffusion coefficient values, we performed analysis of variance and Tukey-Kramer tests. The apparent diffusion coefficient values in each organ were compared among the different blade widths and magnetic field strengths by a t test. Inter and intra-observer agreements regarding apparent diffusion coefficient value measurements were evaluated using the intraclass correlation coefficient. RESULTS No significant differences were observed in apparent diffusion coefficient values of the cerebellum in each blade width at both field strengths. The apparent diffusion coefficient values of the right parotid glands were significantly lower for blade width 32 than for blade width 16 at 3.0 T (1.16 × 10-3 mm2/s vs. 1.01 × 10-3 mm2/s; P < 0.05). The apparent diffusion coefficient values of bilateral parotid glands were significantly higher at 1.5 T than at 3.0 T. Intraclass correlation coefficients were almost perfect to substantial in the cerebellum, whereas they showed moderate agreement in the parotid glands. CONCLUSION The largest blade width 32 at 3.0 T and high magnetic field strength lowered the apparent diffusion coefficient values of parotid glands of PROPELLER diffusion-weighted imaging. The apparent diffusion coefficient values in the parotid glands of PROPELLER diffusion-weighted imaging may be affected for blade width and magnetic field strength.
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Affiliation(s)
- Tetsuo Sumikawa
- Department of Radiology, Yamaguchi Prefectural Grand Medical Center, Japan.,Department of Health Sciences, Kyushu University, Japan
| | | | - Chiharu Sumikawa
- Department of Radiology, Yamaguchi Prefectural Grand Medical Center, Japan
| | | | - Gouji Miura
- Department of Health Sciences, Kyushu University, Japan
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17
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Dias JL, Bilhim T. Modern imaging and image-guided treatments of the prostate gland: MR and ablation for cancer and prostatic artery embolization for benign prostatic hyperplasia. BJR Open 2019; 1:20190019. [PMID: 33178947 PMCID: PMC7592499 DOI: 10.1259/bjro.20190019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/04/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Multiparametric MRI (mpMRI) has proven to be an essential tool for diagnosis, post-treatment follow-up, aggressiveness assessment, and active surveillance of prostate cancer. Currently, this imaging technique is part of the daily practice in many oncological centres. This manuscript aims to review the use of mpMRI in the set of prostatic diseases, either malignant or benign: mpMRI to detect and stage prostate cancer is discussed, as well as its use for active surveillance. Image-guided ablation techniques for prostate cancer are also reviewed. The need to establish minimum acceptable technical parameters for prostate mpMRI, standardize reports, uniform terminology for describing imaging findings, and develop assessment categories that differentiate levels of suspicion for clinically significant prostate cancer led to the development of the Prostate Imaging Reporting and Data System that is reviewed. Special focus will also be given on the most up-to-date evidence of prostatic artery embolization (PAE) for symptomatic benign prostatic hyperplasia (BPH). Management of patients with BPH, technical aspects of PAE, expected outcomes and level of evidence are reviewed with the most recent literature. PAE is a challenging technique that requires dedicated anatomical knowledge and comprehensive embolization skills. PAE has been shown to be an effective minimally-invasive treatment option for symptomatic BPH patients, that can be viewed between medical therapy and surgery. PAE may be a good option for symptomatic BPH patients that do not want to be operated and can obviate the need for prostatic surgery in up to 80% of treated patients.
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18
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Zhong X, Dale BM, Nickel MD, Kannengiesser SAR, Kiefer B, Bashir M. Improved accuracy of apparent diffusion coefficient quantification using a fully automatic noise bias compensation method: Preliminary evaluation in prostate diffusion weighted imaging. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2019; 305:22-30. [PMID: 31158792 DOI: 10.1016/j.jmr.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/11/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
Noise in diffusion magnetic resonance imaging can introduce bias in apparent diffusion coefficient (ADC) quantification. Previous studies proposed methods that are site-specific techniques as research tools with limited availability and typically require manual intervention, not completely ready to use in the clinical environment. The purpose of this study was to develop a fully automatic computational method to correct noise bias in ADC quantification and perform a preliminary evaluation in the clinical prostate diffusion weighted imaging (DWI). Using a pseudo replica approach for the noise map calculation as well as a direct mapping and a stepwise Chebychev polynomial modelling approach for the ADC fitting, a fully automatic noise-bias-compensated ADC calculation method was proposed and implemented both on the scanner and offline. The proposed method was validated in a computer simulation and a standardized diffusion phantom with ground-truth values. Two in vivo studies were performed to evaluate the proposed method in the clinical environment. The first in vivo study performed acquisitions using a clinically routine prostate DWI protocol on 29 subjects to evaluate the consistency between simulated and empirical results. In the second in vivo study, prostate ADC values of 14 subjects were compared between data acquired with external coils only and reconstructed with the proposed method vs. acquired with external combined with endorectal coils and reconstructed with the conventional method. In statistical analyses, p < 0.05 was regarded as significantly different. In the computer simulation, the proposed method showed smaller error percentage than the other methods and was significantly different (p < 2.2 × 10-16). With low signal-to-noise ratio (SNR), the conventional method underestimated ADC values compared to the ground truth values of the diffusion phantom, while the results of the proposed method were more consistent with the ground truth values. Statistical analyses showed no significant differences between measured and simulated results in the first in vivo study (p = 0.5618). Data from the second in vivo study showed that agreement between ADC measured with external coils only and combined coils was improved for the proposed method (mean bias: 0.04 × 10-3 mm2/s, 95% confidence interval (CI) = [-0.01, 0.09] × 10-3 mm2/s, p = 0.187), compared to the conventional method (mean bias: -0.12 × 10-3 mm2/s, 95% CI = [-0.17, -0.06] × 10-3 mm2/s, p < 0.0001). The proposed method compensates noise bias in low-SNR diffusion-weighted acquisitions and results show improved ADC quantification accuracy in the prostate. This method may be suitable for both clinical imaging and research utilizing ADC quantification.
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Affiliation(s)
- Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Los Angeles, CA, United States.
| | - Brian M Dale
- MR R&D Collaborations, Siemens Healthcare, Cary, NC, United States
| | - Marcel D Nickel
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | | | - Berthold Kiefer
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Mustafa Bashir
- Department of Radiology, Duke University Medical Center, Durham, NC, United States; Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC, United States
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O’Donohoe RL, Dunne RM, Kimbrell V, Tempany CM. Prostate MRI using an external phased array wearable pelvic coil at 3T: comparison with an endorectal coil. Abdom Radiol (NY) 2019; 44:1062-1069. [PMID: 30324501 DOI: 10.1007/s00261-018-1804-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate T2w and DWI image quality using a wearable pelvic coil (WPC) compared with an endorectal coil (ERC). METHODS Twenty men consecutively presenting to our prostate cancer MRI clinic were prospectively consented to be scanned using a wearable pelvic coil then an endorectal coil and pelvic phased array coil at 3T. Eighteen patients were suitable for inclusion. Axial T2w images were obtained using the WPC and ERC, and DWI images were obtained using the WPC, ERC, and PPA. Analysis was performed in consensus by two readers with experience in prostate MRI. The readers scored the T2w images using six qualitative criteria and the DWI images using five criteria. Signal-to-noise ratio (SNR) was also measured. RESULTS T2w artifact severity was greater for an ERC than a WPC (p = 0.003). There was no significant difference in T2w qualititatve image quality by other measures. The distinction of zonal anatomy on DWI was superior for an ERC compared with both a WPC and a PPA (p = 0.018 and p < 0.001 respectively), and there was no significant difference in DWI image quality by other measures. SNR was significantly higher for ERC imaging for both T2w and DWI. CONCLUSION WPC imaging provides comparable image quality to that of an ERC, potentially reducing the need for an ERC. WPC imaging shows reduced T2w artifact severity and inferior DWI zonal anatomy distinction compared with an ERC. Imaging with a WPC produces a lower SNR than an ERC.
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20
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New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer? Abdom Radiol (NY) 2018; 43:702-712. [PMID: 28721479 DOI: 10.1007/s00261-017-1255-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Our objective is to determine the accuracy of multiparametric MRI (mpMRI) in predicting pathologic grade of prostate cancer (PCa) after radical prostatectomy (RP) using simple apparent diffusion coefficient metrics and, specifically, whether mpMRI can accurately separate disease into one of two risk categories (low vs. higher grade) or one of three risk categories (low, intermediate, or high grade) corresponding to the new prognostic grade group (PGG) criteria. METHODS This retrospective, HIPAA-compliant, IRB-approved study included 140 patients with PCa who underwent 3 T mpMRI with endorectal coil and transrectal ultrasound-guided (TRUS-G) biopsy before RP. MpMRI was used to classify lesions using a two-tier (low-grade/PGG 1 vs. high-grade/PGG 2-5) or a three-tier system (low-grade/PGG 1 vs. intermediate-grade/PGG 2 vs. high-grade/PGG 3-5). Accuracy of mpMRI was compared against RP for each system. RESULTS The predictive accuracy of mpMRI using the two-tier system is higher than when using three-tier system (0.77 and 0.45, respectively). There were similar rates of undergrading between mpMRI and TRUS-G biopsy compared to RP (16% & 21%; respectively); rate of overgrading was higher for mpMRI vs. TRUS-G biopsy compared to RP (42% & 17%, respectively). When mpMRI and TRUS-G biopsy are combined, rate of undergrading is 1.4% and overgrading is 11%. CONCLUSIONS MpMRI predictive accuracy is higher when using a two-tier vs. a three-tier system, suggesting that advanced metrics may be necessary to delineate intermediate- from high-grade disease. Rates of under- and overgrading decreased when mpMRI and TRUS-G biopsy are combined, suggesting that these techniques may be complementary in predicting tumor grade.
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Fulgham PF, Rukstalis DB, Turkbey IB, Rubenstein JN, Taneja S, Carroll PR, Pinto PA, Bjurlin MA, Eggener S. AUA Policy Statement on the Use of Multiparametric Magnetic Resonance Imaging in the Diagnosis, Staging and Management of Prostate Cancer. J Urol 2017; 198:832-838. [PMID: 28483574 DOI: 10.1016/j.juro.2017.04.101] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE We summarize the available data about the clinical and economic effectiveness of magnetic resonance imaging in the diagnosis and management of prostate cancer, and provide practical recommendations for its use in the screening, diagnosis, staging and surveillance of prostate cancer. MATERIALS AND METHODS A panel of clinicians with expertise in the diagnosis and management of prostate cancer evaluated the current published literature on the use and effectiveness of magnetic resonance imaging for this disease. When adequate studies were available for analysis, recommendations were made on the basis of data and when adequate studies were not available, recommendations were made on the basis of expert consensus. RESULTS At this time the data support the use of magnetic resonance imaging in patients with a previous negative biopsy and ongoing concerns about increased risk of prostate cancer. The data regarding its usefulness for initial biopsy suggest a possible role for magnetic resonance imaging in some circumstances. There is currently insufficient evidence to recommend magnetic resonance imaging for screening, staging or surveillance of prostate cancer. CONCLUSIONS Although it adds cost to the management of prostate cancer, magnetic resonance imaging offers superior anatomic detail, and the ability to evaluate cellular density based on water diffusion and blood flow based on contrast enhancement. Imaging targeted biopsy may increase the diagnosis of clinically significant cancers by identifying specific lesions not visible on conventional ultrasound. The clinical indications for the use of magnetic resonance imaging in the management of prostate cancer are rapidly evolving.
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Affiliation(s)
- Pat F Fulgham
- Texas Health Presbyterian Hospital of Dallas, Dallas, Texas.
| | | | | | | | | | - Peter R Carroll
- University of California San Francisco, San Francisco, Calfornia
| | - Peter A Pinto
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Scott Eggener
- The University of Chicago Medical Center, Chicago, Illinois
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DCE-MRI, DW-MRI, and MRS in Cancer: Challenges and Advantages of Implementing Qualitative and Quantitative Multi-parametric Imaging in the Clinic. Top Magn Reson Imaging 2017; 25:245-254. [PMID: 27748710 PMCID: PMC5081190 DOI: 10.1097/rmr.0000000000000103] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Multi-parametric magnetic resonance imaging (mpMRI) offers a unique insight into tumor biology by combining functional MRI techniques that inform on cellularity (diffusion-weighted MRI), vascular properties (dynamic contrast-enhanced MRI), and metabolites (magnetic resonance spectroscopy) and has scope to provide valuable information for prognostication and response assessment. Challenges in the application of mpMRI in the clinic include the technical considerations in acquiring good quality functional MRI data, development of robust techniques for analysis, and clinical interpretation of the results. This article summarizes the technical challenges in acquisition and analysis of multi-parametric MRI data before reviewing the key applications of multi-parametric MRI in clinical research and practice.
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23
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Improved performance of prostate DCE-MRI using a 32-coil vs. 12-coil receiver array. Magn Reson Imaging 2017; 39:15-23. [PMID: 28132859 DOI: 10.1016/j.mri.2017.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 01/24/2017] [Accepted: 01/24/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE To assess whether acquisition with 32 receiver coils rather than the vendor-recommended 12 coils provides significantly improved performance in 3D dynamic contrast-enhanced MRI (DCE-MRI) of the prostate. MATERIALS The study was approved by the institutional review board and was compliant with HIPAA. 50 consecutive male patients in whom prostate MRI was clinically indicated were prospectively imaged in March 2015 with an accelerated DCE-MRI sequence in which image reconstruction was performed using 12 and 32 coil elements. The two reconstructions were compared quantitatively and qualitatively. The first was done using signal-to-noise ratio (SNR) and g-factor analysis to assess sensitivity to acceleration. The second was done using a five-point scale by two experienced radiologists using criteria of perceived SNR, artifact, sharpness, and overall preference. Significance was assessed with the Wilcoxon signed rank test. Extension to T2-weighted spin-echo and diffusion sequences was assessed in phantom studies. RESULTS Reconstruction using 32 vs. 12 coil elements provided improved performance in DCE-MRI based on intrinsic SNR (18% higher) and g-factor statistics (14% higher), with a median 32% higher overall SNR within the prostate volume over all subjects. Reconstruction using 32 coils was qualitatively rated significantly improved (p<0.001) vs. 12 coils on the basis of perceived SNR and radiologist preference and equivalent for sharpness and artifact. Phantom studies suggested the improvement in intrinsic SNR could extend to T2-weighted spin-echo and diffusion sequences. CONCLUSIONS Reconstruction of 3D accelerated DCE-MRI studies of the prostate using 32 independent receiver coils provides improved overall performance vs. using 12 coils.
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Comparison of image quality and patient discomfort in prostate MRI: pelvic phased array coil vs. endorectal coil. Abdom Radiol (NY) 2016; 41:2218-2226. [PMID: 27369051 DOI: 10.1007/s00261-016-0819-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To compare image quality (IQ) and patient discomfort during prostate MRI using a pelvic phased array (PPA) coil and an endorectal (ER) coil. MATERIALS AND METHODS Ninety-eight patients (median age, 65.7; range 42.1-78.1) underwent prostate MRI on a 3T scanner including T2w and DWI acquired with PPA and an ER coil within the same exam. Acquisition time was kept similar for both acquisitions. Two radiologists evaluated aspects of IQ on a 5-point Likert scale and classified image artifacts. All patients completed a questionnaire on discomfort/pain regarding the ER coil using a visual analogue scale from 1 to 10. RESULTS There was no significant difference in overall IQ for T2w images for both readers (reader 1, 3.27 ± 0.91 and 3.07 ± 0.84, p = 0.057; reader 2, 3.70 ± 0.75 and 3.77 ± 0.81, p = 0.555) for PPA and ER coils, respectively. Overall IQ for DWI acquired with PPA and ER coils was rated similar by reader 1 (3.03 ± 1.10 and 3.08 ± 0.80, respectively, (p = 0.67)), while reader 2 preferred ER coil images (3.27 ± 0.81 and 3.66 ± 0.85 (p < 0.05)). Susceptibility artifacts were more frequent in ER than in PPA coil images (109 vs. 75). Discomfort and pain experienced during insertion of the ER coil was low altogether (VAS score, 3.5 ± 2.1 for "discomfort" and 2.4 ± 2.4 for "pain"). CONCLUSION T2-weighted images may be acquired with comparable IQ using a PPA coil as compared to an ER coil, while DWI images showed better IQ using the ER coil for one of two readers. The insertion of the ER coil caused low to moderate discomfort and pain in patients.
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Starobinets O, Korn N, Iqbal S, Noworolski SM, Zagoria R, Kurhanewicz J, Westphalen AC. Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation. Abdom Radiol (NY) 2016; 41:817-30. [PMID: 27193785 DOI: 10.1007/s00261-015-0590-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The use of multiparametric MRI scans for the evaluation of men with prostate cancer has increased dramatically and is likely to continue expanding as new developments come to practice. However, it has not yet gained the same level of acceptance of other imaging tests. Partly, this is because of the use of suboptimal protocols, lack of standardization, and inadequate patient preparation. In this manuscript, we describe several practical aspects of prostate MRI that may facilitate the implementation of new prostate imaging programs or the expansion of existing ones.
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Affiliation(s)
- Olga Starobinets
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Natalie Korn
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Sonam Iqbal
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Susan M Noworolski
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Ronald Zagoria
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, M372, Box 0628, San Francisco, CA, 94143, USA
| | - John Kurhanewicz
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 1700 4th Street, Ste. 203, San Francisco, CA, 94158, USA
| | - Antonio C Westphalen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, M372, Box 0628, San Francisco, CA, 94143, USA.
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Ream JM, Glielmi C, Lazar M, Campbell N, Pfeuffer J, Schneider R, Rosenkrantz AB. Zoomed echo-planar diffusion tensor imaging for MR tractography of the prostate gland neurovascular bundle without an endorectal coil: a feasibility study. Abdom Radiol (NY) 2016; 41:919-25. [PMID: 27193790 DOI: 10.1007/s00261-015-0587-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to assess the feasibility of zoomed echo-planar imaging (EPI) diffusion tensor imaging (DTI) with 2-channel parallel transmission (pTx) for MR tractography of the periprostatic neurovascular bundle (NVB) without an endorectal coil, and to compare its performance to that of conventionally acquired DTI. METHODS 8 healthy males (28.9 ± 4.6 years) underwent pelvic phased-array coil prostate MRI on a 3T system using both zoomed-EPI DTI (z-DTI) with 2-channel pTx and conventional single-shot spin-echo EPI DTI (c-DTI) acquisitions with 6 encoding directions and b-values of 0 and 1000 s/mm(2). Fractional anisotropy (FA) maps and tractography analysis incorporating 3D visualization of the NVB were performed from each acquisition. Fiber tract counts, estimated signal-to-noise ratio (eSNR), and image quality measures of the FA maps and NVB tractography were compared. Quantitative and image quality measures were compared using Wilcoxon signed rank tests. RESULTS 3 of 8 subjects had no tracts detected with c-DTI acquisition, while all 8 had tracts detected with z-DTI. z-DTI acquisition yielded significantly more fiber tracts (c-DTI: 77 ± 116 tracts; z-DTI: 430 ± 228 tracts; p = 0.019) and higher eSNR (c-DTI: 2.9 ± 1.2; z-DTI: 13.17 ± 9.9; p = 0.014). Relative to c-DTI acquisitions, z-DTI FA maps showed significantly reduced artifact (p = 0.008) and reduced anatomic distortion of the prostate (p = 0.010), while z-DTI tractography showed significantly better overall visual quality (p = 0.011), tract symmetry (p = 0.010), tract coherence (p = 0.011), and subjective similarity to the actual NVB (p = 0.011). CONCLUSION Zoomed-EPI DTI acquisition for tractography of the prostate gland NVB improves quantitative and qualitative measures of image and tract fiber quality, allowing tractography of the NVB at 3T without using an endorectal coil.
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Affiliation(s)
- Justin M Ream
- Department of Radiology, New York University School of Medicine, NYU Langone Medical Center, 660 1st Avenue, New York, NY, 10016, USA.
| | | | - Mariana Lazar
- Department of Radiology, New York University School of Medicine, NYU Langone Medical Center, 660 1st Avenue, New York, NY, 10016, USA
| | - Naomi Campbell
- Department of Radiology, New York University School of Medicine, NYU Langone Medical Center, 660 1st Avenue, New York, NY, 10016, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Josef Pfeuffer
- Imaging and Therapy Division, Siemens AG Healthcare Sector, Erlangen, Germany
| | - Rainer Schneider
- Imaging and Therapy Division, Siemens AG Healthcare Sector, Erlangen, Germany
| | - Andrew B Rosenkrantz
- Department of Radiology, New York University School of Medicine, NYU Langone Medical Center, 660 1st Avenue, New York, NY, 10016, USA
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Abstract
The added value of diffusion-weighted magnetic resonance imaging (DW-MRI) for the detection, localization, and staging of primary prostate cancer has been extensively reported in original studies and meta-analyses. More recently, DW-MRI and related techniques have been used to noninvasively assess prostate cancer aggressiveness and estimate its biological behavior. The present article aims to summarize the potential applications of DW-MRI for noninvasive optimization of pretherapeutic risk assessment, patient management decisions, and evaluation of treatment response.
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Transition Zone Prostate Cancer: Revisiting the Role of Multiparametric MRI at 3 T. AJR Am J Roentgenol 2015; 204:W266-72. [DOI: 10.2214/ajr.14.12955] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Loch R, Fowler K, Schmidt R, Ippolito J, Siegel C, Narra V. Prostate Magnetic Resonance Imaging: Challenges of Implementation. Curr Probl Diagn Radiol 2015; 44:26-37. [DOI: 10.1067/j.cpradiol.2014.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 01/13/2023]
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Korn N, Kurhanewicz J, Banerjee S, Starobinets O, Saritas E, Noworolski S. Reduced-FOV excitation decreases susceptibility artifact in diffusion-weighted MRI with endorectal coil for prostate cancer detection. Magn Reson Imaging 2014; 33:56-62. [PMID: 25200645 DOI: 10.1016/j.mri.2014.08.040] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 08/23/2014] [Accepted: 08/26/2014] [Indexed: 11/25/2022]
Abstract
The purposes of this study were to determine if image distortion is less in prostate MR apparent diffusion coefficient (ADC) maps generated from a reduced-field-of-view (rFOV) diffusion-weighted-imaging (DWI) technique than from a conventional DWI sequence (CONV), and to determine if the rFOV ADC tumor contrast is as high as or better than that of the CONV sequence. Fifty patients underwent a 3T MRI exam. CONV and rFOV (utilizing a 2D, echo-planar, rectangularly-selective RF pulse) sequences were acquired using b=600, 0s/mm(2). Distortion was visually scored 0-4 by three independent observers and quantitatively measured using the difference in rectal wall curvature between the ADC maps and T2-weighted images. Distortion scores were lower with the rFOV sequence (p<0.012, Wilcoxon Signed-Rank Test, n=50), and difference in distortion scores did not differ significantly among observers (p=0.99, Kruskal-Wallis Rank Sum Test). The difference in rectal curvature was less with rFOV ADC maps (26%±10%) than CONV ADC maps (34%±13%) (p<0.011, Student's t-test). In seventeen patients with untreated, biopsy confirmed prostate cancer, the rFOV sequence afforded significantly higher ADC tumor contrast (44.0%) than the CONV sequence (35.9%), (p<0.0012, Student's t-test). The rFOV sequence yielded significantly decreased susceptibility artifact and significantly higher contrast between tumor and healthy tissue.
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Affiliation(s)
- Natalie Korn
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, United States.
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, United States; The Graduate Group in Bioengineering, University of California at San Francisco & Berkeley, CA, United States
| | | | - Olga Starobinets
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, United States; The Graduate Group in Bioengineering, University of California at San Francisco & Berkeley, CA, United States
| | - Emine Saritas
- Department of Bioengineering, University of California at Berkeley, Berkeley, CA, United States
| | - Susan Noworolski
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, United States; The Graduate Group in Bioengineering, University of California at San Francisco & Berkeley, CA, United States
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31
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Jie C, Rongbo L, Ping T. The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis. Eur Radiol 2014; 24:1929-41. [PMID: 24865693 PMCID: PMC4082652 DOI: 10.1007/s00330-014-3201-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/17/2014] [Accepted: 04/23/2014] [Indexed: 02/05/2023]
Abstract
Objectives To evaluate the diagnostic performance of diffusion-weighted imaging (DWI) as a single non-invasive method in detecting prostate cancer (PCa) and to deduce its clinical utility. Methods A systematic literature search was performed to identify relevant original studies. Quality of included studies was assessed by QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). Data were extracted to calculate sensitivity and specificity as well as running the test of heterogeneity and threshold effect. The summary receiver operating characteristic (SROC) curve was drawn and area under SROC curve (AUC) served as a determination of the diagnostic performance of DWI for the detection of PCa. Results A total of 21 studies were included, with 27 subsets of data available for analysis. The pooled sensitivity and specificity with corresponding 95 % confidence interval (CI) were 0.62 (95 % CI 0.61–0.64) and 0.90 (95 % CI 0.89–0.90), respectively. Pooled positive likelihood ratio and negative likelihood ratio were 5.83 (95 % CI 4.61–7.37) and 0.30 (95 % CI 0.23–0.39), respectively. The AUC was 0.8991. Significant heterogeneity was observed. There was no notable publication bias. Conclusions DWI is an informative MRI modality in detecting PCa and shows moderately high diagnostic accuracy. General clinical application was limited because of the absence of standardized DW-MRI techniques. Key points • DWI provides incremental information for the detection and evaluation of PCa • DWI has moderately high diagnostic accuracy in detecting PCa • Patient condition, imaging protocols and study design positively influence diagnostic performance • General clinical application requires optimization of image acquisition and interpretation
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Affiliation(s)
- Chen Jie
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan province, China
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