Diffusion weighted imaging (DWI) is the most important sequence for detection and grading prostate cancer (PCa), but it is considerably prone to artifacts. New approaches like zoomed single-shot imaging (z-EPI) with advanced image processing or multi-shot readout segmentation (rs-EPI) try to improve DWI quality. This study evaluates objective and subjective image quality (IQ) of rs-EPI and z-EPI with and without advanced processing.
Fifty-six consecutive patients (67 ± 8 years; median PSA 8.3 ng/ml) with mp-MRI performed at 3 Tesla between February and October 2019 and subsequently verified PCa by targeted plus systematic MRI/US-fusion biopsy were included in this retrospective single center cohort study. Rs-EPI and z-EPI were prospectively acquired in every patient. Signal intensities (SI) of PCa and benign tissue in ADC, b1000, and calculated high b-value images were analyzed. Endpoints were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), PCa contrast intensity (CI), and subjective IQ on a 5-point scale evaluated by three blinded readers. Wilcoxon signed rank test, Friedman test and Cohen's kappa coefficient was calculated.
SNR, CNR, and PCa CI of z-EPI with and without advanced processing was superior to rs-EPI (p < 0.01), whereas no significant differences were observed between z-EPI with and without advanced processing. Subjective IQ was significantly higher for z-EPI with advanced processing compared rs-EPI for ADC, b1000, and calculated high b-values (p < 0.01). Compared to z-EPI without advanced processing, z-EPI with advanced processing was superior for ADC and calculated high b-values (p < 0.01), but no significant differences were shown for b1000 images.
Z-EPI with and without advanced processing was superior to rs-EPI regarding objective imaging parameters and z-EPI with advanced processing was superior to rs-EPI regarding subjective imaging parameters for the detection of PCa.
Magnetic resonance imaging. 2023 Jan 14 [Epub ahead of print]
M Klingebiel, E Weiland, M Boschheidgen, T Ullrich, C Arsov, J P Radtke, T Benkert, M Nickel, R Strecker, H J Wittsack, P Albers, G Antoch, L Schimmöller
University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany; Siemens Healthcare GmbH, Europe, Middle East & Africa, Karlheinz-Kaske-Str. 2, 91052 Erlangen, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Department of Urology, Univ Dusseldorf, Medical Faculty, Moorenstr. 5, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Department of Urology, Univ Dusseldorf, Medical Faculty, Moorenstr. 5, D-40225 Dusseldorf, Germany. Electronic address: ., MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany; Siemens Healthcare GmbH, Europe, Middle East & Africa, Karlheinz-Kaske-Str. 2, 91052 Erlangen, Germany. Electronic address: ., MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany; Siemens Healthcare GmbH, Europe, Middle East & Africa, Karlheinz-Kaske-Str. 2, 91052 Erlangen, Germany. Electronic address: ., Siemens Healthcare GmbH, Europe, Middle East & Africa, Karlheinz-Kaske-Str. 2, 91052 Erlangen, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Department of Urology, Univ Dusseldorf, Medical Faculty, Moorenstr. 5, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: .