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Shortening the acquisition time of whole-body MRI: 3D T1 gradient echo Dixon vs fast spin echo for metastatic screening in prostate cancer

  • Oncology
  • Published:
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Abstract

Purpose

To compare 3D T1-weighted fast spin echo (FSE) and 3D T1-weighted gradient echo (GE) mDixon as morphologic sequences to complement diffusion-weighted imaging (DWI) for the metastatic screening in prostate cancer (PCa) patients.

Materials and methods

Thirty PCa patients at high risk of metastases prospectively underwent both a 3D T1 FSE (14 min) and a rapid 3D T1 GEmDixon (1 min 20 s) sequences within a WB-MRI protocol. Two readers assessed the diagnostic performance of the FSE/Fat/in-phase (IP)/IP+Fat sequences in detecting bone and node metastases. The reference standard was established by a panel of four physicians on the basis of all baseline and follow-up imaging, biological and clinical information. The reproducibility of readings, predictive accuracy (Acc) from ROC curves analysis, and contrast-to-reference ratio (CRR) in lesions were assessed for each sequence.

Results

In bone and lymph nodes (per-region analysis), reproducibility was at least good for all sequences/readers, except for nodes in the common iliac/inguinal regions. In bone (per-organ analysis), Acc of FSE was superior to that of mDixon (difference + 4%, p < 0.0083). In nodes (per-organ analysis), Acc of Fat was superior to that of other sequences (difference + 4% to + 6% depending on reader, p < 0.0083). In the per-patient analysis, Acc of FSE was superior to that of mDixon (difference + 4% to + 6% depending on sequence, p < 0.0083). Fat images had higher CRR compared with FSE in the thoracic spine, the bony pelvis and lymph node metastases (p < 0.025).

Conclusion

3D T1 GEmDixon may replace 3D T1 FSE to complement DWI in WB-MRI for metastatic screening in PCa. It demonstrates an Acc ranging from + 4% to + 6% (nodes) to − 4% to − 6% (bone and patient staging) compared with FSE and considerably reduces the examination time, offering the perspective of acquiring WB-MRI examinations in less than 20 min.

Key Points

• The replacement of 3D T1 FSE by the 3D T1 GE mDixon as morphologic sequence to complement DWI drastically reduces the acquisition time of WB-MRI studies.

• The 3D T1 GE mDixon sequence offers similar reproducibility of image readings compared with that of the 3D T1 FSE.

• Differences in diagnostic accuracy are limited (+ 4%/+ 6% in favor of mDixon to detect node metastases; + 4%/+ 6% in favor of FSE to detect bone metastases/metastatic disease in a patient).

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Abbreviations

Acc:

Predictive accuracy

ADC:

Apparent diffusion coefficient

AUC:

Area under the receiver operating characteristic curve

BCR:

Biochemical recurrence

BS:

Bone scintigraphy

BVC:

Best valuable comparator

CI:

Confidence interval

CRPC:

Castrate-resistant prostate cancer

CRR:

Contrast-to-reference ratio

DWI:

Diffusion-weighted imaging

DWIBS:

DWI with background signal suppression

FSE:

Fast spin echo

GE:

Gradient echo

IP:

In-phase

IR:

Inversion recovery

ND:

Newly diagnosed

OP:

Out-phase

PACS:

Picture Archiving and Communication System

PCa:

Prostate cancer

PET:

Positron emission tomography

PSA:

Prostate-specific antigen

ROC:

Receiver operating characteristic

ROI:

Region of interest

STIR:

Short tau inversion recovery

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium

    Frédéric E. Lecouvet, Vassiliki Pasoglou, Sandy Van Nieuwenhove, Thomas Van Haver, Quentin de Broqueville, Perrine Triqueneaux, Bertrand Tombal & Nicolas Michoux

  2. Philips Medical Systems International BV, Veenpluis 4-6, 5684 PC, Best, The Netherlands

    Vincent Denolin

Authors
  1. Frédéric E. Lecouvet
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  2. Vassiliki Pasoglou
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  4. Thomas Van Haver
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  5. Quentin de Broqueville
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  8. Bertrand Tombal
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  9. Nicolas Michoux
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Corresponding author

Correspondence to Frédéric E. Lecouvet.

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The scientific guarantor of this publication is F.E. Lecouvet.

Conflict of interest

One of the authors of this manuscript (Vincent Denolin) was an employee of Philips Medical Systems International at the time of this study. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise (N. Michoux).

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Written informed consent was obtained from all subjects (patients) in this study.

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Study subjects or cohorts have not been previously reported.

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• Prospective

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• Performed at one institution

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Lecouvet, F.E., Pasoglou, V., Van Nieuwenhove, S. et al. Shortening the acquisition time of whole-body MRI: 3D T1 gradient echo Dixon vs fast spin echo for metastatic screening in prostate cancer. Eur Radiol 30, 3083–3093 (2020). https://doi.org/10.1007/s00330-019-06515-y

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