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European Radiology

, Volume 24, Issue 12, pp 3233–3241 | Cite as

Diffusion-weighted MRI of the Prostate: Advantages of Zoomed EPI with Parallel-transmit-accelerated 2D-selective Excitation Imaging

  • Kolja M. Thierfelder
  • Michael K. Scherr
  • Mike Notohamiprodjo
  • Jakob Weiß
  • Olaf Dietrich
  • Ullrich G. Mueller-Lisse
  • Josef Pfeuffer
  • Konstantin Nikolaou
  • Daniel Theisen
Oncology

Abstract

Objectives

The purpose of our study was to evaluate the use of 2D-selective, parallel-transmit excitation magnetic resonance imaging (MRI) for diffusion-weighted echo-planar imaging (pTX-EPI) of the prostate, and to compare it to conventional, single-shot EPI (c-EPI).

Methods

The MRI examinations of 35 patients were evaluated in this prospective study. PTX-EPI was performed with a TX-acceleration factor of 1.7 and a field of view (FOV) of 150 × 90 mm2, whereas c-EPI used a full FOV of 380 × 297 mm2. Two readers evaluated three different aspects of image quality on 5-point Likert scales. To quantify distortion artefacts, maximum diameters and prostate volume were determined for both techniques and compared to T2-weighted imaging.

Results

The zoomed pTX-EPI was superior to c-EPI with respect to overall image quality (3.39 ± 0.62 vs 2.45 ± 0.67) and anatomic differentiability (3.29 ± 0.65 vs 2.41 ± 0.65), each with p < 0.0001. Artefacts were significantly less severe in pTX-EPI (0.93 ± 0.73 vs 1.49 ± 1.08), p < 0.001. The quantitative analysis yielded a higher agreement of pTX-EPI with T2-weighted imaging than c-EPI with respect to coronal (ICCs: 0.95 vs 0.93) and sagittal (0.86 vs 0.73) diameters as well as prostate volume (0.94 vs 0.92). Apparent diffusion coefficient (ADC) values did not differ significantly between the two techniques (p > 0.05).

Conclusions

Zoomed pTX-EPI leads to substantial improvements in diffusion-weighted imaging (DWI) of the prostate with respect to different aspects of image quality and severity of artefacts.

Key Points

Recent technical developments in MRI allow the use of accelerated, spatially-selective excitation (parallel-transmit, pTX)

pTX can be used for zoomed echo-planar prostate imaging (pTX-EPI)

pTX-EPI improves different aspects of image quality in prostate MRI

Distortion artefacts are reduced by the use of pTX-EPI in prostate MRI

Further studies should aim at assessing the diagnostic accuracy of pTX-EPI

Keywords

Parallel-transmit pTX-acceleration Echo-planar imaging Zoom-EPI Prostate 

Abbreviations

ADC

Apparent diffusion coefficient

BPH

Benign prostatic hyperplasia

c-EPI

Conventional EPI (full field of view)

DWI

Diffusion-weighted imaging

EPI

Echo-planar imaging

ETL

Echo train length

FOV

Field of view

ICC

Intraclass correlation coefficient

PSA

Prostate-specific antigen

ROI

Region of interest

pTX

Parallel-transmit

pTX-EPI

Echo-planar imaging using parallel transmission technology

TSE

Turbo-spin-echo

Notes

Acknowledgments

The scientific guarantor of this publication is Kolja M. Thierfelder. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic study, performed at one institution.

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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Kolja M. Thierfelder
    • 1
  • Michael K. Scherr
    • 2
  • Mike Notohamiprodjo
    • 1
    • 3
  • Jakob Weiß
    • 1
  • Olaf Dietrich
    • 4
  • Ullrich G. Mueller-Lisse
    • 2
  • Josef Pfeuffer
    • 5
  • Konstantin Nikolaou
    • 1
    • 3
  • Daniel Theisen
    • 1
  1. 1.Institute for Clinical RadiologyLudwig-Maximilians-University Hospital MunichMunichGermany
  2. 2.Institute for Clinical RadiologyLudwig-Maximilians-University Hospital MunichMunichGermany
  3. 3.Department of Diagnostic and Interventional RadiologyUniversity Hospital TuebingenTuebingenGermany
  4. 4.Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical RadiologyLudwig-Maximilians-University Hospital MunichMunichGermany
  5. 5.Siemens Healthcare, Application DevelopmentErlangenGermany

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