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Image quality and diagnostic accuracy of complex-averaged high b value images in diffusion-weighted MRI of prostate cancer

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Abstract

Purpose

To evaluate the impact of complex-averaging on image quality (IQ) and diagnostic accuracy of acquired and calculated high b value (aHBV, cHBV) images in diffusion-weighted prostate MRI.

Materials and methods

This retrospective study included 84 patients who underwent multiparametric prostate MRI at 3 Tesla without endorectal coil. DWIs were acquired at three different b values which included two lower b values (b = 50,900 s/mm2) and one higher b value (aHBV at 2000 s/mm2). The acquired data were postprocessed to generate two different types of trace-weighted images—using conventional magnitude-averaging and complex-averaging. Using lower b values (b = 50,900 s/mm2) from both conventional and complex-averaged image sets, cHBV images (b = 2000 s/mm2) and ADC maps were derived. All image sets were reviewed by two radiologists in different reading sessions to assess image quality and PIRADS. The diagnostic accuracy of different image sets for the detection of prostate lesions was performed by correlating PIRADS and Gleason scores.

Results

Complex-averaging did not impact ADC values of the prostate lesions compared to magnitude-averaging (P = 0.08). Complex-averaging improved image quality of acquired high b value and calculated high b value images (P < 0.0001). Complex-averaging also improved the level of confidence (LOC) of the acquired high b value for both readers (P < 0.0001, P < 0.05), but only for reader A in calculated high b value (P < 0.0001). The image quality of calculated high b value images was not significantly different than acquired high b value images. The dataset combining complex-averaging and calculated high b value provided the highest diagnostic accuracy (but not statistically significant) for detection of the significant prostate lesion compared to the magnitude-averaged acquired high b value (79.55% vs. 72.73%; P = 0.317). The mean acquisition time for b = 2000 s/mm2 sequence (aHBV) was 6 min 30 s (± 1 min 16 s) out of a total of 28 min 31 s (± 4 min 26 s) for the entire mp-MRI protocol (approximately 25% of total scan time).

Conclusion

Complex-averaging provides better image quality and level of confidence without significant impact on ADC values and diagnostic accuracy for detection of the significant prostate lesions . The calculated high b value images are also comparable to (and can substitute) the acquired high b value images which can help in reducing the imaging time.

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Funding

There is no source of funding for this original article. The author biography information is provided on the title page that is separate from the manuscript.

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Authors and Affiliations

  1. Harvard Medical School, Boston, USA

    Mukesh G. Harisinghani

  2. Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Hamed Kordbacheh, Thitinan Chulroek, Martina Cecconi, Vinit Baliyan & Mukesh G. Harisinghani

  3. MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

    Elisabeth Weiland, Berthold Kiefer & Marcel Dominik Nickel

  4. Department of Diagnostic Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Thitinan Chulroek

  5. MR Research and Technology, Siemens Medical Solutions USA, Inc, Boston, USA

    Ravi Teja Seethamraju

Authors
  1. Hamed Kordbacheh
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  2. Ravi Teja Seethamraju
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  3. Elisabeth Weiland
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  8. Vinit Baliyan
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  9. Mukesh G. Harisinghani
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Corresponding author

Correspondence to Mukesh G. Harisinghani.

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Disclosure

Ravi Teja Seethamraju: Employee of Siemens Medical Solutions USA, Inc. Elisabeth Weiland: Employee of Siemens Healthcare GmbH. Berthold Kiefer: Employee of Siemens Healthcare GmbH. Marcel Dominik Nickel: Employee of Siemens Healthcare GmbH.

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Kordbacheh, H., Seethamraju, R.T., Weiland, E. et al. Image quality and diagnostic accuracy of complex-averaged high b value images in diffusion-weighted MRI of prostate cancer. Abdom Radiol 44, 2244–2253 (2019). https://doi.org/10.1007/s00261-019-01961-0

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  • DOI: https://doi.org/10.1007/s00261-019-01961-0

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