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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Diffusion-Weighted Imaging of the Prostate: Image Quality and Geometric Distortion of Readout-Segmented Versus
Borna K Barth1, Alexander Cornelius, Daniel Nanz
1From the *Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, Zurich; †Department for Radiology, Cantonal Hospital Aarau, Aarau; and ‡Department of Urology, University Hospital Zürich, Zurich, Switzerland.
Objective:
To compare image quality and geometric distortion between readout-segmented diffusion-weighted imaging (rs-DWI) and selective-excitation accelerated reduced-field of view (FOV) DWI (sTX-DWI) of the prostate.
Materials And Methods:
Sixty-five patients underwent 3-T MRI of the prostate including rs-DWI and sTX-DWI (b values, 0, 50, and 1000 seconds/mm²; FOV, 150 × 150 mm² and 77 ×150 mm for rs-DWI and sTX-DWI; slice thickness, 3 mm; acquisition time, 8:18 min and 1:37 min for rs-DWI and sTX-DWI). Two readers evaluated aspects of image quality and geometric distortion on a 5-point Likert scale. Quantitative analysis of geometric distortion was assessed by measurements of anteroposterior and left-right diameters and compared to T2-weighted turbo-spin echo sequence using intraclass correlation coefficient (ICC).
Results:
There was no significant difference in resolution, capsule demarcation, and zonal anatomy (P = 0.111-0.866). Overall image quality was rated "above average" by reader 1 (4.09 ± 0.66 and 4.03 ± 0.79; P = 0.433) and reader 2 (3.86 ± 0.66 and 3.80 ± 0.74; P = 0.465) for rs-DWI and sTX-DWI. Reader 1 (0.74 ± 0.67 and 1.17 ± 0.84; P < 0.001) and reader 2 (0.55 ± 0.64 and 1.09 ± 0.95; P < 0.001) rated the level of geometric distortion significantly lower for rs-DWI than sTX-DWI. Readout-segmented DWI (0.9 ± 2.2 mm) and sTX-DWI (2.1 ± 3.8 mm) overestimated the anteroposterior diameter of the prostate compared to T2-weighted turbo-spin echo sequence (P < 0.001), the difference being more pronounced for sTX-DWI [ICC, 0.89 (95% confidence interval, 0.83-0.93)] compared to rs-DWI [ICC, 0.96 (95% confidence interval, 0.94-0.96)].
Conclusion:
Selective-excitation accelerated reduced-FOV DW images (sTX-DWI) of the prostate can be acquired more than 5 times faster than rs-DWI with comparable image quality, at the expense of significantly increased geometric distortion.
Insights
Selective-excitation accelerated reduced-field of view (FOV) DWI (sTX-DWI) offers faster prostate imaging with similar quality but increased geometric distortion compared to readout-segmented DWI (rs-DWI). This trade-off is crucial for clinical application.
Area of Science:
- Radiology and Imaging Science
- Medical Physics
- Oncology Imaging
Background:
- Diffusion-weighted imaging (DWI) is vital for prostate cancer detection and characterization.
- Traditional DWI techniques like readout-segmented DWI (rs-DWI) offer high quality but are time-consuming.
- Accelerated DWI methods are needed to improve patient comfort and workflow efficiency.
Purpose of the Study:
- To compare the image quality and geometric distortion of prostate rs-DWI and selective-excitation accelerated reduced-FOV DWI (sTX-DWI).
- To evaluate the trade-offs between acquisition speed and image fidelity for these two DWI techniques.
Main Methods:
- Sixty-five patients underwent 3-Tesla MRI including both rs-DWI and sTX-DWI sequences.
- Image quality and geometric distortion were assessed by two readers using a 5-point Likert scale.
- Quantitative geometric distortion was measured by comparing prostate diameters to T2-weighted imaging.
Main Results:
- No significant differences were found in resolution, capsule demarcation, or zonal anatomy between rs-DWI and sTX-DWI.
- Overall image quality was rated similarly high for both techniques by both readers.
- sTX-DWI demonstrated significantly higher geometric distortion than rs-DWI, with more pronounced overestimation of prostate diameter.
Conclusions:
- sTX-DWI allows for over 5-fold faster acquisition of prostate images compared to rs-DWI.
- Image quality is comparable between sTX-DWI and rs-DWI.
- The accelerated sTX-DWI technique comes at the cost of significantly increased geometric distortion.
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