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Motion corrected DWI with integrated T2-mapping for simultaneous estimation of ADC, T2-relaxation and perfusion in
M Skorpil1, P Brynolfsson2, M Engström3
1Department of Radiation Sciences, Umeå University, Umeå, Sweden; Department of Radiology, Uppsala University Hospital, Uppsala, Sweden.
Objective:
Multiparametric magnetic resonance imaging (MRI) and PI-RADS (Prostate Imaging - Reporting and Data System) has become the standard to determine a probability score for a lesion being a clinically significant prostate cancer. T2-weighted and diffusion-weighted imaging (DWI) are essential in PI-RADS, depending partly on visual assessment of signal intensity, while dynamic-contrast enhanced imaging is less important. To decrease inter-rater variability and further standardize image evaluation, complementary objective measures are in need.
Methods:
We here demonstrate a sequence enabling simultaneous quantification of apparent diffusion coefficient (ADC) and T2-relaxation, as well as calculation of the perfusion fraction f from low b-value intravoxel incoherent motion data. Expandable wait pulses were added to a FOCUS DW SE-EPI sequence, allowing the effective echo time to change at run time. To calculate both ADC and f, b-values 200s/mm2 and 600s/mm2 were chosen, and for T2-estimation 6 echo times between 64.9ms and 114.9ms were used.
Results:
Three patients with prostate cancer were examined and all had significantly decreased ADC and T2-values, while f was significantly increased in 2 of 3 tumors. T2 maps obtained in phantom measurements and in a healthy volunteer were compared to T2 maps from a SE sequence with consecutive scans, showing good agreement. In addition, a motion correction procedure was implemented to reduce the effects of prostate motion, which improved T2-estimation.
Conclusions:
This sequence could potentially enable more objective tumor grading, and decrease the inter-rater variability in the PI-RADS classification.
Insights
A new MRI sequence provides objective measures for prostate cancer assessment, potentially reducing variability in PI-RADS scoring. This method quantifies apparent diffusion coefficient (ADC) and T2-relaxation, aiding in more reliable tumor grading.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Multiparametric MRI and PI-RADS are standard for prostate cancer assessment.
- Current methods rely partly on visual assessment, leading to inter-rater variability.
- Objective measures are needed to standardize prostate cancer evaluation.
Purpose of the Study:
- To develop and demonstrate a novel MRI sequence for simultaneous quantification of key imaging parameters.
- To enable objective tumor grading and reduce inter-rater variability in PI-RADS classification.
Main Methods:
- A FOCUS DW SE-EPI sequence with expandable wait pulses was developed.
- Simultaneous quantification of apparent diffusion coefficient (ADC), T2-relaxation, and perfusion fraction (f) was achieved.
- Multiple b-values and echo times were used, along with a motion correction procedure.
Main Results:
- Significantly decreased ADC and T2-values were observed in prostate tumors.
- Increased perfusion fraction (f) was noted in 2 of 3 tumors.
- T2 maps showed good agreement with standard sequences, and motion correction improved T2 estimation.
Conclusions:
- The developed MRI sequence offers objective tumor grading potential.
- This approach may decrease inter-rater variability in PI-RADS classification.
- Further standardization of prostate cancer imaging evaluation is facilitated.
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