Related Experiment Video
Updated: Aug 13, 2025
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Usefulness of balanced SSFP sequence in robot-assisted MRI-guided prostate biopsy: Beyond scouting
Joan C Vilanova1, Anna Pérez de Tudela2, Santiago Thio-Henestrosa3
1Department of Magnetic Resonance, Clinica Girona, 17005 Girona, Spain; Research Unit of Diagnostic Imaging Institute (IDI), Department of Radiology (Girona Biomedical Research Institute) IDIBGI, Hospital Universitari Dr. Josep Trueta, 17007 Girona, Spain; Department of Medical Sciences, Faculty of Medicine, University of Girona, 17003 Girona, Spain.
Objectives:
To determine whether bSSFP images are useful for visualizing prostatic lesionsin MRI-guided in-bore transrectal biopsy.
Methods:
This retrospective studyincluded 67 men witha single suspected cancer on MRI (PI-RADS 2.1 category ≥ 3) who underwent in-bore transrectal MRI-guided biopsy. Two uroradiologists independently rated lesion conspicuity on a 3-point scale (1:non-visible, 2:slightly visible, 3:clearly visible) on T2WI, DWI, and balanced SSFP.We used measures of frequency to compare lesion conspicuity in 3 sequences. We used Cohen's kappa to assess inter-rater reliability.
Results:
Lesions were rated (1) non-visible in 18 % (12/67) of T2WI, 5 % (3/67) of DWI, and 10 % (7/67) of balanced SSFP images, (2) slightly visible in 56 % (37/67) on T2WI, 13 % (9/67) on DWI, and 48 % (32/67) on bSSFP, and (3) clearly visible in 27 %(18/67) on T2WI, 82 % (55/67) on DWI, and 42 % (28/67) on bSSFP. Lesions classified as prostate cancer at histology were slightly-clearly visible in 85 % (41/48) on T2WI, 100 % (48/48) on DWI, and 94 % (45/48) on bSSFP. Lesions classified as PI-RADS ≥ 4 were visible in 87 % (47/54) of T2WI, 100 % (54/54) of DWI, and 93 % (50/54) of bSSFP. Gleason ≥ 3 + 4 lesions were visible in 85 % (37/43) of T2WI, 100 % (43/43) of DWI, and 95 % (41/43) of bSSFP. Inter-rater agreement was excellent for T2WI (k = 0.97) and bSSFP (k = 0.94), and good for DWI (k = 0.75).
Conclusion:
Balanced SSFP is useful for visualizing prostatic lesions. Replacing T2WI with balanced SSFP can reduce the duration of in-bore transrectal MRI-guided biopsy.
