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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Prostate MR image quality of apparent diffusion coefficient maps versus fractional intracellular volume maps from
Saurabh Singh1, Francesco Giganti2, Louise Dickinson3
1Centre for Medical Imaging, Division of Medicine, University College London, London, UK; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK.
Purpose:
This study aimed to assess the image quality of apparent diffusion coefficient (ADC) maps derived from conventional diffusion-weighted MRI and fractional intracellular volume maps (FIC) from VERDICT MRI (Vascular, Extracellular, Restricted Diffusion for Cytometry in Tumours) in patients from the INNOVATE trial. The inter-reader agreement was also assessed.
Methods:
Two readers analysed both ADC and FIC maps from 57 patients enrolled in the INNOVATE prospective trial. Image quality was assessed using the Prostate Imaging Quality (PI-QUAL) score and a subjective image quality Likert score (Likert-IQ). The image quality of FIC and ADC were compared using a Wilcoxon Signed Ranks test. The inter-reader agreement was assessed with Cohen's kappa.
Results:
There was no statistically significant difference between the PI-QUAL score for FIC datasets compared to ADC datasets for either reader (p = 0.240 and p = 0.614). Using the Likert-IQ score, FIC image quality was higher compared to ADC (p = 0.021) as assessed by reader-1 but not for reader-2 (p = 0.663). The inter-reader agreement was 'fair' for PI-QUAL scoring of datasets with FIC maps at 0.27 (95% confidence interval; 0.08-0.46) and ADC datasets at 0.39 (95% confidence interval 0.22-0.57). For Likert scoring, the inter-reader agreement was also 'fair' for FIC maps at 0.38 (95% confidence interval; 0.10-0.65) and substantial for ADC maps at 0.62 (95% confidence interval; 0.39-0.86).
Conclusion:
Image quality was comparable for FIC and ADC. The inter-reader agreement was similar when using PIQUAL for both FIC and ADC datasets but higher for ADC maps compared to FIC maps using the image quality Likert score.
Insights
Image quality of fractional intracellular volume (FIC) maps from VERDICT MRI and apparent diffusion coefficient (ADC) maps were comparable. Inter-reader agreement varied by scoring method, with higher agreement for ADC maps using the Likert score.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Diffusion-weighted MRI (DW-MRI) provides apparent diffusion coefficient (ADC) maps for tumor assessment.
- Vascular, Extracellular, Restricted Diffusion for Cytometry in Tumours (VERDICT) MRI offers fractional intracellular volume (FIC) maps.
- Assessing image quality and inter-reader agreement is crucial for clinical adoption.
Purpose of the Study:
- To evaluate and compare the image quality of ADC maps and FIC maps.
- To assess the inter-reader agreement for both types of diffusion imaging maps.
- To analyze data from patients in the INNOVATE trial.
Main Methods:
- Two readers assessed image quality of ADC and FIC maps from 57 INNOVATE trial patients.
- Prostate Imaging Quality (PI-QUAL) and Likert image quality (Likert-IQ) scores were used.
- Statistical analysis included Wilcoxon Signed Ranks test and Cohen's kappa for inter-reader agreement.
Main Results:
- No significant difference in PI-QUAL scores between FIC and ADC maps.
- Reader 1 found higher Likert-IQ for FIC maps (p=0.021), but Reader 2 did not (p=0.663).
- Inter-reader agreement was fair for PI-QUAL (FIC: 0.27, ADC: 0.39) and Likert-IQ (FIC: 0.38, ADC: 0.62).
Conclusions:
- Image quality of FIC and ADC maps is comparable.
- Inter-reader agreement was similar for PI-QUAL, but substantially higher for ADC maps using Likert-IQ.
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