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Prostate T2-weighted spin-echo MRI with and without glucagon: a paired scan quality assessment
Sara Hassanzadeh1, Eric A Borisch1, Adam T Froemming1
1Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Purpose:
To evaluate the effectiveness of subcutaneous glucagon in reducing motion artifact during prostate MRI through intraindividual comparison.
Methods:
At our institution patients undergoing a clinical prostate MRI exam receive 1 mg of subcutaneous glucagon before scanning. From February 15, 2024 to February 11, 2025 33 such patients were recruited to undergo an additional, research exam without glucagon. All exams were acquired at 3T. An axial T2-weighted spin-echo series (T2-WI) was acquired within both exams. Evaluation of the T2-WI series was done by three experienced radiologists using the criteria of diagnostic quality (0-3 scale), PI-QUALv2 (0-3 sum), motion artifact (significant, visible, none), and reviewer preference (five-point relative scale). Due to differences in prescribed coverage, the scan times for the two T2-WI sequences were in general different for each subject. Results were stratified using the acquisition time ratio (Trel) between the glucagon vs. non-glucagon scans. Wilcoxon tests assessed score differences.
Results:
Across all 33 subjects, no significant differences were found between glucagon and non-glucagon scans. However, the observed negative correlation between glucagon preference and Trel (p = 0.026) led to stratification into low-Trel (N = 16) and high-Trel (N = 17) groups. In the low-Trel group the glucagon scans provided significantly improved diagnostic quality (p = 0.048), PI-QUALv2 sum (p = 0.049), motion scores (p = 0.047), and reader preference (p = 0.042).
Conclusion:
Subcutaneous glucagon provides improved image quality in prostate T2-WI MRI when scan duration remains within 1.25× of that of a non-glucagon T2-WI series. The benefit appears to decrease with longer scan times.
Insights
Subcutaneous glucagon improves prostate MRI image quality by reducing motion artifact, especially when scan times are similar. This benefit diminishes with longer scan durations, impacting diagnostic quality.
Area of Science:
- Radiology
- Medical Imaging
Background:
- Motion artifact is a common challenge in prostate MRI.
- Subcutaneous glucagon is used to reduce gastrointestinal motion during MRI.
Purpose of the Study:
- To evaluate the effectiveness of subcutaneous glucagon in reducing motion artifact during prostate MRI.
- To compare image quality intraindividually between scans with and without glucagon.
Main Methods:
- 33 patients underwent two 3T MRI prostate exams: one with 1 mg subcutaneous glucagon and one without.
- Axial T2-weighted spin-echo (T2-WI) series were acquired for both exams.
- Three radiologists assessed diagnostic quality, PI-QUALv2, motion artifact, and reader preference, stratifying results by acquisition time ratio (Trel).
Main Results:
- No significant difference in overall image quality was found between glucagon and non-glucagon scans.
- In a subgroup with a low acquisition time ratio (Trel ≤ 1.25), glucagon significantly improved diagnostic quality, PI-QUALv2 scores, motion artifact reduction, and reader preference.
- The benefits of glucagon decreased with longer scan times.
Conclusions:
- Subcutaneous glucagon enhances prostate T2-WI MRI image quality when scan duration is comparable (within 1.25x) to non-glucagon scans.
- The positive impact of glucagon on image quality is dependent on scan time, diminishing with prolonged acquisitions.
