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Applicability of readout-segmented echoplanar diffusion weighted imaging for prostate MRI.

ABSTRACT: To evaluate readout-segmented echoplanar (rsEPI) diffusion weighted imaging (DWI) for multiparametric (mp) magnetic resonance imaging (MRI) of the prostate compared to the established single-shot echoplanar imaging (ssEPI) sequence.One hundred ten consecutive patients with clinical suspicion of prostate cancer underwent mp prostate MRI using both, the ssEPI and the rsEPI DWI sequence. For an objective assessment, delineation of the prostate shape on both DWI sequences was compared to T2-weighted images by measuring organ diameters. Apparent diffusion coefficient (ADC) values, image contrast and contrast-to-noise ratio (CNR) were compared between the 2 sequences on a region-of-interest-based analysis. Diagnostic accuracy for quantitative ADC-values was calculated. Histopathology from MRI/ultrasound fusion-guided biopsy was used as reference standard. For a subjective assessment, 2 independent readers visually assessed image quality of both sequences using Likert-scales.Delineation of the prostate shape was more accurate with rsEPI compared to ssEPI. ADC values in target lesions were not significantly different but significantly higher in the surrounding normal prostatic tissue of the transition zone. CNR was comparable between ssEPI and rsEPI. Sensitivity and specificity were good for both sequences with 84/84% and 82/73% with a Youden selected cut-off of ADC?=?0.971*10?mm/s for rsEPI and 1.017*10?mm/s for ssEPI. Anatomic artifacts were significantly less and SNR was lower on rsEPI compared to ssEPI in the subjective analysis.Delineation of the prostate shape was more accurate with rsEPI DWI than with ssEPI DWI with less anatomic artifacts and higher subjective SNR and image quality on rsEPI DW images. Diagnostic ability of quantitative ADC-values was not significantly different between the 2 sequences. Thus, rsEPI DWI might be more suitable for prostate MRI with regard to MRI-guided targeted biopsy and therapy planning.

SUBMITTER: Hellms S

PROVIDER: S-EPMC6709253 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Applicability of readout-segmented echoplanar diffusion weighted imaging for prostate MRI.

Hellms Susanne S Gutberlet Marcel M Peperhove Matti Joonas MJ Pertschy Stefanie S Henkenberens Christoph C Peters Inga I Wacker Frank F Derlin Katja K

Medicine 20190701 29

To evaluate readout-segmented echoplanar (rsEPI) diffusion weighted imaging (DWI) for multiparametric (mp) magnetic resonance imaging (MRI) of the prostate compared to the established single-shot echoplanar imaging (ssEPI) sequence.One hundred ten consecutive patients with clinical suspicion of prostate cancer underwent mp prostate MRI using both, the ssEPI and the rsEPI DWI sequence. For an objective assessment, delineation of the prostate shape on both DWI sequences was compared to T2-weighted ...[more]

PMID: 31335699

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Project description:We compared the clinical utility of single-shot echo-planar imaging (SS-EPI) using different breathing schemes, readout-segmented EPI and zoomit EPI in the repeatability of apparent diffusion coefficient (ADC) measurements, cortico-medullary contrast to noise ratio (c-mCNR) and image quality. In this institutional review board-approved prospective study, some common clinically applicable diffusion-weighted imaging (b = 50, 400, 800 s/mm2) of kidney on 3.0 T MRI were performed on 22 volunteers using SS-EPI with breath-hold diffusion-weighted imaging (BH-DWI), free-breathing (FB-DWI), navigator-triggered (NT-DWI) and respiratory-triggered (RT-DWI), readout-segmented DWI (RS-DWI), and Zoomit DWI (Z-DWI). ADC and c-mCNR were measured in 12 anatomic locations (the upper, middle, and lower pole of the renal cortex and medulla), and image quality was assessed on these DWI sequences. A DWI with the optimal clinical utility was decided by systematically assessing the ADC repeatability, c-mCNR and image quality among the DWIs. For ADC measurements, Z-DWI had an excellent intra-observer agreement (intra-class correlation coefficients (ICCs): 0.876-0.944) and good inter-observer agreement (inter-class ICCs: 0.798-0.856) in six DWI sequences. Z-DWI had the highest ADC repeatability in most of the 12 anatomic locations of the kidneys (mean ADC absolute difference: 0.070-0.111 × 10-3 mm2/s, limit of agreement: 0.031-0.056 × 10-3 mm2/s). In all DWIs, Z-DWI yielded a slightly higher c-mCNR than other DWIs in most representative locations (P > 0.05), which was significantly higher than BH-DWI and FB-DWI in the middle pole of both kidneys and the upper pole of the left kidney (P < 0.05). In addition, Z-DWI yielded image quality that was similar to RT-DWI and NT-DWI (P > 0.05) and superior to BH-DWI, FB-DWI and RS-DWI (P < 0.05). Our results suggest that Z-DWI provides the highest ADC reproducibility, better c-mCNR and good image quality on 3.0 T MRI, making it the recommended sequence for clinical DWI of the kidney.

Project description:BackgroundHistogram analysis of the diffusion-weighted imaging (DWI) parameters is widely used to differentiate the breast lesions. However, histogram analysis of the diffusion-kurtosis imaging (DKI) parameters for the single-shot echo-planar imaging (ss-EPI) and readout-segmented echo planar imaging (rs-EPI) sequences has not been compared in breast cancer. Thus, this study is to investigate the diagnostic accuracy and reliability of the histogram parameters derived from the rs-EPI and ss-EPI sequences of DKI parameters in distinguishing between the benign and malignant breast lesions.MethodsThis single-center, retrospective cohort study enrolled 205 consecutive patients with breast lesions (65 benign and 140 malignant). The patients underwent breast magnetic resonance imaging (MRI) with a 3T scanner using the rs-EPI and ss-EPI sequences with 4 b values (0, 50, 1,000, and 2,000 s/mm2). The regions of interest (ROIs) were manually delineated for all the lesion images from both the sequences, and the histogram parameters were extracted from the apparent diffusion coefficient (ADC) and apparent diffusional kurtosis (Kapp) maps. Statistical analysis was performed using the Kolmogorov-Smirnov test, the student's t-test, and the receiver operating characteristic (ROC) curves.ResultsThe mean, 25th, 50th, 75th, and 100th percentiles, skewness, and kurtosis values derived from apparent diffusion for non-Gaussian distribution (Dapp) and Kapp maps showed good or excellent intra-observer agreement (ICC: 0.695 to 0.863).The mean and the 25th, 50th, 75th, and 100th percentile values for Dapp were significantly lower and the mean and the 25th, 50th, 75th, and 100th percentile values for Kapp were significantly higher in the malignant breast lesions compared with those in the benign breast lesions for both the rs-EPI and ss-EPI sequences (all P<0.05). The majority of the histogram Kapp and Dapp parameters (except skewness and kurtosis) for the benign and malignant lesions showed significant differences between the ss-EPI and the rs-EPI sequences (P<0.05). ROC curve analysis showed that the AUC values for the 75th percentile of Kapp (0.854 for rs-EPI, 0.844 for ss-EPI) and the 25th percentile of Dapp (0.866 for rs-EPI, 0.858 for ss-EPI) were highest for both DKI sequences. The diagnostic performance of the rs-EPI sequence was better than the ss-EPI sequence for all the histogram parameters except the skewness value of Dapp.ConclusionsHistogram parameters from the rs-EPI sequence were more reliable and accurate in differentiating malignant and benign breast lesions than those from the ss-EPI sequence.

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Applicability of readout-segmented echoplanar diffusion weighted imaging for prostate MRI.

Publications

Applicability of readout-segmented echoplanar diffusion weighted imaging for prostate MRI.

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