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A multitransmit external body array combined with a 1 H and 31 P endorectal coil to enable a multiparametric and multimetabolic MRI examination of the prostate at 7T.

ABSTRACT: PURPOSE:In vivo 1 H and 31 P magnetic resonance spectroscopic imaging (MRSI) provide complementary information on the biology of prostate cancer. In this work we demonstrate the feasibility of performing multiparametric imaging (mpMRI) and 1 H and 31 P spectroscopic imaging of the prostate using a 31 P and 1 H endorectal radiofrequency coil (ERC) in combination with a multitransmit body array at 7 Tesla (T). METHODS:An ERC with a 31 P transceiver loop coil and 1 H receive (Rx) asymmetric microstrip (31 P/1 H ERC) was designed, constructed and tested in combination with an external 8-channel 1 H transceiver body array coil (8CH). Electromagnetic field simulations and measurements and in vivo temperature measurements of the ERC were performed for safety validation. In addition, the signal-to-noise (SNR) benefit of the 1 H microstrip with respect to the 8CH was evaluated. Finally, the feasibility of the setup was tested in one volunteer and three patients with prostate cancer by performing T2 -weighted and diffusion-weighted imaging in combination with 1 H and 31 P spectroscopic imaging. RESULTS:Electromagnetic field simulations of the 31 P loop coil showed no differences in the E- and B-fields of the 31 P/1 H ERC compared with a previously safety validated ERC without 1 H microstrip. The hotspot of the specific absorption rate (SAR) at the feed point of the 31 P/1 H ERC loop coil was 9.42 W/kg when transmitting on 31 P at 1 W. Additional in vivo measurements showed a maximum temperature increase at the SAR hotspot of 0.7°C over 6 min on 31 P at 1.9 W transmit (Tx) power, indicating safe maximum power levels. When transmitting with the external 1 H body array at 40W for 2:30 min, the temperature increase around the ERC was < 0.3°C. Up to 3.5 cm into the prostate the 1 H microstrip of the ERC provided higher SNR than the 8CH. The total coil combination allowed acquisition of an mpMRI protocol and the assessment of 31 P and 1 H metabolites of the prostate in all test subjects. CONCLUSION:We developed a setup with a 31 P transceiver and 1 H Rx endorectal coil in combination with an 8-channel transceiver external body array coil and demonstrated its safety and feasibility for obtaining multiparametric imaging and 1 H and 31 P MRSI at 7T in patients with prostate cancer within one MR examination.

SUBMITTER: Philips BWJ

PROVIDER: S-EPMC6852321 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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A multitransmit external body array combined with a <sup>1</sup> H and <sup>31</sup> P endorectal coil to enable a multiparametric and multimetabolic MRI examination of the prostate at 7T.

Philips Bart W J BWJ van Uden Mark J MJ Rietsch Stefan H G SHG Orzada Stephan S Scheenen Tom W J TWJ

Medical physics 20190801 9

<h4>Purpose</h4>In vivo <sup>1</sup> H and <sup>31</sup> P magnetic resonance spectroscopic imaging (MRSI) provide complementary information on the biology of prostate cancer. In this work we demonstrate the feasibility of performing multiparametric imaging (mpMRI) and <sup>1</sup> H and <sup>31</sup> P spectroscopic imaging of the prostate using a <sup>31</sup> P and <sup>1</sup> H endorectal radiofrequency coil (ERC) in combination with a multitransmit body array at 7 Tesla (T).<h4>Methods</h4 ...[more]

PMID: 31274201

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Project description:PurposeTo investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for magnetic resonance imaging (MRI)-based postimplant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an endorectal coil (ERC).Methods and materialsSeventeen patients at a major academic cancer center who underwent MRI-assisted radiosurgery (MARS) LDR prostate cancer brachytherapy were imaged with moderate, high, or very high spatial resolution fully bSSFP MRIs without using an ERC. Between 1 and 3 signal averages (NEX) were acquired with acceleration factors (R) between 1 and 2, with the goal of keeping scan times between 4 and 6 minutes. Acquisitions with R >1 were reconstructed with parallel imaging and compressed sensing (PICS) algorithms. Radioactive seeds were identified by 3 medical dosimetrists. Additionally, some of the MRI techniques were implemented and tested at a community hospital; 3 patients underwent MARS LDR prostate brachytherapy and were imaged without an ERC.ResultsIncreasing the in-plane spatial resolution mitigated partial volume artifacts and improved overall seed and seed marker visualization at the expense of reduced signal-to-noise ratio (SNR). The reduced SNR as a result of imaging at higher spatial resolution and without an ERC was partially compensated for by the multi-NEX acquisitions enabled by PICS. Resultant image quality was superior to the current clinical standard. All 3 dosimetrists achieved near-perfect precision and recall for seed identification in the 17 patients. The 3 postimplant MRIs acquired at the community hospital were sufficient to identify 208 out of 211 seeds implanted without reference to computed tomography (CT).ConclusionsAcquiring postimplant prostate brachytherapy MRI without an ERC has several advantages including better patient tolerance, lower costs, higher clinical throughput, and widespread access to precision LDR prostate brachytherapy. This prospective study confirms that the use of an ERC can be circumvented with fully bSSFP and advanced MRI scan techniques in a major academic cancer center and community hospital, potentially enabling postimplant assessment of MARS LDR prostate brachytherapy without CT.

Dataset Information

A multitransmit external body array combined with a 1 H and 31 P endorectal coil to enable a multiparametric and multimetabolic MRI examination of the prostate at 7T.

Publications

A multitransmit external body array combined with a <sup>1</sup> H and <sup>31</sup> P endorectal coil to enable a multiparametric and multimetabolic MRI examination of the prostate at 7T.

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