Dataset Information

Fully Balanced SSFP Without an Endorectal Coil for Postimplant QA of MRI-Assisted Radiosurgery (MARS) of Prostate Cancer: A Prospective Study.

ABSTRACT:

Purpose

To 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 materials

Seventeen 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.

Results

Increasing 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).

Conclusions

Acquiring 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.

SUBMITTER: Sanders JW

PROVIDER: S-EPMC7855300 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:PurposeThe purpose of this study was to investigate the feasibility and sensitivity of cellular magnetic resonance imaging (MRI) with ferumoxytol nanocomplex-labeled macrophages at ultrahigh magnetic field of 7 T.Materials and methodsTHP-1-induced macrophages were labeled using self-assembling heparin + protamine + ferumoxytol nanocomplexes which were injected into a gelatin phantom visible on both microscope and MRI. Susceptibility-weighted imaging (SWI) and balanced steady-state free precession (bSSFP) pulse sequences were applied at 3 and 7 T. The average, maximum intensity projection, and root mean square combined images were generated for phase-cycled bSSFP images. The signal-to-noise ratio and contrast-to-noise ratio (CNR) efficiencies were calculated. Ex vivo experiments were then performed using a formalin-fixed pig brain injected wit?100 and ~1,000 labeled cells, respectively, at both 3 and 7 T.ResultsA high cell labeling efficiency (.90%) was achieved with heparin + protamine + ferumoxytol nanocomplexes. Less than 100 cells were detectable in the gelatin phantom at both 3 and 7 T. The 7 T data showed more than double CNR efficiency compared to the corresponding sequences at 3 T. The CNR efficiencies of phase-cycled bSSFP images were higher compared to those of SWI, and the root mean square combined bSSFP showed the highest CNR efficiency with minimal banding. Following co-registration of microscope and MR images, more cells (51/63) were detected by bSSFP at 7 T than at 3 T (36/63). On pig brain, bot?100 and ~1,000 cells were detected at 3 and 7 T. While the cell size appeared larger due to blooming effects on SWI, bSSFP allowed better contrast to precisely identify the location of the cells with higher signal-to-noise ratio efficiency.ConclusionThe proposed cellular MRI with ferumoxytol nanocomplex-labeled macrophages at 7 T has a high sensitivity to detect, 100 cells. The proposed method has great translational potential and may have broad clinical applications that involve cell types with a primary phagocytic phenotype.