Abstract

PurposeTo subjectively and quantitatively compare the quality of 3 Tesla magnetic resonance imaging of the prostate acquired with a novel flexible surface coil (FSC) and with a conventional endorectal coil (ERC).MethodsSix radiologists independently reviewed 200 pairs of axial, high-resolution T2-weighted and diffusion-weighted image data sets, each containing one examination acquired with the FSC and one with the ERC, respectively. Readers selected their preferred examination from each pair and assessed every single examination using six quality criteria on 4-point scales. Signal-to-noise ratios were measured and compared.ResultsTwo readers preferred FSC acquisition (36.5–45%) over ERC acquisition (13.5–15%) for both sequences combined, and four readers preferred ERC acquisition (41–46%). Analysis of pooled responses for both sequences from all readers shows no significant preference for FSC or ERC. Analysis of the individual sequences revealed a pooled preference for the FSC in T2WI (38.7% vs 17.8%) and for the ERC in DWI (50.9% vs 19.6%). Patients’ weight was the only weak predictor of a preference for the ERC acquisition (p = 0.04). SNR and CNR were significantly higher in the ERC acquisitions (p<0.001) except CNR differentiating tumor lesions from benign prostate (p=0.1).ConclusionAlthough readers have strong individual preferences, comparable subjective image quality can be obtained for prostate MRI with an ERC and the novel FSC. ERC imaging might be particularly valuable for sequences with inherently lower SNR as DWI and larger patients whereas the FSC is generally preferred in T2WI. FSC imaging generates a lower SNR than with an ERC.

Highlights

  • Multiparametric magnetic resonance (MR) imaging of the prostate has become integral to management of patients with suspected or known prostate cancer (PCA) [1, 2]

  • Prostate MRI was initially performed with an endorectal receiver coil (ERC) [3] because its proximity to the gland increased the signal-to-noise ratio (SNR) of the acquired images

  • Half of patients in group A (26/50 patients, 52%) and about two-thirds of patients in group B (69/100, 69%) had biopsy-proven PCA at the time of the scan, whereas PCA was suspected in the remaining cases due to elevated prostate-specific antigen (PSA)

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Summary

Introduction

Multiparametric magnetic resonance (MR) imaging of the prostate has become integral to management of patients with suspected or known prostate cancer (PCA) [1, 2]. Prostate MRI was initially performed with an endorectal receiver coil (ERC) [3] because its proximity to the gland increased the signal-to-noise ratio (SNR) of the acquired images. The higher SNR could be exploited to increase spatial and/or temporal resolution [4, 5], possibly improving clinical performance [6,7,8]. ERCs entail several disadvantages such as increased costs, examination time, and discomfort for patients [9, 10], possibly compromising compliance. ERCs can induce severe signal inhomogeneities [11] and artifacts because of their non-uniform reception profile and/or poor positioning. ERCs can cause anatomical distortion of the gland or even stimulate intestinal peristalsis and motion artifacts

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