Abstract
Facilitating clinical translation of quantitative imaging techniques has been suggested as means of improving interobserver agreement and diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) of the prostate. One such technique, magnetic resonance fingerprinting (MRF), has significant competitive advantages over conventional mapping techniques in terms of its multi-site reproducibility, short scanning time and inherent robustness to motion. It has also been shown to improve the detection of clinically significant prostate cancer when added to standard mpMRI sequences, however, the existing studies have all been conducted on 3.0 T MRI systems, limiting the technique’s use on 1.5 T MRI scanners that are still more widely used for prostate imaging across the globe. The aim of this proof-of-concept study was, therefore, to evaluate the cross-system reproducibility of prostate MRF T1 in healthy volunteers (HVs) using 1.5 and 3.0 T MRI systems. The initial validation of MRF T1 against gold standard inversion recovery fast spin echo (IR-FSE) T1 in the ISMRM/NIST MRI system revealed a strong linear correlation between phantom-derived MRF and IR-FSE T1 values was observed at both field strengths (R2 = 0.998 at 1.5T and R2 = 0.993 at 3T; p = < 0.0001 for both). In young HVs, inter-scanner CVs demonstrated marginal differences across all tissues with the highest difference of 3% observed in fat (2% at 1.5T vs 5% at 3T). At both field strengths, MRF T1 could confidently differentiate prostate peripheral zone from transition zone, which highlights the high quantitative potential of the technique given the known difficulty of tissue differentiation in this age group. The high cross-system reproducibility of MRF T1 relaxometry of the healthy prostate observed in this preliminary study, therefore, supports the technique’s prospective clinical validation as part of larger trials employing 1.5 T MRI systems, which are still widely used clinically for routine mpMRI of the prostate.
Highlights
Multiparametric magnetic resonance imaging has recently been adopted by major European and American prostate cancer (PCa) guidelines as the key diagnostic tool for detection, local staging and active surveillance of the disease [1, 2]
The analysis showed a strong linear correlation between magnetic resonance fingerprinting (MRF) and inversion recovery fast spin echo (IR-FSE) at both field strengths (R2 = 0.998 at 1.5T and R2 = 0.993 at 3T; p = < 0.0001 for both) with slopes of the linear fits and y-intercepts presented in the corresponding figures
The study was preceded by a phantom experiment that confirmed high reliability of MRF T1 mapping used when validated against IR-FSE imaging
Summary
Multiparametric magnetic resonance imaging (mpMRI) has recently been adopted by major European and American prostate cancer (PCa) guidelines as the key diagnostic tool for detection, local staging and active surveillance of the disease [1, 2]. Making prostate MRI more objective by facilitating clinical translation of quantitative imaging techniques is viewed by many experts as key to solving the aforementioned challenges [9, 10]. This move is supported by the Prostate Imaging Reporting and Data System (PI-RADS) steering committee with a view to complement the current recommendations that are based exclusively on qualitative visual assessment of images [11, 12]. The key competitive advantages of MRF over standard mapping techniques, which make it attractive for PCa imaging, include its higher multisite reproducibility and significantly shorter acquisition time, which is important given the current move towards developing abbreviated prostate imaging protocols in order to reduce scanning times whilst maintaining quality [14,15,16,17,18,19]
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