Tamada Tsutomu, Ream Justin M, Doshi Ankur M, Taneja Samir S, Rosenkrantz Andrew B
From the *Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, New York University, New York, NY; †Department of Radiology, Kawasaki Medical School, Kurashiki, Japan; and ‡Department of Urologic Oncology, NYU School of Medicine, NYU Langone Medical Center, New York University, New York, NY.
J Comput Assist Tomogr. 2017 Nov/Dec;41(6):949-956. doi: 10.1097/RCT.0000000000000634.
The purpose of this study was to compare image quality and tumor assessment at prostate magnetic resonance imaging (MRI) between reduced field-of-view diffusion-weighted imaging (rFOV-DWI) and standard DWI (st-DWI).
A total of 49 patients undergoing prostate MRI and MRI/ultrasound fusion-targeted biopsy were included. Examinations included st-DWI (field of view [FOV], 200 × 200 mm) and rFOV-DWI (FOV, 140 × 64 mm) using a 2-dimensional (2D) spatially-selective radiofrequency pulse and parallel transmission. Two readers performed qualitative assessments; a third reader performed quantitative evaluation.
Overall image quality, anatomic distortion, visualization of capsule, and visualization of peripheral/transition zone edge were better for rFOV-DWI for reader 1 (P ≤ 0.002), although not for reader 2 (P ≥ 0.567). For both readers, sensitivity, specificity, and accuracy for tumor with a Gleason Score (GS) of 3 + 4 or higher were not different (P ≥ 0.289). Lesion clarity was higher for st-DWI for reader 2 (P = 0.008), although similar for reader 1 (P = 0.409). Diagnostic confidence was not different for either reader (P ≥ 0.052). Tumor-to-benign apparent diffusion coefficient ratio was not different (P = 0.675).
Potentially improved image quality of rFOV-DWI did not yield improved tumor assessment. Continued optimization is warranted.
本研究旨在比较缩小视野扩散加权成像（rFOV-DWI）与标准扩散加权成像（st-DWI）在前列腺磁共振成像（MRI）中的图像质量和肿瘤评估情况。
共纳入49例行前列腺MRI及MRI/超声融合靶向活检的患者。检查包括使用二维（2D）空间选择性射频脉冲和平行传输技术的st-DWI（视野[FOV]，200×200 mm）和rFOV-DWI（FOV，140×64 mm）。两名阅片者进行定性评估；第三名阅片者进行定量评估。
对于阅片者1，rFOV-DWI的整体图像质量、解剖结构变形、包膜可视化以及外周/移行带边缘可视化均更好（P≤0.002），但阅片者2的情况并非如此（P≥0.567）。对于两名阅片者，Gleason评分（GS）为3+4或更高的肿瘤的敏感性、特异性和准确性均无差异（P≥0.289）。阅片者2的st-DWI的病变清晰度更高（P=0.008），但阅片者1的情况相似（P=0.409）。两名阅片者的诊断信心均无差异（P≥0.052）。肿瘤与良性组织的表观扩散系数比值无差异（P=0.675）。
rFOV-DWI潜在改善的图像质量并未带来更好的肿瘤评估效果。仍需继续优化。
