Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium.
Philips Medical Systems International BV, Veenpluis 4-6, 5684 PC, Best, The Netherlands.
Eur Radiol. 2020 Jun;30(6):3083-3093. doi: 10.1007/s00330-019-06515-y. Epub 2020 Feb 17.
To compare 3D T1-weighted fast spin echo (FSE) and 3D T1-weighted gradient echo (GE) mDixon as morphologic sequences to complement diffusion-weighted imaging (DWI) for the metastatic screening in prostate cancer (PCa) patients.
Thirty PCa patients at high risk of metastases prospectively underwent both a 3D T1 FSE (14 min) and a rapid 3D T1 GE (1 min 20 s) sequences within a WB-MRI protocol. Two readers assessed the diagnostic performance of the FSE/Fat/in-phase (IP)/IP+Fat sequences in detecting bone and node metastases. The reference standard was established by a panel of four physicians on the basis of all baseline and follow-up imaging, biological and clinical information. The reproducibility of readings, predictive accuracy (Acc) from ROC curves analysis, and contrast-to-reference ratio (CRR) in lesions were assessed for each sequence.
In bone and lymph nodes (per-region analysis), reproducibility was at least good for all sequences/readers, except for nodes in the common iliac/inguinal regions. In bone (per-organ analysis), Acc of FSE was superior to that of mDixon (difference + 4%, p < 0.0083). In nodes (per-organ analysis), Acc of Fat was superior to that of other sequences (difference + 4% to + 6% depending on reader, p < 0.0083). In the per-patient analysis, Acc of FSE was superior to that of mDixon (difference + 4% to + 6% depending on sequence, p < 0.0083). Fat images had higher CRR compared with FSE in the thoracic spine, the bony pelvis and lymph node metastases (p < 0.025).
3D T1 GE may replace 3D T1 FSE to complement DWI in WB-MRI for metastatic screening in PCa. It demonstrates an Acc ranging from + 4% to + 6% (nodes) to - 4% to - 6% (bone and patient staging) compared with FSE and considerably reduces the examination time, offering the perspective of acquiring WB-MRI examinations in less than 20 min.
• The replacement of 3D T1 FSE by the 3D T1 GE mDixon as morphologic sequence to complement DWI drastically reduces the acquisition time of WB-MRI studies. • The 3D T1 GE mDixon sequence offers similar reproducibility of image readings compared with that of the 3D T1 FSE. • Differences in diagnostic accuracy are limited (+ 4%/+ 6% in favor of mDixon to detect node metastases; + 4%/+ 6% in favor of FSE to detect bone metastases/metastatic disease in a patient).
比较 3D T1 加权快速自旋回波（FSE）和 3D T1 加权梯度回波（GE）mDixon 作为形态学序列，以补充扩散加权成像（DWI）在前列腺癌（PCa）患者中的转移筛查。
30 例高危转移的 PCa 患者前瞻性地在 WB-MRI 方案中同时进行 3D T1 FSE（14 分钟）和快速 3D T1 GE（1 分 20 秒）序列检查。两位读者评估了 FSE/Fat/同相（IP）/IP+Fat 序列在检测骨和淋巴结转移方面的诊断性能。参考标准由四位医生根据所有基线和随访影像学、生物学和临床信息建立。评估了每个序列的阅读可重复性、来自 ROC 曲线分析的预测准确性（Acc）以及病变中的对比参考比（CRR）。
在骨和淋巴结（区域分析）中，除了髂总和腹股沟区淋巴结外，所有序列/读者的可重复性均至少为良好。在骨（器官分析）中，FSE 的 Acc 优于 mDixon（差异+4%，p<0.0083）。在淋巴结（器官分析）中，Fat 序列的 Acc 优于其他序列（差异+4%至+6%，取决于读者，p<0.0083）。在患者分析中，FSE 的 Acc 优于 mDixon（差异+4%至+6%，取决于序列，p<0.0083）。与 FSE 相比，脂肪图像在胸椎、骨盆骨和淋巴结转移中具有更高的 CRR（p<0.025）。
3D T1 GE 可替代 3D T1 FSE 与 DWI 联合用于 WB-MRI 转移筛查，与 FSE 相比，Acc 可提高+4%至+6%（淋巴结）至-4%至-6%（骨和患者分期），同时显著缩短检查时间，为在 20 分钟内完成 WB-MRI 检查提供了可能性。
3D T1 FSE 被 3D T1 GE mDixon 替代为形态学序列，与 DWI 联合使用，大大缩短了 WB-MRI 研究的采集时间。
3D T1 GE mDixon 序列的图像阅读可重复性与 3D T1 FSE 相似。
诊断准确性的差异有限（以 mDixon 检测淋巴结转移时为+4%/+6%；以 FSE 检测骨转移/患者转移疾病时为+4%/+6%）。
