Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Box 1234, New York, NY, 10029, USA.
BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Cancer Imaging. 2022 Mar 16;22(1):15. doi: 10.1186/s40644-022-00453-7.
To compare image quality, lesion detection and patient comfort of 3T prostate MRI using a combined rigid two-channel phased-array endorectal coil and an external phased-array coil (ERC-PAC) compared to external PAC acquisition in the same patients.
Thirty three men (mean age 65.3y) with suspected (n = 15) or biopsy-proven prostate cancer (PCa, n = 18) were prospectively enrolled in this exploratory study. 3T prostate MRI including T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) was performed using an ERC-PAC versus PAC alone, in random order. Image quality, lesion detection and characterization (biparametric PI-RADSv2.1) were evaluated by 2 independent observers. Estimated signal-to-noise ratio (eSNR) was measured in identified lesions and the peripheral zone (PZ). Patient comfort was assessed using a questionnaire. Data were compared between sequences and acquisitions. Inter/intra-observer agreement for PI-RADS scores was evaluated.
Twenty four prostate lesions (22 PCa) were identified in 20/33 men. Superior image quality was found for ERC-PAC compared to PAC for T2WI for one observer (Obs.1, p < 0.03) and high b-value DWI for both observers (p < 0.05). The sensitivity of PI-RADS for lesion detection for ERC-PAC and PAC acquisitions was 79.2 and 75% for Obs.1, and 79.1 and 66.7%, for Obs.2, without significant difference for each observer (McNemar p-values ≥0.08). Inter-/intra-observer agreement for PI-RADS scores was moderate-to-substantial (kappa = 0.52-0.84). Higher eSNR was observed for lesions and PZ for T2WI and PZ for DWI using ERC-PAC (p < 0.013). Most patients (21/33) reported discomfort at ERC insertion.
Despite improved image quality and eSNR using the rigid ERC-PAC combination, no significant improvement in lesion detection was observed, therefore not supporting the routine use of ERC for prostate MRI.
本研究旨在比较使用刚性双通道直肠内相控阵线圈（ERC-PAC）联合外部相控阵线圈（ERC-PAC）与单独使用外部相控阵线圈（PAC）采集 3T 前列腺 MRI 的图像质量、病灶检出率和患者舒适度，评估其在疑似（n=15）或经活检证实的前列腺癌（PCa，n=18）患者中的应用价值。
本前瞻性研究共纳入 33 例疑似前列腺癌或经活检证实的前列腺癌患者（平均年龄 65.3 岁）。所有患者均接受了包括 T2 加权成像（T2WI）和弥散加权成像（DWI）的 3T 前列腺 MRI 检查，采用 ERC-PAC 联合或不联合 PAC 采集，采集顺序随机。由 2 名独立观察者评估图像质量、病灶检出和特征（PI-RADSv2.1 双参数评分）。测量识别病灶和外周带（PZ）的估计信噪比（eSNR）。采用问卷评估患者舒适度。比较两种序列和采集方法之间的数据。评估 PI-RADS 评分的观察者内和观察者间一致性。
20 例患者（33 例患者中的 24 例）共检出 24 个前列腺病灶（22 个 PCa）。一名观察者（Obs.1）发现 ERC-PAC 采集的 T2WI 图像质量优于 PAC（p<0.03），两名观察者均发现 ERC-PAC 采集的高 b 值 DWI 图像质量优于 PAC（p<0.05）。对于 ERC-PAC 和 PAC 采集，Obs.1 观察到的病灶检出敏感性分别为 79.2%和 75%，Obs.2 观察到的病灶检出敏感性分别为 79.1%和 66.7%，两种观察者间差异均无统计学意义（McNemar 检验 p 值均≥0.08）。PI-RADS 评分的观察者内和观察者间一致性为中度至高度（kappa=0.52-0.84）。对于 T2WI 的病灶和 PZ 以及 DWI 的 PZ，ERC-PAC 采集的 eSNR 更高（p<0.013）。大多数患者（21/33）在 ERC 插入时感到不适。
尽管使用刚性 ERC-PAC 联合采集可提高图像质量和 eSNR，但并未观察到病灶检出率的显著改善，因此不支持常规使用 ERC 进行前列腺 MRI 检查。
