Optimized biparametric magnetic resonance imaging protocol for prostate cancer detection

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Abstract

BACKGROUND: Prostate cancer is one of the most commonly diagnosed cancers in men worldwide. PI-RADS v2.1 contains the requirements for the magnetic resonance imaging protocol, which cannot be fully implemented on a significant component of functioning scanners. Consequently, magnetic resonance imaging approaches vary in different medical organizations and often do not allow for a qualitative interpretation of images and diagnosis of the target pathology.

AIM: To develop a biparametric magnetic resonance imaging protocol optimized for the existing magnetic resonance imaging scanners for the diagnosis of prostate cancer and to allow the screening and detection of neoplasms as early as possible. Simultaneously, the protocol should fulfill the current PI-RADS v2.1 recommendations to the maximum possible extent and meet the requirements of effective workflow in the radiology department.

MATERIALS AND METHODS: Preliminary analysis of prostate magnetic resonance imaging scanning in medical organizations of the Moscow Health Care Department showed the absence of a unified approach. Using the iterative adjustment of scanning parameters, we adjusted the protocol to ensure acceptable quality with maximum available compliance with PI-RADS v2.1.

To quantify the quality of the images, we used the magnetic resonance imaging phantom recommended by the American College of Radiology.

RESULTS: The biparametric protocol was developed for Excelart Vantage 1.5 T, including T2-weighted images in three planes and diffusion-weighted images, which took less than 11 min. Moreover, the image quality parameters (intensity inhomogeneity, nonlinearity, resolution, and slice thickness) were within the acceptable ranges recommended by the magnetic resonance imaging manufacturer.

CONCLUSION: The prostate may be effectively evaluated using the proposed magnetic resonance imaging protocol. Introducing it into practice could have a significant impact on the detection of prostate cancer in men. The entire duration of the protocol provides a possibility to supplement it with any sequences, depending on the final purpose of investigation.

About the authors

Liya R. Abuladze

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: l.abuladze@npcmr.ru
ORCID iD: 0000-0001-6745-1672
SPIN-code: 5640-9989
Russian Federation, Moscow

Dmitriy S. Semenov

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: d.semenov@npcmr.ru
ORCID iD: 0000-0002-4293-2514
SPIN-code: 2278-7290
Scopus Author ID: 57213154475
ResearcherId: P-5228-2017

Researcher of the Department of Innovative Technologies

Russian Federation, Moscow

Olga Y. Panina

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies; City Clinical Oncological Hospital No. 1; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: olgayurpanina@gmail.com
ORCID iD: 0000-0002-8684-775X
SPIN-code: 5504-8136
ResearcherId: AAG-6447-2020
Russian Federation, Moscow; Moscow; Moscow

Yuriy A. Vasilev

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Author for correspondence.
Email: dr.vasilev@me.com
ORCID iD: 0000-0002-0208-5218
SPIN-code: 4458-5608
Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Evaluation of visualization quality: a) prostate phantom; b - patient; c) phantom of the American Society of Radiology (ACR).

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3. Fig. 2. Medical organization 1 (MO 1): a) T2-WI, axial projection (TR 5851, TE 120, FOV 35×30 cm, Matrix 256×256); b, c) DWI and ICD (TR 6772, TE 80, FOV 40×32 cm, Matrix 128×128).

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4. Fig. 3. Medical organization 2 (MO 2). In the peripheral zone on the right, a hypointense zone on T2-WI and ICD map adjacent to the capsule (arrows) is defined: a) T2-WI, axial projection (TR 6006, TE 75, FOV 30×25 cm, Matrix 256×256); b, c) DWI and ICD (TR 9377, TE 80, FOV 37×30 cm, Matrix 128×192).

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5. Fig. 4. Medical organization 3 (MO 3). In the peripheral zone on the left, a hypointense lesion on T2-WI and ICD map is defined (arrows): a) T2-WI, axial projection (TR 5082, TE 75, FOV 40×30 cm, Matrix 512×256); b, c) DWI and ICD (TR 8841, TE 100, FOV 30×30 cm, Matrix 128×128).

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6. Fig. 5. Images obtained using the accelerated protocol of biparametric magnetic resonance imaging. Patient with prostate changes consistent with PI-RADS 2: a) T2-WI, axial view; b, c) DWI and ICD.

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