Update of prostate magnetic resonance imaging at 3 T

More recently, 3-T magnetic resonance (MR) scanner become more clinically available, and clinical application of 3-T MR imaging (MRI) of the abdomen and pelvis is now feasible and being performed at many institutions. However, few prostrate 3-T MRI studies have been published. The increase in signal-to-noise ratio at 3 versus 1.5 T clearly improves spatiotemporal and spectral resolutions of the prostate. Thus, we asked whether 3-T MRI improves the localization and staging of prostate cancer versus 1.5-T MRI. To answer this question, this article reviews the current limitations of prostate 1.5-T MRI and addresses its pros and cons. Moreover, we present preliminary results of prostate 3-T MRI and introduce our experience for prostate 3-T MRI using a phased-array coil, with an emphasis on imaging sequences, for example, T2-weighted, dynamic contrast-enhanced, diffusion-weighted, and MR spectroscopic imaging.     

MRI快速自旋回波序列和盆腔相控线圈对前列腺癌的诊断价值

评价快速自旋回波序列和盆腔相控线圈在前列腺癌ＭＲＩ诊断的价值。方法１４６例进行前殂朱ＭＲＩ检查,其中２４例应用常规ＳＥＴ２ＷＩ和体线圈;７０例应用ＦＳＥＴ２ＷＩ和体线圈;５２例应用ＦＳＥＴ２ＷＩ和盆腔相控线圈;比较３种扫描方法所获图像质量之间的差异和对前列腺癌诊断的准确性、敏感性、特异性、阳性预测值和阴性预测值。     

Initial experience of 3 tesla endorectal coil magnetic resonance imaging and 1H-spectroscopic imaging of the prostate

RATIONALE AND OBJECTIVES: We sought to explore the feasibility of magnetic resonance imaging (MRI) of the prostate at 3T, with the knowledge of potential drawbacks of MRI at high field strengths. MATERIAL AND METHOD: MRI, dynamic MRI, and 1H-MR spectroscopic imaging were performed in 10 patients with prostate cancer on 1.5T and 3T whole-body scanners. Comparable scan protocols were used, and additional high-resolution measurements at 3T were acquired. For both field strengths the signal-to-noise ratio was calculated and image quality was assessed. RESULT: At 3T the signal-to-noise ratio improved. This resulted in increased spatial MRI resolution, which significantly improved anatomic detail. The increased spectral resolution improved the separation of individual resonances in MRSI. Contrast-enhanced time-concentration curves could be obtained with a doubled temporal resolution. CONCLUSIONS: Initial results of endorectal 3T 1H-MR spectroscopic imaging in prostate cancer patients showed potential advantages: the increase in spatial, temporal, and spectral resolution at higher field strength may result in an improved accuracy in delineating and staging prostate cancer.     

A solid reusable endorectal receiver coil for magnetic resonance imaging of the prostate: Design,use, and comparison with an inflatable endorectal coil

We have designed a solid endorectal receiver coil for MRI of the prostate. The coil provided an improved signal-to-noise ratio up to 5 cm from its surface when compared with a standard pelvic phased array. This preliminary report describes 16 patients who were imaged using this coil, seven of whom had been examined previously with a balloon-design endorectal coil. Patient tolerance of these coils was compared. The solid coil was easy to insert and quick to set up because it did not require external tuning and matching. It avoided uncomfortable rectal distension experienced with the balloon coil as well as susceptibility artifacts from air in the balloon. In addition, it could be sterilized and reused.     

Prostate MR imaging at 3T with a longitudinal array endorectal surface coil and phased array body coil

PURPOSE: To demonstrate the feasibility of using a double loop phased array endorectal coil combined with a phased array body coil to image the prostate at 3T. MATERIALS AND METHODS: We designed and constructed a novel prostate coil employing two arrayed 4.0 x 5.0 cm loops, tuned the device for optimal performance at 3T, and characterized the signal-to-noise ratio (SNR) associated with it. RESULTS: The coil Q factor was calculated to be approximately 50 unloaded, and 30 when loaded on human tissue. SNR maps at multiple orientations were constructed and images were acquired on both a phantom and a human. As expected, SNR was highest along the midpoint of the array and demonstrated strong signal even at 4 cm from the coil. CONCLUSION: The double loop phased array endorectal coil combined with a phased array body coil at 3T is feasible in vivo and compelling enough to warrant future clinical trials to evaluate its efficacy. These trials are currently under way.     

Endourethral MRI.

Although high-resolution MRI with phased array pelvic, endorectal, and endovaginal coils has dramatically enhanced the ability to visualize abnormalities of the female urethra and periurethral tissues, controversy still remains about the anatomy of this region. This study introduces an endourethral approach for ultra-high-resolution MRI of the female urethra and the periurethral tissues. To this end, two different radiofrequency (RF) receiver coil designs for an endourethral insertion have been developed: a single-loop coil and a phased array/quadrature coil. Both designs feature a flexible coil circuit, small loss tuning and matching directly at the coil, active decoupling, and the integration of a lambda/4 coaxial choke to decrease unbalanced currents and limit potential RF heating effects. Effective reduction of the mutual inductance between the two coils of the phased array design was achieved by introducing a metallic "paddle" to steer the flux between the coils. The performance of the coils has been evaluated in female human cadaver studies and in an in vivo pig experiment. The novel endourethral approach enabled a dramatic increase of the signal-to-noise ratio (SNR) at the region of interest (ROI). High-resolution MR images of the female urethra have been acquired with a spatial resolution down to 78 x 78 microm. Histologic correlation was achieved for the MR images generated. The achieved high local SNR and resulting high spatial resolution will add valuable information to the discussion of female urethral anatomy. Magn Reson Med 45:138-146, 2001.     

3D proton MR spectroscopic imaging of prostate cancer using a standard spine coil at 1.5 T in clinical routine: a feasibility study

The objective of this study was to demonstrate the feasibility of 3D proton MR spectroscopic imaging (MRSI) of the prostate using a standard spine instead of a dedicated endorectal coil at 1.5 T. Twenty-eight patients (25 with biopsy proven prostate cancers and three patients with a benign prostate hyperplasia) were examined. MRI and MRSI were conducted with commercial array surface coils at 1.5 T. Ratios of choline (Cho), creatine (Cr) and citrate (Ci) were calculated for tumour, central and peripheral zone retrospectively, based on axial T2 weighed MR images and histology reports. Prostate cancer was characterized by significantly elevated (Cho+Cr)/Ci ratio compared with non-tumourous prostate tissue. The quality of all proton MR spectra was considered to be good or acceptable in 17/28 patients (61%) and poor in 11/28 (39%) examinations. In 20/25 patients with proven malignancy (80%), MRSI was considered to be helpful for the detection of prostate cancer. In 4/25 patients with proven malignancy (16%) who underwent seed implantation, radiotherapy or hormone deprivation before MR examination spectroscopy was of poor and non-diagnostic quality. MRSI of the prostate is feasible within clinical routine using the spine array surface coil at 1.5 T. It can consequently be applied to patients even with contraindications for endorectal coils. However, spectral quality and signal-to-noise ratio is clearly inferior to 3D MRSI examinations with endorectal coils.     

Moving-table MR angiography of the peripheral runoff vessels: comparison of body coil and dedicated phased array coil systems

OBJECTIVE: The aim of our study was to compare the signal-to-noise ratio and the diagnostic accuracy of moving-table MR angiography of the peripheral arteries with body coil and dedicated phased array coil systems. SUBJECTS AND METHODS: Forty patients were examined with digital subtraction angiography and moving-table MR angiography with a 1.5-T MR imaging system either with a body coil (n = 20) or with a dedicated phased array coil (n = 20). The timing of contrast material was performed with real-time MR fluoroscopy. RESULTS: For the iliac artery, upper leg, and lower leg, the mean values for signal-to-noise ratios were 56, 51, and 17, respectively, for the body coil, and 54, 74, and 64, respectively, for the dedicated phased array coil. For the body coil, sensitivity and specificity in identifying stenosis greater than 50% and occlusions were 100% and 96%, respectively, for the iliac arteries, and 100% and 96%, respectively, for the upper leg. For the dedicated phased array coil, sensitivity and specificity for stenosis greater than 50% and occlusions were 100% and 96%, respectively, for the iliac arteries, and 100% and 98%, respectively, for the upper leg. Sensitivity and specificity were inferior for the body coil (88% and 85%) compared with the dedicated phased array coil (100% and 96%) in the lower leg. A significant difference of the mean values of contrast-to-noise ratio was found before and after subtraction for the dedicated phased array coil and body-coil techniques (Student's t test, p < 0.01). CONCLUSION: In comparison with the body coil, the dedicated peripheral phased array surface coil system improves signal-to-noise ratio for the upper and lower leg and diagnostic accuracy in the lower leg.     

Clinical 1H magnetic resonance spectroscopy of brain metastases at 1.5T and 3T

Purpose: To investigate whether improvements in signal-to-noise ratio (SNR) and spectral resolution are found in spectra from patients with brain metastases obtained at higher magnetic field strengths using standard clinical instrumentation.

Material and Methods: Six patients with brain metastases, 13 healthy volunteers, and a phantom containing brain metabolites were examined using two clinical MR instruments operating at 1.5T (Siemens) and 3T (Philips) with standard clinical head coils. Spectra were obtained using a point resolved spectroscopy pulse sequence, echo times (TE) 32 ms and 144 ms, and repetition time 2000 ms from a volume-of-interest (VOI) of size 15×15×15 mm³. SNR and spectral resolution of the metabolites N-acetylaspartate, choline, and creatine compounds in spectra from 3T were compared to the 1.5T spectra.

Results: In general, spectral resolution was improved by 25-30% at higher magnetic field strength. Only minor improvements in SNR were obtained at 3T using short echo time and 20-50% at long echo time.

Conclusion: SNR and spectral resolution were improved at higher magnetic field strength, especially with TE 144 ms, including spectra from patients with heterogeneous brain tumors. However, differences in the defined effective VOI, particularly at short echo time, reduced the expected effect of increased magnetic field strength on the measured SNR.     

Image construction methods for phased array magnetic resonance imaging

PURPOSE: To study image construction in phased array magnetic resonance imaging (MRI) systems from a statistical signal processing point of view. MATERIALS AND METHODS: Three new approaches for image combination with multiple coils are proposed: 1) one based on the singular value decomposition of the measurement matrix, which is asymptotically optimal in the signal-to-noise ratio sense; 2) one based on a maximum-likelihood formulation, incorporating a priori information on the coil sensitivities in a Bayesian manner; and 3) one based on a least-squares formulation, which incorporates a smoothness constraint on the coil sensitivities. RESULTS: Numerical examples using synthetic and real data are presented to illustrate the performance of these new approaches. Results on the synthetic data show improvement in signal-to-error ratio, while results on the real data (a 4.7 T four-coil image of a cat spinal cord) show that the proposed methods can improve the SNR in the final image by up to 3 dB in the regions of interest compared to conventional sum-of-squares processing. CONCLUSION: It is demonstrated that phased array MRI reconstruction performance can be improved by the use of more elaborate statistical signal processing algorithms.     

3 Tesla magnetic resonance imaging of the prostate with combined pelvic phased-array and endorectal coils; Initial experience(1)

RATIONALE AND OBJECTIVES: High-resolution magnetic resonance imaging of the prostate at 1.5T has gained acceptance for pretherapeutic staging of prostate cancer. The aim of this study was to evaluate the potential clinical utility of combined pelvic phased-array and endorectal coils at 3T. MATERIALS AND METHODS: Six volunteers were examined on 1.5T and 3T scanners with pelvic phased-array surface coil combined with a disposable endorectal prostate coil. RESULTS: We were able to acquire T2-W fast spin echo images with 1.5 mm slices, field of view 12, matrix 320 x 192, (voxel size 0.35 mm(3)), with excellent anatomic detail and good T2 contrast. A 1.5 mm axial slice thickness permitted high-quality multiplanar reconstructions with clear visualization of small patho-anatomic structures. Dynamic contrast-enhanced gradient echo images showed excellent spatial resolution (voxel size, 0.38 mm(3)) and temporal resolution. With this level of anatomic information in dynamic images we could clearly distinguish between intracapsular and extracapsular contrast enhancement. CONCLUSION: Using modified T2-fast spin echo and dynamic contrast-enhanced gradient echo sequences, we obtained whole gland coverage with 35-38 microm(3) resolution, without interfering artifacts, in reasonable acquisition times and staying well below the specific absorption rate guidelines. The high spatial resolution in the axial plane allowed meaningful multiplanar reconstructions. The initial results show the clinical utility of endorectal 3T for the noninvasive evaluation of the prostate with image features and quality not achievable at 1.5 T.     

MR imaging of the pelvis with an endorectal-external multicoil array.

Magnetic resonance (MR) images of the pelvis obtained with an endorectal coil have improved resolution relative to that of body coil images; however, they have limited spatial coverage. The sensitivity profile can be improved by using the endorectal coil combined with an external anterior coil as part of a multicoil array. If each coil is connected to a separate receiver, the individual images can be combined to provide an optimal signal-to-noise ratio (S/N). The authors have investigated a 5-inch (12.7-cm) surface coil or a two-coil array as the anterior coil. In both of these configurations, the S/N is improved relative to that of the endorectal coil alone at distances greater than 3 cm from the endorectal coil. The anterior two-coil array provides more lateral coverage. The improved spatial coverage available with this technique expands potential clinical applications of endorectal MR imaging.     

Design and development of a prototype endocavitary probe for high-intensity focused ultrasound delivery with integrated magnetic resonance imaging

Purpose

To integrate a high intensity focused ultrasound (HIFU) transducer with an MR receiver coil for endocavitary MR‐guided thermal ablation of localized pelvic lesions.

Materials and Methods

A hollow semicylindrical probe (diameter 3.2 cm) with a rectangular upper surface (7.2 cm × 3.2 cm) was designed to house a HIFU transducer and enable acoustic contact with an intraluminal wall. The probe was distally rounded to ease endocavitary insertion and was proximally tapered to a 1.5‐cm diameter cylindrical handle through which the irrigation tubes (for transducer cooling) and electrical connections were passed. MR compatibility of piezoceramic and piezocomposite transducers was assessed using gradient‐echo (GRE) sequences. The radiofrequency (RF) tuning of identical 6.5 cm × 2.5 cm rectangular receiver coils on the upper surface of the probe was adjusted to compensate for the presence of the conductive components of the HIFU transducers. A T1‐weighted (T1‐W) sliding window dual‐echo GRE sequence monitored phase changes in the focal zone of each transducer. High‐intensity (2400 W/cm^–2), short duration (<1.5 seconds) exposures produced subtherapeutic temperature rises.

Results

For T1‐W images, signal‐to‐noise ratio (SNR) improved by 40% as a result of quartering the conductive surface of the piezoceramic transducer. A piezocomposite transducer showed a further 28% improvement. SNRs for an endocavitary coil in the focal plane of the HIFU trans‐ducer (4 cm from its face) were three times greater than from a phased body array coil. Local shimming improved uniformity of phase images. Phase changes were detected at subtherapeutic exposures.

Conclusion

We combined a HIFU transducer with an MR receiver coil in an endocavitary probe. SNRs were improved by quartering the conductive surface of the piezoceramic. Further improvement was achieved with a piezocomposite transducer. A phase change was seen on MR images during both subtherapeutic and therapeutic HIFU exposures. J. Magn. Reson. Imaging 2007. © 2007 Wiley‐Liss, Inc.     

Pelvic imaging with phased-array coils: quantitative assessment of signal-to-noise ratio improvement.

The signal-to-noise ratios (S/Ns) of two different pelvic magnetic resonance (MR) imaging phased arrays were compared with that of the body coil. Each array consisted of two coils placed anteriorly and two posteriorly, oriented transversely in one array and longitudinally in the other. S/N measurements were obtained in an adjustable water-filled phantom that stimulated the shape and radio-frequency loading effects of various-size patients. Depending on the simulated anterior-posterior thickness of the patient, the S/N produced by the longitudinal array ranged from 2.3 to 3.1 times higher than that of the body coil. The S/N of the transverse array was 3.1 to 3.4 times higher. The increased coil sensitivity permits imaging with shorter acquisition times, smaller fields of view, finer resolution, and/or thinner sections. Two examples in patients demonstrate the enhanced imaging capability of the phased arrays.     

Hybrid phased array for improved internal auditory canal imaging at 3.0-T MR

PURPOSE: To develop and evaluate a hybrid phased array for internal auditory canal (IAC) imaging at 3.0 T. MATERIALS AND METHODS: A hybrid phased array was designed and built as two circular surface receive-only coils combined with a volume transmit-receive birdcage head coil for simultaneous image acquisition. Phantom and volunteer images were obtained to assess the coil performance. RESULTS: The phantom data show that significant signal-to-noise ratio (SNR) improvement was achieved in the region corresponding to the inner ear, i.e., by a factor of 2.5 compared to the standard head coil data. Volunteer IAC image quality was deemed superior as compared to images acquired at 3.0 T using a standard head coil. CONCLUSION: This hybrid array combined with three-dimensional fast spin-echo (FSE) acquisition resulted in improved high spatial resolution IAC imaging.     

Geometrical optimization of a phased array coil for high-resolution MR imaging of the carotid arteries.

The geometry of an RF phased-array receiving coil for high-resolution MRI of the carotid artery, particularly the bifurcation, was optimized with respect to signal-to-noise ratio (SNR). A simulation tool was developed to determine homogeneity, sensitivity, and SNR for a given imaging situation. The algorithm takes into account the coil geometry, the parameters of the measured object, and the imaging parameters of the pulse sequence. The coil with the optimum geometry was implemented as a receive-only coil for 1.5 T and comparative SNR measurements with different coils were performed. The experimental SNR measurements verified the simulations. The optimized carotid artery phased array offered the best SNR over the desired field of view. In vivo high-resolution MRI of the carotid arteries of healthy volunteers and patients with known stenosis was conducted with the optimized phased array coil. The capability of the phased array coil for resolving components within the carotid artery walls is demonstrated. Magn Reson Med 50:439-443, 2003.     

A phased array coil for human cardiac imaging

A prototype cardiac phased array receiver coil was constructed that comprised a cylindrical array and a separate planar array. Both arrays had two coil loops with the same coil dimensions. Data acquisition with the cylindrical array placed on the human chest, and the planar array placed under the back, yielded an overall enhancement of the signal-to-noise ratio (SNR) over the entire heart by a factor of 1.1–2.85 over a commercially available flexible coil and a commercially available four-loop planar phased array coil. This improvement in SNR can be exploited in cardiac imaging to increase the spatial resolution and reduce the image acquisition time.     

Local staging of prostate carcinoma with phased array MR imaging: prospective study over 5 years

PURPOSE: To assess by MRI, using a pelvic phased array coil, the accuracy for staging prostate carcinoma and to correlate the results with the rate of positive surgical margins. Materials and Methods: Between January 1995 and December 1999, 176 patients with localized prostate carcinoma underwent a preoperative MRI examination using a pelvic phased-array coil (1 Tesla). MRI and histological results were compared in a prospective study. RESULTS: 131 were classified T2 and 45 were classified T3 at MRI. Pathologic findings showed 103 pT2 and 73 pT3. The accuracy of MRI (extra capsular or vesicle extension) was 75%. The risk for a patient labelled T2 or T3 at MRI to have a positive surgical margin was respectively 13.7% and 31%. CONCLUSION: This study shows that the phased-array coil has a low sensitivity but a good specificity to distinguish between organ-confined cancer or not. It shows that the risk of positive surgical margins is higher for T3 lesions at MRI. The low sensitivity should be improved by using a multi coil phased array.     

T2-weighted MR imaging of prostate cancer: multishot echo-planar imaging vs fast spin-echo imaging

The aim of the present study was to assess the performance of pre-biopsy T2-weighted MR imaging using multishot echo-planar imaging (EPI) sequence for visualization of prostate cancer and to compare image quality with that of fast spin-echo (FSE) sequence. Thirty-nine patients with suspected prostate cancer and one healthy male volunteer were examined on a 1.5-T MR scanner equipped with a pelvic phased-array coil. Axial MR images were obtained using multishot EPI sequence with a multishot number of 16 and FSE sequence without fat suppression. Paired EPI and FSE images were independently evaluated by three radiologists. Furthermore, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared between EPI and FSE images of 12 pathologically proven lesions of prostate cancer. Delineation of the periprostatic venous plexus, prostate zonal anatomy, and seminal vesicle on EPI was graded to be superior/inferior to FSE in 15.8/0, 14.6/0, and 21.5/4.3% of cases, respectively. On the other hand, delineation of the neurovascular bundle was superior/inferior to FSE in 2.6/13.2% of cases. The SNR and CNR of prostate cancer on EPI were significantly higher than those on FSE (7.99±2.51 vs 3.36±0.58, p<0.0001, and 5.51±2.02 vs 2.21±0.79, p<0.0001, respectively). In conclusion, multishot EPI has higher quality of contrast resolution for imaging of prostate cancer compared with FSE and would have the potential usefulness in the detection of prostate cancer, although these results obtained with a phased-array coil cannot be extrapolated to examinations performed with an endorectal coil.     

Reduced power magnetic resonance spectroscopic imaging of the prostate at 4.0 Tesla

Proton magnetic resonance spectroscopic imaging (MRSI) of the prostate has been described at 1.5 T and 3 T as a means of localizing prostate cancers with high sensitivity and specificity. This technique could be improved by increasing the field strength further; however, it has not been described in detail above 3 T. To address the increase in B₁ and SAR at high field strengths, a new protocol is described for reduced power STEAM MRSI of the prostate at 4.0 Tesla, using a pelvic surface coil array for RF transmission and reception, and a solid, reusable endorectal coil for reception only. The optimal STEAM sequence timing parameters for observation of the strongly coupled citrate spin system were determined through simulation to be echo time (TE) = 27 ms and mixing time (TM) = 27 ms, and the results were verified in vitro. Power reduction was achieved by applying the VERSE method to each of the three slice selective pulses in the STEAM sequence, and the B₁max and SAR were reduced by 43% and 36%, respectively. Finally, in vivo spectroscopic imaging data were acquired from a prostate cancer patient, demonstrating the detection of citrate, choline, and creatine with 0.37 cc nominal resolution in a 10 minute scan. Magn Reson Med 61:273–281, 2009. © 2009 Wiley‐Liss, Inc.