A clinical comparison of rigid and inflatable endorectal-coil probes for MRI and 3D MR spectroscopic imaging (MRSI) of the prostate

PURPOSE: To compare the data quality and ease of use of four endorectal-coil probe setups for prostate MRI. MATERIALS AND METHODS: Four endorectal-coil probe setups were compared: 1) air-inflated probe; 2) perfluorocarbon (PFC)-inflated probe; 3) rigid, smaller prototype coil; and 4) rigid, smaller coil designed for biopsying the prostate. Signal-to-noise ratio (SNR), positioning, shimming, MRI motion artifact, and MR spectroscopic imaging (MRSI) spectral quality were assessed. RESULTS: Rigid coils provided approximately 2.5-fold higher SNR than inflatable coils near the peripheral zone midline. The biopsy probe sensitivity decreased dramatically by the apex. The rigid probes, as compared to the inflatable probes, took longer to place (10 +/- 2 vs. 7 +/- 2 minutes, P < 0.0002), tended to be placed too superiorly, required repositioning more often (73% vs. 20%, P < 0.003), and had higher motion artifacts (P < 0.001). Shimming time was least for the PFC-inflated probe (2 +/- 0.5 minutes, P < 0.05). The air-inflated probe produced larger linewidths (P < 0.01) and tended to have longer shim times (7 +/- 4 minutes) and poorer spectral quality. CONCLUSION: The inflatable coil is a good clinical choice due to ease of use, good coverage, and low motion artifacts. PFC-inflation is recommended as it provided higher quality data than air-inflation. The rigid, smaller probes have higher SNR and produce less tissue distortion and may be preferred for certain applications.     

Post‐processing correction of the endorectal coil reception effects in MR spectroscopic imaging of the prostate

Purpose:

To develop and validate a post‐processing correction algorithm to remove the effect of the inhomogeneous reception profile of the endorectal coil on MR spectroscopic imaging (MRSI) data.

Materials and Methods:

A post‐processing algorithm to correct for the endorectal coil reception effects on MRSI data was developed based upon theoretical modeling of the endorectal coil reception profile and of the spatial saturation pulse profiles. This algorithm was evaluated on three‐dimensional (3D) MRSI data acquired at 3T from a uniform phantom and from 18 patients with known or suspected prostate cancer.

Results:

For the phantom data, the coefficient of variation of metabolite peak areas decreased 16% to 46% and the peak area distributions became more Gaussian with correction, as demonstrated by higher Q‐Q plot linear correlations (R² = 0.98 ± 0.007 vs. R² = 0.89 ± 0.066). Across the 18 patients, the mean coefficient of variation for suppressed water decreased significantly, from 0.95 ± 0.18, to 0.66 ± 0.11, (P < 10^?6, paired t‐test) and the linear correlations of the Q‐Q plots for the suppressed water increased from R² = 0.91 to R² = 0.95 (P = 0.0083, paired t‐test) with correction.

Conclusion:

An algorithm for reducing the effect of the inhomogeneous reception profile in endorectal coil acquired 3D MRSI prostate data was demonstrated, illustrating increased homogeneity and more Gaussian peak area distributions. J. Magn. Reson. Imaging 2010;32:654–662. © 2010 Wiley‐Liss, Inc.

     

Proton MR spectroscopic imaging of rhesus macaque brain in vivo at 7T

Due to the overall similarity of their brains' structure and physiology to its human counterpart, nonhuman primates provide excellent model systems for the pathogenesis of neurological diseases and their response to treatments. Its much smaller size, 80 versus 1250 cm(3), however, requires proportionally higher spatial resolution to study, nondestructively, as many analogous regions as efficiently as possible in anesthetized animals. The confluence of these requirements underscores the need for the highest sensitivity, spatial coverage, resolution, and exam speed. Accordingly, we demonstrate the feasibility of 3D multi-voxel, proton ((1)H) MRSI at (0.375 cm)(3)=0.05 cm(3) isotropic spatial resolution over 21 cm(3) (approximately 25%) of the anesthetized rhesus macaques brain at 7T in 25 min. These voxels are x10(2)-10(1) times smaller than the 8-1 cm(3) common to (1)H-MRS in humans, retaining similar proportions between the macaque and human brain. The spectra showed a signal-to-noise-ratio (SNR) approximately 9-10 for the major metabolites and the interanimal SNR spatial distribution reproducibility was in the +/-10% range for the standard error of their means (SEMs). Their metabolites' linewidths, 9+/-2 Hz, yield excellent spectral resolution as well. These results indicate that 3D (1)H-MRSI can be integrated into comprehensive MR studies in primates at such high fields.     

Reproducibility of 3D 1H MR spectroscopic imaging of the prostate at 1.5T

Purpose:

To determine the reproducibility of 3D proton magnetic resonance spectroscopic imaging (¹H‐MRSI) of the human prostate in a multicenter setting at 1.5T.

Materials and Methods:

Fourteen subjects were measured twice with 3D point‐resolved spectroscopy (PRESS) ¹H‐MRSI using an endorectal coil. MRSI voxels were selected in the peripheral zone and combined central gland at the same location in the prostate in both measurements. Voxels with approved spectral quality were included to calculate Bland–Altman parameters for reproducibility from the choline plus creatine to citrate ratio (CC/C). The repeated spectroscopic data were also evaluated with a standardized clinical scoring system.

Results:

A total of 74 voxels were included for reproducibility analysis. The complete range of biologically interesting CC/C ratios was covered. The overall within‐voxel standard deviation (SD) of the CC/C ratio of the repeated measurements was 0.13. This value is equal to the between‐subject SD of noncancer prostate tissue. In >90% of the voxels the standardized clinical score did not differ relevantly between the measurements.

Conclusion:

Repeated measurements of in vivo 3D ¹H‐MRSI of the complete prostate at 1.5T produce equal and quantitative results. The reproducibility of the technique is high enough to provide it as a reliable tool in assessing tumor presence in the prostate. J. Magn. Reson. Imaging 2012;35:166‐173. © 2011 Wiley Periodicals, Inc.     

Quantitative (31)P spectroscopic imaging of human brain at 4 Tesla: assessment of gray and white matter differences of phosphocreatine and ATP.

This report describes the implementation and application of a multicompartment analysis of (31)P spectroscopic imaging data to determine the tissue-specific heterogeneities in metabolite content in the human brain and surrounding tissue. Using this information and a multicompartment regression analysis the phosphocreatine and ATP content of "pure" cerebral gray and white matter, the cerebellum, and skeletal muscle was determined in a group of 10 healthy volunteers. The data were converted to mM units using previously reported values for the T(1)s of phosphocreatine and ATP at 4 T, the water content of human brain, and an external reference for absolute quantification. The phosphocreatine concentration in cerebral gray and white matter, the cerebellum, and skeletal muscle was 3.53 +/- 0.33, 3.33 +/- 0.37, 3.75 +/- 0.66, and 25.8 +/- 2.3 mM, respectively. The ATP concentration in cerebral gray and white matter, the cerebellum, and skeletal muscle was 2.19 +/- 0.33, 3.41 +/- 0.33, 1.75 +/- 0.58, and 8.5 +/- 1.9 mM, respectively. Magn Reson Med 45:46-52, 2001.     

Combined quantitative dynamic contrast-enhanced MR imaging and (1)H MR spectroscopic imaging of human prostate cancer

PURPOSE: To differentiate prostate carcinoma from healthy peripheral zone and central gland using quantitative dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and two-dimensional (1)H MR spectroscopic imaging (MRSI) combined into one clinical protocol. MATERIALS AND METHODS: Twenty-three prostate cancer patients were studied with a combined DCE-MRI and MRSI protocol. Cancer regions were localized by histopathology of whole mount sections after radical prostatectomy. Pharmacokinetic modeling parameters, K(trans) and k(ep), as well as the relative levels of the prostate metabolites citrate, choline, and creatine, were determined in cancer, healthy peripheral zone (PZ), and in central gland (CG). RESULTS: K(trans) and k(ep) were higher (P < 0.05) in cancer and in CG than in normal PZ. The (choline + creatine)/citrate ratio was elevated in cancer compared to the PZ and CG (P < 0.05). While a (choline + creatine)/citrate ratio above 0.68 was found to be a reliable indicator of cancer, elevated K(trans) was only a reliable cancer indicator in the diagnosis of individual patients. K(trans) and (choline + creatine)/citrate ratios in cancer were poorly correlated (Pearson r(2) = 0.07), and thus microvascular and metabolic abnormalities may have complementary value in cancer diagnosis. CONCLUSION: The combination of high-resolution spatio-vascular information from dynamic MRI and metabolic information from MRSI has excellent potential for improved localization and characterization of prostate cancer in a clinical setting. J. Magn. Reson. Imaging 2004;20:279-287. Copyright 2004 Wiley-Liss, Inc.     

Dualband spectral-spatial RF pulses for prostate MR spectroscopic imaging.

Although MR spectroscopic imaging (MRSI) of the prostate has demonstrated clinical utility for the staging and monitoring of cancer extent, current acquisition methods are often inadequate in several aspects. Conventional 180 degrees pulses can suffer from chemical shift misregistration, and have high peak-power requirements that can exceed hardware limits in many prostate MRSI studies. Optimal water and lipid suppression are also critical to obtain interpretable spectra. While complete suppression of the periprostatic lipid resonance is desired, controlled partial suppression of water can provide a valuable phase and frequency reference for data analysis and an assessment of experimental success in cases in which all other resonances are undetectable following treatment. In this study, new spectral-spatial RF pulses were developed to negate chemical shift misregistration errors and to provide dualband excitation with partial excitation of the water resonance and full excitation of the metabolites of interest. Optimal phase modulation was also included in the pulse design to provide 40% reduction in peak RF power. Patient studies using the new pulses demonstrated both feasibility and clear benefits in the reliability and applicability of prostate cancer MRSI.     

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.     

Investigation of the PSF‐choice method for reduced lipid contamination in prostate MR spectroscopic imaging

The purpose of this work was to evaluate a previously proposed approach that aims to improve the point spread function (PSF) of MR spectroscopic imaging (MRSI) to avoid corruption by lipid signal arising from neighboring voxels. Retrospective spatial filtering can be used to alter the PSF; however, this either reduces spatial resolution or requires extending the acquisition in k‐space at the cost of increased imaging time. Alternatively, the method evaluated here, PSF‐choice, can modify the PSF localization to reduce the contamination from adjacent lipids by conforming the signal response more closely to the desired MRSI voxel grid. This is done without increasing scan time or degrading SNR of important metabolites. PSF‐choice achieves improvements in spatial localization through modifications to the radiofrequency excitation pulses. An implementation of this method is reported for MRSI of the prostate, where it is demonstrated that, in 13 of 16 pilot prostate MRSI scans, intravoxel spectral contamination from lipid was significantly reduced when using PSF‐choice. Phantom studies were also performed that demonstrate, compared with MRSI with standard Fourier phase encoding, out‐of‐voxel signal contamination of spectra was significantly reduced in MRSI with PSF‐choice. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.     

Performance of external and internal coil configurations for prostate investigations at 7 T

Three different coil configurations were evaluated through simulation and experimentally to determine safe operating limits and evaluate subject size‐dependent performance for prostate imaging at 7 T. The coils included a transceiver endorectal coil (trERC), a 16‐channel transceiver external surface array (trESA) and a trESA combined with a receive‐only ERC (trESA+roERC). Although the transmit B₁ (B) homogeneity was far superior for the trESA, the maximum achievable B is subject size dependent and limited by transmit chain losses and amplifier performance. For the trERC, limitations in transmit homogeneity greatly compromised image quality and limited coverage of the prostate. Despite these challenges, the high peak B close to the trERC and subject size‐independent performance provides potential advantages especially for spectroscopic localization where high‐bandwidth radiofrequency pulses are required. On the receive side, the combined trESA+roERC provided the highest signal‐to‐noise ratio and improved homogeneity over the trERC resulting in better visualization of the prostate and surrounding anatomy. In addition, the parallel imaging performance of the trESA+roERC holds strong promise for diffusion‐weighted imaging and dynamic contrast‐enhanced MRI. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

3D 31P Spectroscopic Imaging of the Human Heart at 4.1 T

High field (4 Tesla) spectroscopic imaging offers the advantages of increased signal-to-noise ratio and the possibility of acquiring high resolution metabolite images. We have applied a three dimensional spectroscopic imaging sequence using a sparse Gaussian sampling method to acquire phosphocreatine (PCr) images of the human heart with 8-cc voxels. PCr images enabled observation of the septum, left ventricular free wall, apex, and skeletal muscle. Quantitative evaluation of the 50 myocardial voxels acquired from 10 studies of healthy adults revealed a PCr/adenosine triphosphate (ATP) ratio of 1.80 ± 0.32 after correction for saturation effects. Due to the small size of the voxels and the ability to choose the location of the volumes to minimize inclusion of blood, no correction for blood pool ATP was required. The calculated PCr/ATP ratio is in agreement with other studies at 1.5 and 4.0 T.     

Fast acquisition-weighted three-dimensional proton MR spectroscopic imaging of the human prostate.

The clinical application of 3D proton spectroscopic imaging (3D SI) of the human prostate requires a robust suppression of periprostatic lipid signal contamination, minimal intervoxel signal contamination, and the shortest possible measurement time. In this work, a weighted elliptical sampling of k-space, combined with k-space filtering and pulse repetition time (TR) reduction minimized lipid signals, intervoxel contamination, and measurement time. At 1.5 T, the MR-visible prostate metabolites citrate, creatine, and choline can now be mapped over the entire human prostate with uncontaminated spherical voxels, with a volume down to 0.37 cm3, in measurement times of 7-15 min.