A Faster Prostate MRI: Comparing a Novel Denoised, Single‐Average T2 Sequence to the Conventional Multiaverage T2 Sequence Regarding Lesion Detection and PI‐RADS Score Assessment

• Published in: Journal of magnetic resonance imaging 2023-08, Vol.58 (2), p.620-629
• Main Authors: Kelleher, Colm B., Macdonald, Jacob, Jaffe, Tracy A., Allen, Brian C., Kalisz, Kevin R., Kauffman, Travis H., Smith, Jordan D., Maurer, Kimberly R., Thomas, Sarah P., Coleman, Aaron D., Zaki, Islam H., Kannengiesser, Stephan, Lafata, Kyle, Gupta, Rajan T., Bashir, Mustafa R.
• Format: Article
• Language: English
• Subjects: Correlation coefficient; Correlation coefficients; denoising; Field strength; Image contrast; Image enhancement; Image processing; Image quality; Iterative methods; Lesions; Magnetic resonance imaging; Medical imaging; Noise reduction; PI‐RADS; Population studies; Prostate; Prostate cancer; Quality assessment; Quality control; Standard components; Statistical analysis; Statistical tests
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.28577

Background The T2w sequence is a standard component of a prostate MRI examination; however, it is time‐consuming, requiring multiple signal averages to achieve acceptable image quality. Purpose/Hypothesis To determine whether a denoised, single‐average T2 sequence (T2‐R) is noninferior to the standard multiaverage T2 sequence (T2‐S) in terms of lesion detection and PI‐RADS score assessment. Study Type Retrospective. Population A total of 45 males (age range 60–75 years) who underwent clinically indicated prostate MRI examinations, 21 of whom had pathologically proven prostate cancer. Field Strength/Sequence A 3 T; T2w FSE, DWI with ADC maps, and dynamic contrast‐enhanced images with color‐coded perfusion maps. T2‐R images were created from the raw data utilizing a single “average” with iterative denoising. Assessment Nine readers randomly assessed complete exams including T2‐R and T2‐S images in separate sessions. PI‐RADS version 2.1 was used. All readers then compared the T2‐R and T2‐S images side by side to evaluate subjective preference. An additional detailed image quality assessment was performed by three senior level readers. Statistical Tests Generalized linear mixed effects models for differences in lesion detection, image quality features, and overall preference between T2‐R and T2‐S sequences. Intraclass correlation coefficients (ICC) were used to assess reader agreement for all comparisons. A significance threshold of P = 0.05 was used for all statistical tests. Results There was no significant difference between sequences regarding identification of lesions with PI‐RADS ≥3 (P = 0.10) or PI‐RADS score (P = 0.77). Reader agreement was excellent for lesion identification (ICC = 0.84). There was no significant overall preference between the two sequences regarding image quality (P = 0.07, 95% CI: [−0.23, 0.01]). Reader agreement was good regarding sequence preference (ICC = 0.62). Data Conclusion Use of single‐average, denoised T2‐weighted images was noninferior in prostate lesion detection or PI‐RADS scoring when compared to standard multiaverage T2‐weighted images. Evidence Level 3. Technical Efficacy Stage 3.