Comparison of motion-insensitive T2-weighted MRI pulse sequences for visualization of the prostatic urethra during MR simulation Journal Article


Authors: Zakian, K. L.; Wibmer, A.; Vargas, H. A.; Alberts, E.; Kadbi, M.; Mychalczak, B.; Kollmeier, M.; Gorovets, D.; McBride, S.; Hunt, M.; Zelefsky, M. J.; Tyagi, N.
Article Title: Comparison of motion-insensitive T2-weighted MRI pulse sequences for visualization of the prostatic urethra during MR simulation
Abstract: Purpose: The use of magnetic resonance imaging (MRI) for radiation therapy simulation is growing because of its ability to provide excellent delineation of target tissue and organs at risk. With the use of hypofractionated schemes in prostate cancer, urethral sparing is essential; however, visualization of the prostatic urethra can be challenging because of the presence of benign prostatic hyperplasia as well as respiratory motion artifacts. The goal of this study was to compare the utility of 2 motion-insensitive, T2-weighted MRI pulse sequences for urethra visualization in the setting of MRI-based simulation. Methods and Materials: Twenty-two patients undergoing MRI simulation without Foley catheters were imaged on a 3 Tesla MRI scanner between October 2018 and January 2019. Sagittal multislice data were acquired using (1) MultiVane XD radial sampling with parallel imaging acceleration (MVXD) and (2) single-shot fast-spin-echo (SSFSE) sequences with acquisition times of 2 to 3 minutes per sequence. For each examination, 2 genitourinary radiologists scored prostatic urethra visibility on a 1-to-5 scale and rated the signal-to-noise ratio and the presence of artifacts in each series. Results: Urethral visibility was scored higher in the MVXD series than in the SSFSE series in 18 of 22 cases (Reader 1) and 17 of 22 cases (Reader 2). The differences in scores between MVXD and SSFSE were statistically significant for both readers (P < .0001 for both, paired Student's t-test) and interobserver agreement was high (Cohen's kappa = 0.67). Both readers found the signal-to-noise ratio of the MVXD sequence to be superior in all cases. The MVXD sequence was found to generate more artifacts than the SSFSE sequence, but these tended to appear in the periphery and did not affect the ability to visualize the urethra. Conclusions: A radial T2-weighted multislice pulse sequence was superior to an SSFSE sequence for visualization of the urethra in the setting of magnetic resonance simulation for prostate cancer. © 2019 American Society for Radiation Oncology
Keywords: adult; clinical article; aged; middle aged; nuclear magnetic resonance imaging; signal noise ratio; simulation; clinical effectiveness; imaging and display; comparative effectiveness; very elderly; human; male; priority journal; article; motion insensitive; parallel imaging acceleration sequence; prostate urethra; single shot fast spin echo sequence
Journal Title: Practical Radiation Oncology
Volume: 9
Issue: 6
ISSN: 1879-8500
Publisher: Elsevier Inc.  
Date Published: 2019-11-01
Start Page: e534
End Page: e540
Language: English
DOI: 10.1016/j.prro.2019.06.009
PUBMED: 31252087
PROVIDER: scopus
PMCID: PMC6832802
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Michael J Zelefsky
    658 Zelefsky
  2. Marisa A Kollmeier
    160 Kollmeier
  3. Kristen L Zakian
    78 Zakian
  4. Margie A Hunt
    253 Hunt
  5. Neelam Tyagi
    69 Tyagi
  6. Andreas Georg Wibmer
    22 Wibmer
  7. Sean Matthew McBride
    149 McBride