Influence of Enema and Dietary Restrictions on Prostate MR Image Quality: A Multireader Study

Purysko, Andrei S.; Mielke, Nathan; Bullen, Jennifer; Nachand, Douglas; Rizk, Alain; Stevens, Erica; Ward, Ryan D.; Klein, Eric A.; Rosenkrantz, Andrew B.; Ream, Justin

doi:10.1016/j.acra.2020.10.019

Cited by 27 publications

(30 citation statements)

References 11 publications

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“…Furthermore, Reischauer et al compared the image quality of DWI in patients that either received an enema or rectal gas suction via a rectal catheter prior to the exam and observed favorable outcomes for the enema group [23]. In addition, adhering to a clear liquid diet combined with a selfadministered enema has also been shown to decrease DWI distortion artefacts in prostate MRI [24].…”

Section: Discussionmentioning

confidence: 99%

Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual grading characteristics

Arnoldner

Polanec

Lázár³

et al. 2022

European Journal of Radiology

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To investigate the effects of a rectal preparation regimen, that consisted of a rectal cleansing enema and an endorectal gel filling protocol, on prostate imaging quality (PI-QUAL). Methods: Multiparametric MRI (mpMRI) was performed in 150 consecutive patients divided into two groups of 75 patients. One group received a rectal preparation with a cleansing enema and endorectal gel filling (median age 65.3 years, median PSA level 6 ng/ml). The other patient group did not receive such a preparation (median age 64 years, median PSA level 6 ng/ml). Two uroradiologists independently rated general image quality and lesion visibility on diffusion-weighted imaging (DWI), T2-weighted (T2w), and dynamic contrast-enhanced (DCE) images using a five-point ordinal scale. In addition, two uroradiologists assigned PI-QUAL scores, using the dedicated scoring sheet. Data sets were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/ area under the curve (AUC) analysis. Results: VGC revealed significantly better general image quality for DWI (AUC R1 0.708 (0.628-0.779 CI, p < 0.001; AUC R2 0.687 (0.606-0.760 CI, p < 0.001) and lesion visibility for both readers (AUC R1 0.729 (0.607-0.831 CI, p < 0.001); AUC R2 0.714 (0.590-0.818CI, p < 0.001) in the preparation group. For T2w imaging, rectal preparation resulted in significantly better lesion visibility for both readers (R1 0.663 (0.537-0.774 CI, p = 0.014; R2 0.663 (0.537-0.774 CI, p = 0.014)). Averaged PI-QUAL scores were significantly improved with rectal preparation (AUC R3/R4 0.667, CI 0.581-0.754, p < 0.001). Conclusion: Rectal preparation significantly improved prostate imaging quality (PI-QUAL) and lesion visibility. Hence, a rectal preparation regimen consisting of a rectal cleansing enema and an endorectal gel filling could be considered.

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Section: Discussionmentioning

confidence: 99%

Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual grading characteristics

Arnoldner

Polanec

Lázár³

et al. 2022

European Journal of Radiology

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“…In addition to this, the use of rectal enemas, specific dietary restrictions and the administration of anti-spasmodic agents have been shown to improve the quality of prostate MRI as they reduce artefacts due to rectal distension and bowel motility [10,27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Growing evidence that the quality of prostate MRI influences the rate of detection clinically significant prostate cancer has resulted in the publication of a number of studies addressing this topic [9][10][11][12][13][14][15][16][17][18][19][20]. In addition, two panels of experts [21,22] have stressed the importance to establish quality criteria for the technical acquisition of mpMRI of the prostate.…”

Section: Introductionmentioning

confidence: 99%

Understanding PI-QUAL for prostate MRI quality: a practical primer for radiologists

et al. 2021

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Prostate magnetic resonance imaging (MRI) of high diagnostic quality is a key determinant for either detection or exclusion of prostate cancer. Adequate high spatial resolution on T2-weighted imaging, good diffusion-weighted imaging and dynamic contrast-enhanced sequences of high signal-to-noise ratio are the prerequisite for a high-quality MRI study of the prostate. The Prostate Imaging Quality (PI-QUAL) score was created to assess the diagnostic quality of a scan against a set of objective criteria as per Prostate Imaging-Reporting and Data System recommendations, together with criteria obtained from the image. The PI-QUAL score is a 1-to-5 scale where a score of 1 indicates that all MR sequences (T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced sequences) are below the minimum standard of diagnostic quality, a score of 3 means that the scan is of sufficient diagnostic quality, and a score of 5 implies that all three sequences are of optimal diagnostic quality. The purpose of this educational review is to provide a practical guide to assess the quality of prostate MRI using PI-QUAL and to familiarise the radiologist and all those involved in prostate MRI with this scoring system. A variety of images are also presented to demonstrate the difference between suboptimal and good prostate MR scans.

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“…3). 26 PROPORTION OF CORRECTLY CLASSIFIED LESIONS USING PI-RADS V2.1. Histopathology results were derived from men who underwent MRI-directed Trans-rectal Ultrasound (TRUS)-guided biopsy targeted biopsy and template biopsy using cognitive fusion or software fusion, two of whom also eventually underwent radical prostatectomy.…”

Section: Image Evaluationmentioning

confidence: 99%

Utility of Quantitative T2‐Mapping Compared to Conventional and Advanced Diffusion Weighted Imaging Techniques for Multiparametric Prostate MRI in Men with Hip Prosthesis

Sathiadoss

Schieda

Haroon

et al. 2021

Magnetic Resonance Imaging

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P rostate MRI is an integral component in the care of men with suspected or confirmed prostate cancer (PCa). A fundamental imaging component for detection of PCa with MRI is high-quality diffusion weighted imaging (DWI) 1,2 ; DWI is the determining sequence for the assessment of the peripheral zone (PZ) and also plays a critical role in evaluating the transition zone (TZ). 3 DWI is most commonly performed using echo planar imaging (EPI), 4 however, a challenge with EPI is its sensitivity to magnetic susceptibility artifacts. [5][6][7] Sensitivity to susceptibility artifact on DWI is particularly problematic in men with hip prostheses or other metallic hardware. 8 When DWI is suboptimal or non-diagnostic, a reader may use dynamic contrast enhanced (DCE)-MRI as a surrogate for DWI combined with T2-weighted (T2W) imaging, 9 however, at the cost of lower diagnostic performance particularly in the TZ. [10][11][12] Alternative EPI-DWI techniques have been studied, including reduced or zoomed field-of-view (FOV) EPI-DWI and segmented readout EPI-DWI, which may improve image quality compared to conventional EPI-DWI; however, these remain limited in men with hip replacements. [13][14][15] The use of a PROPELLER based fast spin echo (FSE)-DWI sequence has also been studied in men with hip replacement with some preliminary success 8 ; however, this has lacked validation and commercial availability for the prostate application.Quantitative T2-mapping is a technique which has been previously studied and validated for PCa detection and characterization. 16,17 T2 maps offer similar information to apparent diffusion coefficient (ADC) maps derived from DWI. 17 Both ADC and T2 relaxation times have been shown to be good indicators of cell density, 18 with the potential to predict tumor aggressiveness. Advantages of quantitative T2-maps, compared to DWI, include: more reproducible quantitative values [19][20][21] and less vulnerability to magnetic susceptibility artifacts, since these sequences are spin-echo based. 22 The purpose of this study was therefore to evaluate T2-mapping in men with hip prosthesis undergoing prostate MRI and to compare image quality and impact on the interpretation to conventional and variant DWI techniques in the same prospective patient cohort.

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Influence of Enema and Dietary Restrictions on Prostate MR Image Quality: A Multireader Study

Cited by 27 publications

References 11 publications

Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual grading characteristics

Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual grading characteristics

Understanding PI-QUAL for prostate MRI quality: a practical primer for radiologists

Utility of Quantitative T2‐Mapping Compared to Conventional and Advanced Diffusion Weighted Imaging Techniques for Multiparametric Prostate MRI in Men with Hip Prosthesis

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