Ultra-high gradient performance 3-Tesla MRI for super-fast and high-quality prostate imaging: initial experience.

Objectives: To implement and evaluate a super-fast and high-quality biparametric MRI (bpMRI) protocol for prostate imaging acquired at a new ultra-high gradient 3.0-T MRI system.
Methods: Participants with clinically suspected prostate cancer prospectively underwent a multiparametric MRI (mpMRI) on a new 3.0-T MRI scanner (maximum gradient strength: 200 mT/m, maximum slew rate: 200 T/m/s). The bpMRI protocol was extracted from the full mpMRI protocol, including axial T2-weighted and diffusion-weighted (DWI) sequences (b0/800, b1500). Overall image quality was rated by two readers on a five-point Likert scale from (1) non-diagnostic to (5) excellent. PI-RADS 2.1 scores were assessed by three readers separately for the bpMRI and mpMRI protocols. Cohen's and Fleiss' κ were calculated for PI-RADS agreement between protocols and interrater reliability between readers, respectively.
Results: Seventy-seven male participants (mean age, 66 ± 8 years) were included. Acquisition time of the bpMRI protocol was reduced by 62% (bpMRI: 5 min, 33 ± 21 s; mpMRI: 14 min, 50 ± 42 s). The bpMRI protocol showed excellent overall image quality for both the T2-weighted (median score both readers: 5 [IQR: 4-5]) and DWI (b1500) sequence (median score reader 1: 4 [IQR: 4-5]; reader 2: 4 [IQR: 4-4]). PI-RADS score agreement between protocols was excellent (Cohen's κ range: 0.91-0.95 [95% CI: 0.89, 0.99]) with an overall good interrater reliability (Fleiss' κ, 0.86 [95% CI: 0.80, 0.92]).
Conclusion: Ultra-high gradient MRI allows the establishment of a high-quality and rapidly acquired bpMRI with high PI-RADS agreement to a full mpMRI protocol.
Trials Registration: Clinicaltrials.gov, NCT06244680, Registered 06 February 2024, retrospectively registered, https://classic.
Clinicaltrials: gov/ct2/show/NCT06244680 .
Critical Relevance Statement: A novel 3.0-Tesla MRI system with an ultra-high gradient performance enabled high-quality biparametric prostate MRI in 5.5 min while achieving excellent PI-RADS agreement with a standard multiparametric protocol.
Key Points: Multi- and biparametric prostate MRIs were prospectively acquired utilizing a maximum gradient of 200 mT/m. Super-fast biparametric MRIs showed excellent image quality and had high PI-RADS agreement with multiparametric MRIs. Implementation of high gradient MRI in clinical routine allows accelerated and high-quality biparametric prostate examinations.
Competing Interests: Declarations. Ethics approval and consent to participate: The institutional review committee (Ethikkommission Bonn) approved the prospective study under reference number 198/23-EP. Oral and written informed consent was acquired from any individual in this study before participation. Consent for publication: Consent for publication was acquired from any individual in this study before participation. Competing interests: A.I.: Grants from the Medical Faculty Bonn and the German Research Foundation. J.E.: Editorial Board member of Cancers. U.A.: Speakers bureau payments from Siemens; advisory board member for Bayer. Editorial Board member of Investigative Radiology and Die Radiologie. C.P.: Payment for lectures from Guerbet and Julius Zorn; support for attending meetings or travel from Guerbet and Julius Zorn; advisory board member for Guerbet. Editorial Board member of Investigative Radiology. J.L.: Consulting fees from Bayer; payment for presentation from Philips. Editorial Board member of Investigative Radiology, Radiology: Cardiothoracic Imaging, Die Radiologie and Frontiers in Cardiovascular Medicine. The other authors declare that they have no competing interests.
(© 2024. The Author(s).)