PURPOSE: MR localization of implanted devices for radiotherapy (RT) in prostatic carcinoma is critical for treatment planning.
This clinical note studies the application of a multi-echo gradient recalled echo (GRE) pulse sequence with sum of squares echo combination (ME GRE) to enhance detection of seeds and fiducials.
MATERIALS AND METHODS: Fifteen patients who underwent MRI using fast spin echo (FSE), single-echo and ME GRE over a 9-month period were retrospectively evaluated by two readers who assessed overall image quality, depiction of seeds/fiducials and image sharpness using a 5-point scale (1 = poor, 2 = suboptimal, 3 = adequate, 4 = above average, 5 = excellent). Image scores were compared using the Wilcoxon sign rank test.
RESULTS: In all 15 patients, both readers rated the depiction of seeds/fiducials with ME GRE as excellent. In all 15 patients, overall image quality and image sharpness with ME GRE was rated as excellent by reader 1. In 12/15 patients, overall image quality and image sharpness with ME GRE was rated as excellent and in the other patients above average by reader 2. There was a difference in depiction of seeds/fiducials comparing GRE to FSE (P < 0.001) and ME to single echo GRE (P < 0.001). Overall image quality and sharpness was higher with ME compared with single echo GRE (P < 0.001) and similar to FSE (P = 0.26 and P = 0.16).
CONCLUSION: Multi-echo GRE provides better detection of implanted seeds and fiducial markers when compared with both FSE and single-echo GRE potentially improving RT treatment planning for prostate carcinoma.
Written by:
Schieda N, Avruch L, Shabana WM, Malone SC. Are you the author?
The Ottawa Hospital, The University of Ottawa, Department of Radiology, Civic Campus C1, Ottawa, Ontario, Canada.
Reference: J Magn Reson Imaging. 2014 Feb 8. Epub ahead of print.
doi: 10.1002/jmri.24590
PubMed Abstract
PMID: 24510444
UroToday.com Prostate Cancer Section
