Accelerated diffusion-weighted imaging of the prostate employing echo planar imaging with compressed SENSE based reconstruction

Aim was to evaluate accelerated diffusion-weighted imaging (DWI) of the prostate using echo planar imaging with compressed SENSE based reconstruction (EPICS) and assess its performance in comparison to conventional DWI with parallel imaging. In this single-center, prospective study, 35 men with clinically suspected prostate cancer underwent prostate MRI at 3T. In each patient, two different DWI sequences, one with 3 b-values (b = 100, 400, 800s/mm²) for ADC-calculation and one with b = 1500s/mm², were acquired with conventional SENSE and with EPICS. Quantitative evaluation was done by regions-of-interest (ROIs) analysis of prostate lesions and normal appearing peripheral zones (PZ). Apparent contrast-to-noise (aCNR) and apparent signal-to-noise ratios (aSNR) were calculated. Mean ADC and coefficient of variation (CV) of ADC were compared. For qualitative assessment, artifacts, lesion conspicuity, and overall image quality were rated using a 5-point-Likert-scale (1: nondiagnostic to 5: excellent). Additionally, the Prostate Imaging Reporting and Data System (PIRADS 2.1) was rated for DWI. The average total scan time reduction with EPICS was 43%. Quantitative analysis showed no significant differences between conventional SENSE and EPICS, neither for aSNR_Lesion (e.g. b1500_conv: 24.37 ± 10.28 vs. b1500_EPICS: 24.08 ± 12.2; p = 0.98) and aCNR_Lesion (e.g. b1500_conv:9.53 ± 7.22 vs. b1500_EPICS:8.88 ± 6.16; p = 0.55) nor for aSNR_PZ (e.g. b1500_conv:15.18 ± 6.48 vs. b1500_EPICS: 15 ± 7.4; p = 0.94). Rating of artifacts, lesion conspicuity, overall image quality and PIRADS-scores yielded comparable results for the two techniques (e.g. lesion conspicuity for ADC_conv: 4(2-5) vs. ADC_EPICS 4(2-5); p = 0.99 and for b1500_conv: 4(2-5) vs. b1500_EPICS 4(2-5); p = 0.25). Overall, accelerated DWI of the prostate using EPICS significantly reduced acquisition time without compromising image quality compared to conventional DWI.