Pros and cons of high-performance gradient enabled short-TE prostate DWI – a prospective study

Motivation: Recent advances in high-performance gradient technology have enabled shorter echo times (TEs) for diffusion-weighted prostate MRI. Short TE may enhance the conspicuity of T2 hypointense lesions, but may also influence the diagnostic performance of the apparent diffusion coefficient (ADC) due to altered subcompartments weighting. Goal(s): To investigate the effect of shorter TEs on lesion conspicuity and ADC performance in prostate diagnostics. Approach: Fifty-five patients underwent DWI at 41 and 70 ms TEs. Overall image quality and lesion conspicuity were rated. ADC diagnostic performance was also analysed. Results: Shorter TE improved image quality and lesion visibility but decreased ADC's ability to distinguish significant lesions. Impact: Shortening TEs beyond the PI-RADS v.2.1 recommendations in prostate DWI increases lesion conspicuity and image quality, but compromises the ADC diagnostic performance. Further studies are needed to validate our findings and derive specific recommendations on prostate DWI acquisition protocols.