Giving the prostate the boost it needs: Spiral diffusion MRI using a high-performance whole-body gradient system for high b-values at short echo times

Purpose: To address key issues of low SNR and image distortions in prostate diffusion MRI (dMRI) by means of using strong gradients, single-shot spiral readouts and an expanded encoding model for image reconstruction. Methods: Diffusion-weighted spin echo imaging with EPI and spiral readouts is performed on a whole-body system equipped with strong gradients (up to 250 mT/m). An expanded encoding model including static off-resonance, coil sensitivities, and magnetic field dynamics is employed for image reconstruction. The acquisitions are performed on a phantom and in vivo (one healthy volunteer and one patient with prostate cancer). The resulting images are compared to conventional dMRI EPI with navigator-based image reconstruction and assessed in terms of their congruence, SNR, tissue contrast, and quantitative parameters. Results: Using the expanded encoding model, high-quality images of the prostate gland are obtained across all b-values (up to 3 ms/μm2), clearly outperforming the results obtained with conventional image reconstruction. Compared to EPI, spiral imaging provides an SNR gain up to 45% within the gland and even higher in the lesion. In addition, prostate dMRI with single-shot spirals at submillimeter in-plane resolution (0.85 mm) is accomplished. Conclusion: The combination of strong gradients and an expanded encoding model enables imaging of the prostate with unprecedented image quality. Replacing the commonly used EPI with spirals provides the inherent benefit of shorter echo times and superior readout efficiency and results in higher SNR, which is in particular relevant for considered applications.