A Faster Prostate MRI: Comparing a Novel Denoised, Single‐Average T2 Sequence to the Conventional Multiaverage T2 Sequence Regarding Lesion Detection and PI‐RADS Score Assessment

Abstract

BackgroundThe T2w sequence is a standard component of a prostate MRI examination; however, it is time‐consuming, requiring multiple signal averages to achieve acceptable image quality.Purpose/HypothesisTo determine whether a denoised, single‐average T2 sequence (T2‐R) is noninferior to the standard multiaverage T2 sequence (T2‐S) in terms of lesion detection and PI‐RADS score assessment.Study TypeRetrospective.PopulationA total of 45 males (age range 60–75 years) who underwent clinically indicated prostate MRI examinations, 21 of whom had pathologically proven prostate cancer.Field Strength/SequenceA 3 T; T2w FSE, DWI with ADC maps, and dynamic contrast‐enhanced images with color‐coded perfusion maps. T2‐R images were created from the raw data utilizing a single “average” with iterative denoising.AssessmentNine readers randomly assessed complete exams including T2‐R and T2‐S images in separate sessions. PI‐RADS version 2.1 was used. All readers then compared the T2‐R and T2‐S images side by side to evaluate subjective preference. An additional detailed image quality assessment was performed by three senior level readers.Statistical TestsGeneralized linear mixed effects models for differences in lesion detection, image quality features, and overall preference between T2‐R and T2‐S sequences. Intraclass correlation coefficients (ICC) were used to assess reader agreement for all comparisons. A significance threshold of P = 0.05 was used for all statistical tests.ResultsThere was no significant difference between sequences regarding identification of lesions with PI‐RADS ≥3 (P = 0.10) or PI‐RADS score (P = 0.77). Reader agreement was excellent for lesion identification (ICC = 0.84). There was no significant overall preference between the two sequences regarding image quality (P = 0.07, 95% CI: [−0.23, 0.01]). Reader agreement was good regarding sequence preference (ICC = 0.62).Data ConclusionUse of single‐average, denoised T2‐weighted images was noninferior in prostate lesion detection or PI‐RADS scoring when compared to standard multiaverage T2‐weighted images.Evidence Level3.Technical EfficacyStage 3.