Dominic Carlin1,2, Matthew R Orton1,2, Veronica A Morgan1,2, David J Collins1,2, and Nandita M deSouza1,2
1CRUK Imaging Centre, Institute of Cancer Research, London, United Kingdom, 2MRI Unit, The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
Synopsis
Spectral modelling and
model fitting were compared for quantitative T2 mapping of the prostate.
32-echo data were acquired from 11 patients with biopsy-proven prostate cancer
at 3T. There was excellent correlation between
the two approaches for estimates of T2-short, T2-long and luminal water
fraction (r=0.96, 0.71, 0.94 respectively). Luminal water fractions were
significantly higher in normal peripheral and transition zones using the model
fitting approach (P = 0.04 and <0.01 respectively), but were comparable in
tumor. The larger quantitative difference between tumour and normal tissue
could mean model fitting is superior for qualitative assessment in prostate
cancer.
Background
The percentage of luminal
space differs significantly between normal and malignant prostate tissue. This
difference can be illustrated with quantitative T2 mapping of the prostate, where
mono-exponential decay characterises prostate cancer and biexponential decay
characterises normal tissue1,2.
Quantitative estimation of
T2 relaxation is performed by analysing data collected over a range of echo
times. However, to capture the longer
relaxation times observed in this setting long echo times are required, which
implies that the noise floor may be reached in some voxels . The level
of noise affects the T2 estimation accuracy, and it is known that noise levels
vary spatially when endorectal coils are used (Fig 1). Models that do not explicitly account for the noise floor
and its spatial variation could therefore be subject to estimation errors.
Multi-exponential model fitting to the data with an appropriate noise model
would allow the noise floor to be accounted for, and could therefore be
preferable to spectral modelling methods3. The
purpose of this study was therefore to compare model fitting and spectral
modelling approaches for quantitative T2 mapping of the prostate.Methods
Data Acquisition: 11 patients with biopsy-proven prostate cancer
who had 3T endorectal MRI that included T2-weighted images and T2 multi-echo
data GRASE acquisitions were studied with IRB approval. Sequence parameters for
the multi-echo data were as follows:
repetition time msec/echo time msec, 3000/25; number of echoes, 32; field of
view, 200 x 200; voxel size, 1 x 1 x 2.5 mm3; imaging matrix size, 160 x 156; reconstruction matrix size, 224
x 224; slice thickness, 2.2-2.5 mm; flip angle, 90°; number of averages, one and imaging duration, 784 seconds.
Data Analysis
Tumor region of interests (ROI) were drawn on
T2W images by an experienced radiologist around low signal-intensity lesions on
T2-W imaging that showed diffusion restriction in biopsy positive sectors of
prostate. Multi-echo T2 data were analysed using the spectral modelling
approach described previously by Sabouri et al.3 to give estimates of T2‑long,
T2‑short, luminal water fraction (LWF) and number of exponential components. In
addition the multi-echo data in each voxel were fitted with mono- and
bi-exponential decays assuming a Rician noise model, and the scale parameter of
the Rician noise (related to the noise standard deviation) was also estimated
per voxel. The Bayesian information criterion (BIC) was used to determine the
number of exponential components by discriminating between mono- and
bi-exponential decays for each voxel, and the BIC calculation accounted for the
Rician noise distribution.
Correlation between the
two analysis methods was performed using Pearson’s correlation coefficient. Parameter
values for T2-short, T2-long, luminal water fraction and number of components,
N, were compared between the two analysis methods using a paired t-test, with P
< 0.05 considered statistically significant.
Results and Discussion
Representative examples of
the two analysis methods are shown in Fig.
2. The attenuation curve for the spectral model fit corresponds well with
the model fit for voxels where the noise floor is not reached for later echo
times (Fig. 2a), however the two
curves diverge at later echo times when the noise floor is reached (Fig. 2c).
There was excellent
correlation between the two approaches for T2-short (r = 0.96), T2-long (r =
0.71) and the luminal water fraction (r = 0.94) across the whole prostate (Fig. 3). Quantitative values for T2
short, T2 long, luminal water fraction and N are given for each analysis
approach in Table 1 for tumor,
peripheral zone and transition zone.
Luminal water fractions were significantly higher for the model fitting
approach in the transition zone (P < 0.01) and peripheral zone (P = 0.04),
but were comparable in tumor. Similarly, the number of components estimated by
data fitting were significantly higher using the data fitting approach but were
comparable in tumor. The larger luminal water fractions in the model fitting
approach for normal tissue led to increased contrast between tumor and normal
tissue (a representative example is shown in Fig. 4). Conclusion
The increased contrast between malignant and
non-malignant tissue for luminal water fraction maps may make model fitting that
includes a spatially varying noise estimate more suitable for qualitative and quantitative
analysis than spectral estimation methods.Acknowledgements
CRUK and EPSRC support to the Cancer Imaging Centre at ICR and RMH in association with MRC and Department of Health C1060/A10334, C1060/A16464 and NHS funding to the NIHR Biomedical Research Centre and the Clinical Research Facility in Imaging.References
1.
Storås TH,
Gjesdal KI, Gadmar ØB, Geitung JT, Kløw NE. Prostate magnetic resonance imaging: multiexponential T2 decay in
prostate tissue. J Magn Reson
Imaging. 2008 Nov;28(5):1166-72.
2.
Kjaer L,
Thomsen C, Iversen P, Henriksen O. In vivo estimation of relaxation processes
in benign hyperplasia and carcinoma of the prostate gland by magnetic resonance
imaging. Magn Reson Imaging.
1987;5(1):23-30.
3.
Sabouri S,
Chang SD, Savdie R, Zhang J, Jones EC, Goldenberg SL, Black PC, Kozlowski P.
Luminal Water Imaging: A New MR Imaging T2 Mapping Technique for Prostate
Cancer Diagnosis. Radiology. 2017 Aug;284(2):451-459.