T2- and diffusion-weighted magnetic resonance imaging at 3 T for the detection of prostate cancer with and without endorectal coil: An intraindividual comparison of image quality and diagnostic performance

Abstract

Objectives To intraindividually compare image quality and diagnostic performance of multiparametric MRI (mpMRI) at 3 T for the detection of prostate cancer (PCa) using a pelvic phased-array coil (PAC) and a combined endorectal and pelvic phased-array coil (ERC-PAC). Methods Forty-five patients were prospectively included and received mpMRI of the prostate using a PAC and an ERC-PAC during one imaging session. Two radiologists evaluated image quality and the most suspicious lesion according to the PI-RADS scoring system. Results of MRI-TRUS-fusion biopsy of the prostate served as reference standard. Patient comfort and acceptance were assessed using a standardized questionnaire. Results Overall image quality for T2WI was rated significantly better with an ERC-PAC compared to a PAC (p = 0.0038). The weighted kappa for PI-RADS scores for T2WI and DWI with a PAC and an ERC-PAC was 0.70 and 0.73, respectively. For a PI-RADS sum score including T2WI and DWI the area under the curve with a PAC and an ERC-PAC were 0.95-0.99 and 0.93-0.97, respectively (p = 0.1395). Conclusion For T2WI and DWI performed at 3 T index PCa lesion identification and evaluation did not differ significantly with both coil setups. Patients preferred MRI without an ERC. Therefore, the use of an ERC may be omitted in a prostate cancer detection setting.