4.7 Article

How to improve image quality of DWI of the prostate-enema or catheter preparation?

期刊

EUROPEAN RADIOLOGY
卷 31, 期 9, 页码 6708-6716

出版社

SPRINGER
DOI: 10.1007/s00330-021-07842-9

关键词

Prostate; Diffusion magnetic resonance imaging; Artifacts; Enema; Suction

资金

  1. Universite de Fribourg - Swiss National Science Foundation [32003B_176229/1]
  2. Swiss National Science Foundation (SNF) [32003B_176229] Funding Source: Swiss National Science Foundation (SNF)

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The study found that enema preparation is superior to catheter preparation for prostate DWI imaging, significantly improving image quality by reducing susceptibility-related artifacts and image distortions.
Objectives To compare the impact of laxative enema preparation versus air/gas suction through a small catheter on image quality of prostate DWI. Methods In this single-center study, 200 consecutive patients (100 in each arm) with either enema or catheter preparation were retrospectively included. Two blinded readers independently assessed aspects of image quality on 5-point Likert scales. Scores were compared between groups and the influence of confounding factors evaluated using multivariable logistic regression. Prostate diameters were compared on DWI and T-2-weighted imaging using intraclass correlation coefficients. Results Image quality was significantly higher in the enema group regarding the severity of susceptibility-related artifacts (reader 1: 0.34 +/- 0.77 vs. 1.73 +/- 1.34, reader 2: 0.38 +/- 0.86 vs. 1.76 +/- 1.39), the differentiability of the anatomy (reader 1: 3.36 +/- 1.05 vs. 2.08 +/- 1.31, reader 2: 3.37 +/- 1.05 vs. 2.09 +/- 1.35), and the overall image quality (reader 1: 3.66 +/- 0.77 vs. 2.26 +/- 1.33, Reader 2: 3.59 +/- 0.87 vs. 2.23 +/- 1.38) with almost perfect inter-observer agreement (kappa = 0.92-0.95). In the enema group, rectal distention was significantly lower and strongly correlated with the severity of artifacts (reader 1: rho = 0.79, reader 2: rho = 0.73). Furthermore, there were significantly fewer substantial image distortions, with odds ratios of 0.051 and 0.084 for the two readers which coincided with a higher agreement of the prostate diameters in the phase-encoding direction (0.96 vs. 0.89). Conclusions Enema preparation is superior to catheter preparation and yields substantial improvements in image quality.

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