Rationale and Objectives
To investigate image quality and rate of lesion detection in a novel three-dimensional
T2-weighted turbo-spin-echo sequence with inner-volume excitation (zoomed imaging)
and iterative denoising processing in pelvic MRI at 1.5T. Two-dimensional T2-weighted
turbo-spin-echo sequences were used as the clinical reference standard (2D-T2-TSE).
Materials and Methods
This is a prospective study of patients with various pelvic pathologies. Each patient
underwent standard 2D-T2-TSE in three planes with two-fold acceleration as well as
a single three-dimensional T2-TSE in the sagittal plane with four-fold acceleration
known as Sampling-Perfection-with-Application-optimized-Contrast-using-different-flip-angle-Evolutions
(3D-T2-SPACE). The 3D-T2-SPACE images were reconstructed in three orthogonal planes
at a slice thickness of 2 mm (vs. 2D-T2-TSE at 4 mm). Two radiologists conducted a
qualitative image analysis on standard 2D-T2-TSE and multiplanar reconstructed 3D-T2-SPACE
images. These parameters were compared and inter-reader agreement was computed. Furthermore,
each reader documented the observed lesions of various pelvic organs. The rate of
lesion detection was compared between readers and sequences. Inter-reader and inter-sequence
agreement were computed.
Results
Forty patients (25 females) were included. Mean patient age was 58 ± 13 years. 3D-T2-SPACE
enabled an approximate 22% reduction of acquisition time and 50% of reconstructed
slice thickness. 3D-T2-SPACE showed fewer artifacts than 2D-T2-TSE (p < 0.001). However, 2D-T2-TSE was rated to have significantly higher signal intensity
than 3D-T2-SPACE (p < 0.001). There were no significant differences between the two sequences regarding
all other parameters. Inter-reader agreement regarding image quality parameters was
substantial (Kappa = 0.772). For all analyzed pelvic anatomic structures, inter-reader
and inter-sequence agreement for lesion detection was excellent (Kappa > 0.80).
Conclusion
3D-T2-SPACE with the inner-volume excitation and iterative denoising is clinically
feasible at 1.5 T, enabling faster imaging, thinner slices, and significant reduction
of artifacts. Despite that signal intensity was inferior in the SPACE images, overall
image quality, diagnostic confidence and lesion detection were not compromised. This
prospective study sets the stage for further clinical implementation and future investigations
tailored to specific indications in pelvis MRI.
Key Words
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Article info
Publication history
Published online: February 07, 2022
Accepted:
January 5,
2022
Received in revised form:
December 25,
2021
Received:
November 29,
2021
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
