3 T v 1.5 T MRI prostate with total hip prosthesis

Case contributed by Chris O'Donnell , 15 Dec 2017
Diagnosis certain
Changed by Daniel J Bell, 12 Mar 2018

Updates to Study Attributes

Findings was changed:

Less susceptibility artefactartifact from the right hip prosthesis using the same b value.  PI-RADS 5 lesion of >15mm;15 mm in the left anterior prostate with reduced "smudgy" T2 signal and restricted diffusion on the DWI and ADC.  Biopsy was very difficult as transrectal ultrasound could not be used.  Using Using the perineum as the acoustic window, transperineal prostate biopsy confirmed GleesonGleason 3+3 cancer, although MRI suggests a higher GleesonGleason score.

Updates to Study Attributes

Findings was changed:

Very severe susceptibility artefactartifact produced by the right total hip prosthesis causing the DWI images to be non-diagnostic.  The patient was therefore referred for repeat 1.5 T MRI prostate.

Images Changes:

Image MRI (DWI - B 1400 s/mm2) ( update )

Description was changed:
b value 1400msec: 1400 s/mm2

Updates to Case Attributes

Body was changed:

mpMRI prostate has rapidly increased in popularity in the last three years following the release of PI-RADS v2 in 2015.  It is a robust reporting protocol and can be used for both 1.5 and 3 T MRI scanners although 3 T has become the standard especially for DWI sequences with long b values (DWI being the keystone to cancer diagnosis, especially in the peripheral zone).  Susceptibility artefactartifact is heightened with the use of 3 T especially in relation to bowel gas in the rectum and any metal hardware such as a hip prosthesis.  This has been addressed to some degree by meticulous bowel preparation and use of different EPI sequences for DWI acquisition including read-out segmented multishot EPI rather than single shot effectively reducing the Te.  Modern 1.5 T MRI of the prostate with improved gradients can produce very diagnostic images and, as in this case, are less prone to susceptibility artefactartifact.

  • -<p>mpMRI prostate has rapidly increased in popularity in the last three years following the release of PI-RADS v2 in 2015.  It is a robust reporting protocol and can be used for both 1.5 and 3 T MRI scanners although 3 T has become the standard especially for DWI sequences with long b values (DWI being the keystone to cancer diagnosis especially in the peripheral zone).  Susceptibility artefact is heightened with the use of 3 T especially in relation to bowel gas in the rectum and any metal hardware such as a hip prosthesis.  This has been addressed to some degree by meticulous bowel preparation and use of different EPI sequences for DWI acquisition including read-out segmented multishot EPI rather than single shot effectively reducing the T<sub>e</sub>.  Modern 1.5 T MRI of the prostate with improved gradients can produce very diagnostic images and, as in this case, are less prone to susceptibility artefact.</p>
  • +<p>mpMRI prostate has rapidly increased in popularity in the last three years following the release of PI-RADS v2 in 2015.  It is a robust reporting protocol and can be used for both 1.5 and 3 T MRI scanners although 3 T has become the standard especially for DWI sequences with long b values (DWI being the keystone to cancer diagnosis, especially in the peripheral zone).  Susceptibility artifact is heightened with the use of 3 T especially in relation to bowel gas in the rectum and any metal hardware such as a hip prosthesis.  This has been addressed to some degree by meticulous bowel preparation and use of different EPI sequences for DWI acquisition including read-out segmented multishot EPI rather than single shot effectively reducing the T<sub>e</sub>.  Modern 1.5 T MRI of the prostate with improved gradients can produce very diagnostic images and, as in this case, are less prone to susceptibility artifact.</p>

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