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Multi‐echo gradient recalled echo imaging of the pelvis for improved depiction of brachytherapy seeds and fiducial markers facilitating radiotherapy planning and treatment of prostatic carcinoma
Author(s) -
Schieda Nicola,
Avruch Leonard,
Shabana Wael M.,
Malone Shawn Christopher
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24590
Subject(s) - fiducial marker , medicine , brachytherapy , radiology , echo (communications protocol) , radiation therapy , pelvis , nuclear medicine , computer science , computer network
Purpose MR localization of implanted devices for radiotherapy (RT) in prostatic carcinoma is critical for treatment planning. This clinical note studies the application of a multi‐echo gradient recalled echo (GRE) pulse sequence with sum of squares echo combination (ME GRE) to enhance detection of seeds and fiducials. Materials and Methods Fifteen patients who underwent MRI using fast spin echo (FSE), single‐echo and ME GRE over a 9‐month period were retrospectively evaluated by two readers who assessed overall image quality, depiction of seeds/fiducials and image sharpness using a 5‐point scale (1 = poor, 2 = suboptimal, 3 = adequate, 4 = above average, 5 = excellent). Image scores were compared using the Wilcoxon sign rank test. Results In all 15 patients, both readers rated the depiction of seeds/fiducials with ME GRE as excellent. In all 15 patients, overall image quality and image sharpness with ME GRE was rated as excellent by reader 1. In 12/15 patients, overall image quality and image sharpness with ME GRE was rated as excellent and in the other patients above average by reader 2. There was a difference in depiction of seeds/fiducials comparing GRE to FSE ( P < 0.001) and ME to single echo GRE ( P < 0.001). Overall image quality and sharpness was higher with ME compared with single echo GRE ( P < 0.001) and similar to FSE ( P = 0.26 and P = 0.16). Conclusion Multi‐echo GRE provides better detection of implanted seeds and fiducial markers when compared with both FSE and single‐echo GRE potentially improving RT treatment planning for prostate carcinoma. J. Magn. Reson. Imaging 2015;41:715–720. © 2014 Wiley Periodicals, Inc.