title: Whole-body 3D T1-weighted MR imaging in patients with prostate cancer: feasibility and evaluation in screening for metastatic disease.
abstract: OBJECTIVE
  To develop and assess the diagnostic performance of a three-dimensional (3D) whole-body T1-weighted magnetic resonance (MR) imaging pulse sequence at 3.0 T for bone and node staging in patients with prostate cancer. MATERIALS AND METHODS This prospective study was approved by the institutional ethics committee; informed consent was obtained from all patients. Thirty patients with prostate cancer at high risk for metastases underwent whole-body 3D T1-weighted imaging in addition to the routine MR imaging protocol for node and/or bone metastasis screening, which included coronal two-dimensional (2D) whole-body T1-weighted MR imaging, sagittal proton-density fat-saturated (PDFS) imaging of the spine, and whole-body diffusion-weighted MR imaging. Two observers read the 2D and 3D images separately in a blinded manner for bone and node screening. Images were read in random order. The consensus review of MR images and the findings at prospective clinical and MR imaging follow-up at 6 months were used as the standard of reference. The interobserver agreement and diagnostic performance of each sequence were assessed on per-patient and per-lesion bases.
  
  
  RESULTS
  The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were significantly higher with whole-body 3D T1-weighted imaging than with whole-body 2D T1-weighted imaging regardless of the reference region (bone or fat) and lesion location (bone or node) (P < .003 for all). For node metastasis, diagnostic performance (area under the receiver operating characteristic curve) was higher for whole-body 3D T1-weighted imaging (per-patient analysis; observer 1: P < .001 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P = .006 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging; observer 2: P = .006 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P = .006 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging), as was sensitivity (per-lesion analysis; observer 1: P < .001 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P < .001 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging; observer 2: P < .001 for 2D T1-weighted imaging vs 3D T1-weighted imaging, P < .001 for 2D T1-weighted imaging + PDFS imaging vs 3D T1-weighted imaging).
  
  
  CONCLUSIONS
  Whole-body MR imaging is feasible with a 3D T1-weighted sequence and provides better SNR and CNR compared with 2D sequences, with a diagnostic performance that is as good or better for the detection of bone metastases and better for the detection of lymph node metastases.
authors.affiliation: From the Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10/2942, B-1200 Brussels, Belgium (V.P., N.M., F.P., A.L., T.S., B.C.V.B., F.E.L.); Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium (B.T.); and Department of Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (P.O.).
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Pasoglou
authors.forename: Nicolas
authors.initials: N
authors.lastname: Michoux
authors.forename: Frank
authors.initials: F
authors.lastname: Peeters
authors.forename: Ahmed
authors.initials: A
authors.lastname: Larbi
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.forename: Tom
authors.initials: T
authors.lastname: Selleslagh
authors.forename: Patrick
authors.initials: P
authors.lastname: Omoumi
authors.forename: Bruno C
authors.initials: BC
authors.lastname: Vande Berg
authors.forename: Frédéric E
authors.initials: FE
authors.lastname: Lecouvet
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001859:Bone Neoplasms / Q000556:secondary*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology*; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging
chemical_list: D000726:Androgen Antagonists; D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen