The T2-weighted prostate sequence is a multi-slice 2D FSE sequence with the following parameters;
Axial, sagital and coronal planes
TR = 3500 ms
ETE = 102 ms
ETL = 19
BW = 31 kHz
FOV = 16 cm
Slice thickness = 3 mm
Gap = 0 mm
freq dir (coronal = S/I, axial and sag = A/P)
matrix = 384 x 224 (freq x phase)
NEX = 2
The T1-weighted prostate sequence is a multi-slice spoiled gradient echo (SPGR) sequence with the following parameters
Axial plane
TR = 385 ms
TE = 6.2 ms
Flip angle = 65o
BW = 31 kHz
FOV = 16 cm
Slice thickness = 3 mm
Gap = 0 mm
Freq direction = A/P
Matrix = 384 x 192
NEX = 1
ESUR
Table 2 Acquisition protocols: minimum requirements
A. Detection protoco
Fast <30-min protocol without an endorectal coil (ERC). Images should cover entire prostate, and include T2WI, DWI and DCE-MRI. Imaging
can adequately be performed at 1.5 T using a good 8- to 16-channel pelvic phased array (PPA). Anti-peristaltic drugs (Buscopan®, Glucagon®)
should be given.
• T2WI axial+sagittal: 4 mm at 1.5 T, 3 mm at 3 T; in plane resolution: 0.5×0.5 mm to 0.7×0.7 mm at both 1.5 T and 3 T.
• DWI axial: 5 mm at 1.5 T, 4 mm at 3 T; in-plane resolution: 1.5×1.5 mm to 2.0×2.0 mm at 1.5 T and 1.0×1.0 mm to 1.5×1.5 mm at 3 T.
ADC map should be calculated. At least 3 b-values should be acquired in three orthogonal directions and adapted to quality of SNR: 0, 100 and
800–1000 s/mm2. For calculation of ADC, the highest b-value that should be used is 1000 s/mm2.
• DCE-MRI axial: 4 mm at 1.5 T and 3 T; in plane resolution: 1.0×1.0 mm at 1.5 T and 0.7×0.7 mm at 3 T. Quantitative or semi-quantitative
DCE-MRI analysis does not have to be performed. Maximum temporal resolution should be 15 s following single dose of contrast agent with
an injection rate of 3 mL/s. For DCE-MRI, imaging acquisition should be continued for 5 min to detect washout. Unenhanced T1WI images
from this sequence can be used to detect post-biopsy haematomas.
• MRSI: optionally, MRSI can be added to the detection protocol, but this requires an extra 10–15 min of examination time. For this ERC is
mandatory at 1.5 T and optional at 3 T; volume of interest (VOI) aligned to axial T2WI; coverage of the whole prostate in the VOI; field of
view at least 1.5 voxels larger than the VOI in all directions to avoid wrap-around or back folding; matrix of at least 8 x 8 x 8 phase-encoding
steps with nominal voxel size <0.5 cc; spectral selective suppression of water and lipid signals; positioning of at least six fat saturation bands
close to the prostatic margin (may be positioned inside the VOI) to conform to the prostatic shape as closely as possible; automatic or manual
shimming up to a line width at half height of the water resonance peak between 15 and 20 Hz at 1.5 T and between 20 and 25 Hz at 3 T.
B. Staging protocol
45-min protocol for evaluating minimal extra-capsular extension. Preferably, this examination should be done with an ERC. Images should include
entire prostate, with anti-peristaltic drugs.
• T2WI axial, coronal and sagittal planes, 3 mm at 1.5 T and 3 T; in plane resolution: 0.3×0.3 mm to 0.7×0.7 mm at 1.5 T and 0.3×0.3 mm to
0.5×0.5 mm at 3 T.
• DWI and DCE as detection protocol.
• MRSI optional.
C. Nodes and bone protocol
30-min protocol, to assess nodal size and bone marrow metastases. Should be performed separately from A and B, as most patients do not require
bone or node staging.
• T1WI coronal of lower lumbar spine plus pelvis (SE or f/T SE) 3.0-mm slices
• 3D f/T SE T2WI coronal of lower lumbar spine plus pelvis; 1.0-mm isometric voxels
• DWI coronal of lower lumbar spine plus pelvis (b-values 0 and 600); slice thickness 3–4 mm, in plane resolution: 2.5–3.0 mm voxels
• T1WI sagittal cervical and thoracic spine (SE or f/T SE)
• STIR or DWI sagittal cervical and thoracic spine.