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Appendix III Sample Protocols

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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.


01/07/2014 (16:06 EST) - mChatfield - Dia: Like the ESUR paper it is better to define minimum pixel size. Better to use the ESUR guideline paper recommendations?
01/07/2014 (16:06 EST) - mChatfield - DJAM: I would almost prefer a qualitative specifier, “sufficient to resolve the T2-dark line delineating the prostate” or something to that effect.
01/07/2014 (16:06 EST) - mChatfield - CMT: I have no preference
02/19/2014 (21:36 EST) - mChatfield - [CMT1]AlL PROTOCOL DETAILS SHOULD BELONG ELSWHERE- APPENDIX? [CMT2]I have no preference [JW3] DM I would almost prefer a qualitative specifier, “sufficient to resolve the T2-dark line delineating the prostate” or something to that effect. [Dia4]Like the ESUR paper it is better to define minimum pixel size. Better to use the ESUR guideline paper recommendations? [JW5] DM We use a single-shot sagittal since our anatomic evaluation is done with the axial and coronal or 3D T2.
Chat is archived on 04/26/2014 (08:54 EST) by mChatfield

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