The authors evaluated a magnetic resonance (MR) imaging-compatible biopsy device comprising a needle guide that can be visualized with MR imaging and manipulated mechanically from outside the MR unit. With approval from the local ethics committee and patient consent, this device was tested in 12 patients by using a closed 1.5-T MR unit and a body phased-array coil. Patients had elevated prostate-specific antigen levels (6-60 ng/mL) and one or more areas in the prostate that were suspicious for carcinoma at prebiopsy MR imaging. Biopsy was performed with transrectal access and with the patient prone. A 16-gauge MR imaging-compatible needle was successfully positioned with the device, and between six and nine tissue cores were obtained in each patient. In one patient, two suspicious basal areas could not be reached with the device. Histologic analysis showed prostate cancer in five patients and prostatitis in six. No complications were observed. The device enabled MR imaging-guided core-needle biopsy of prostate areas suspicious for cancer on MR images.
Experimental data show accumulation of superparamagnetic iron oxide (SPIO) particles in atherosclerotic plaques. SPIO uptake occurred in plaques, suggesting an increased endothelial permeability and macrophage infiltrates as signs of inflammatory plaque activity. We incidentally observed SPIO uptake in aortic and arterial wall segments in patients who had originally received the magnetic resonance (MR) contrast agent for staging lymph node metastases. Twenty patients (19 male, 1 female; mean age, 64; range, 41-78 years) with bladder or prostate cancer underwent MR imaging (MRI) using a T2*-weighted high-resolution gradient-echo sequence prior to and 24 -36 hours after intravenous injection of 2.6 mg of Fe/kg of SPIO (Sinerem ). The aorta, both common external and internal iliac, as well as both superficial femoral arteries, were retrospectively analyzed for atherosclerotic wall changes. One patient was excluded. A positive finding was defined as an area of pronounced signal loss on postcontrast images clearly confined to the arterial wall, which was absent in the precontrast examination or increased in size. Such a finding was observed in one to three arteries in 7 of the 19 patients. The pronounced signal loss in the wall of the aorta and pelvic arteries seen in part of an elderly patient population after intravenous SPIO administration strongly suggests that this contrast agent accumulates in human atherosclerotic plaques. J. Magn. Reson. Imaging 2001;14: 355-361.
Intraindividual comparison shows that image quality and delineation of prostate cancer at 1.5 T with the use of an endorectal coil in a pelvic phased-array is superior to the higher field strength of 3.0 T with a torso phased-array coil alone. As long as no endorectal coil is available for 3-T imaging, imaging at 1.5 T using the combined endorectal-body phased-array coil will continue to be the gold standard for prostate imaging.
MR-guided transrectal prostate biopsy is currently a time-consuming procedure because the imaging slice is often manually realigned with the biopsy needle during lesion targeting. In this work a pulse sequence is presented that automatically follows a passive marker attached to a dedicated MR biopsy device holder, thus providing an alternative to existing active tracking methods. In two orthogonal tracking FLASH images of the marker the position of the needle axis is automatically identified using a phase-only cross-correlation (POCC) algorithm. The position information is then used to realign a trueFISP imaging slice in real time. In phantom experiments the sensitivity of this technique to initial misalignments of the marker and to the signal-to-noise ratio was evaluated. In several puncture experiments the precision of the needle placement was analyzed. The POCC algorithm allowed for a precise identification of the marker in the images even under severe initial misalignments of up to 45°. At a frame rate 1 image/s a precision of the needle placement of 1.5 ؎ 1.1 mm could be achieved. Magn Reson Med 59:1043-1050, 2008.
The aim of the present study was to quantify both perfusion and extravasation in the prostate to discriminate tumor from healthy tissue, which might be achieved by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using a nonspecific low-molecular-weight contrast medium (CM). To determine extravasation as well as tissue perfusion an inversion-prepared dual-contrast sequence employing a parallel acquisition technique (PAT) was designed for interleaved acquisition of T(1)-weighted images for extravasation measurement and T(2)*-weighted images for determination of the highly concentrated bolus with a sufficiently high temporal and spatial resolution at an acceptable signal-to-noise ratio. Thirteen patients with proven prostate cancer were examined with the sequence using a combined body-array prostate coil. Before pharmacokinetic evaluation the images were intensity-corrected and, if required, motion-corrected. The pharmacokinetic model used to calculate perfusion, permeability, blood volume, interstitial volume, transit time, and vessel size index included two compartments and a correction of delay and dispersion of the arterial input function. The information provided by the dual-contrast sequence allowed application of a more elaborate model for evaluation and enabled quantification of all parameters. Peripheral prostate tumors were found to differ from peripheral healthy prostate tissue in perfusion (1.38 mL/(min cm(3)) vs. 0.23 mL/(min cm(3)), p=0.004), mean transit time (2.88 vs. 4.88 s, p=0.039), and blood volume (1.9 vs. 0.7%, p=0.019). A inversion-prepared dual-contrast sequence acquiring T(1)- and T*(2)-weighted images with sufficient temporal resolution and signal-to-noise ratio was successfully applied in patients with prostate cancer to quantify all pharmacokinetic parameters of inflow and extravasation of a low-molecular-weight inert tracer.
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