Prostate MRI using a rigid two-channel phased-array endorectal coil: comparison with phased array coil acquisition at 3 T.

BACKGROUND: To compare image quality, lesion detection and patient comfort of 3T prostate MRI using a combined rigid two-channel phased-array endorectal coil and an external phased-array coil (ERC-PAC) compared to external PAC acquisition in the same patients. METHODS: Thirty three men (mean age 65.3y) with suspected (n = 15) or biopsy-proven prostate cancer (PCa, n = 18) were prospectively enrolled in this exploratory study. 3T prostate MRI including T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) was performed using an ERC-PAC versus PAC alone, in random order. Image quality, lesion detection and characterization (biparametric PI-RADSv2.1) were evaluated by 2 independent observers. Estimated signal-to-noise ratio (eSNR) was measured in identified lesions and the peripheral zone (PZ). Patient comfort was assessed using a questionnaire. Data were compared between sequences and acquisitions. Inter/intra-observer agreement for PI-RADS scores was evaluated. RESULTS: Twenty four prostate lesions (22 PCa) were identified in 20/33 men. Superior image quality was found for ERC-PAC compared to PAC for T2WI for one observer (Obs.1, p < 0.03) and high b-value DWI for both observers (p < 0.05). The sensitivity of PI-RADS for lesion detection for ERC-PAC and PAC acquisitions was 79.2 and 75% for Obs.1, and 79.1 and 66.7%, for Obs.2, without significant difference for each observer (McNemar p-values ≥0.08). Inter-/intra-observer agreement for PI-RADS scores was moderate-to-substantial (kappa = 0.52-0.84). Higher eSNR was observed for lesions and PZ for T2WI and PZ for DWI using ERC-PAC (p < 0.013). Most patients (21/33) reported discomfort at ERC insertion. CONCLUSION: Despite improved image quality and eSNR using the rigid ERC-PAC combination, no significant improvement in lesion detection was observed, therefore not supporting the routine use of ERC for prostate MRI.

Prospective Motion Correction for Brain MRI Using an External Tracking System.

BACKGROUND AND PURPOSE: A wide range of strategies have been developed to mitigate motion, as a major source of image quality degradation in clinical MRI. We aimed to assess the efficiency of a commercially available prospective motion correction (PMC) system in reducing motion in acquiring high-resolution 3D magnetization-prepared rapid gradient-echo (MPRAGE). METHODS: A total of 100 patients who referred for brain MRI studies were prospectively imaged using a 3.0T scanner. 3D MPRAGE acquisition was obtained with and without application of PMC. The motion tracking system (KinetiCor Inc.) consisted of a quad camera apparatus, which tracks a specific marker on patient's head by evaluating the marker's optical pattern. The patient's head motion in 6 degrees of freedom throughout the acquisition was then incorporated into the MRI sequence, updating the image acquisition in real time based on the most recent head pose data. MPRAGE images with and without motion correction were assessed independently by two board-certified neuroradiologists using a 5-point Likert scale. Statistical analysis included kappa and Wilcoxon Rank-Sum tests. RESULTS: Observers 1 and 2 identified nondiagnostic studies in 17.2% and 20.7% of patients (K = .78, 95% CI .70-.86) without motion correction and in 5.7% and 8% of the studies with motion correction (K = .84, 95% CI .76-.92). The number of nondiagnostic studies was significantly (P = .001) reduced from 19.5% to 5.7% after motion correction in consensus read analysis. CONCLUSION: The described motion tracking system can be used effectively in clinical practice reducing motion artifact and improving image quality of 3D MPRAGE sequence.

Sleep Fragmentation Hypersensitizes Healthy Young Women to Deep and Superficial Experimental Pain.

The effect of sleep deprivation on pain sensitivity has typically been studied using total and partial sleep deprivation protocols. These protocols do not mimic the fragmented pattern of sleep disruption usually observed in individuals with clinical pain conditions. Therefore, we conducted a controlled experiment to investigate the effect of sleep fragmentation on pain perception (deep pain: forearm muscle ischemia, and superficial pain: graded pin pricks applied to the skin) in 11 healthy young women after 2 consecutive nights of sleep fragmentation, compared with a normal night of sleep. Compared with normal sleep, sleep fragmentation resulted in significantly poorer sleep quality, morning vigilance, and global mood. Pin prick threshold decreased significantly (increased sensitivity), as did habituation to ischemic muscle pain (increased sensitivity), over the course of the 2 nights of sleep fragmentation compared with the night of normal sleep. Sleep fragmentation did not increase the maximum pain intensity reported during muscle ischemia (no increase in gain), and nor did it increase the number of spontaneous pains reported by participants. Our data show that sleep fragmentation in healthy, young, pain-free women increases pain sensitivity in superficial and deep tissues, indicating a role for sleep disruption, through sleep fragmentation, in modulating pain perception. PERSPECTIVE: Our findings that pain-free, young women develop hyperalgesia to superficial and deep muscle pain after short-term sleep disruption highlight the need for effective sleep management strategies in patients with pain. Findings also suggest the possibility that short-term sleep disruption associated with recurrent acute pain could contribute to increased risk for future chronic pain conditions.