Reduced-FOV excitation decreases susceptibility artifact in diffusion-weighted MRI with endorectal coil for prostate cancer detection

The purposes of this study were to determine if image distortion is less in prostate MR apparent diffusion coefficient (ADC) maps generated from a reduced-field-of-view (rFOV) diffusion-weighted-imaging (DWI) technique than from a conventional DWI sequence (CONV), and to determine if the rFOV ADC tumor contrast is as high as or better than that of the CONV sequence. Fifty patients underwent a 3 T MRI exam. CONV and rFOV (utilizing a 2D, echo-planar, rectangularly-selective RF pulse) sequences were acquired using b = 600, 0 s/mm2. Distortion was visually scored 0–4 by three independent observers and quantitatively measured using the difference in rectal wall curvature between the ADC maps and T2-weighted images. Distortion scores were lower with the rFOV sequence (p < 0.012, Wilcoxon Signed-Rank Test, n = 50), and difference in distortion scores did not differ significantly among observers (p = 0.99, Kruskal–Wallis Rank Sum Test). The difference in rectal curvature was less with rFOV ADC maps (26% ± 10%) than CONV ADC maps (34% ± 13%) (p < 0.011, Student's t-test). In seventeen patients with untreated, biopsy confirmed prostate cancer, the rFOV sequence afforded significantly higher ADC tumor contrast (44.0%) than the CONV sequence (35.9%), (p < 0.0012, Student's t-test). The rFOV sequence yielded significantly decreased susceptibility artifact and significantly higher contrast between tumor and healthy tissue.