Prostate MR image quality of apparent diffusion coefficient maps versus fractional intracellular volume maps from VERDICT MRI using the PI-QUAL score and a dedicated Likert scale for artefacts

Saurabh Singh; Francesco Giganti; Louise Dickinson; Harriet Rogers; Baris Kanber; Joey Clemente; Hayley Pye; Susan Heavey; Urszula Stopka-Farooqui; Edward W Johnston; Caroline M Moore; Alex Freeman; Hayley C Whitaker; Daniel C Alexander; Eleftheria Panagiotaki; Shonit Punwani

doi:10.1016/j.ejrad.2023.111109

Prostate MR image quality of apparent diffusion coefficient maps versus fractional intracellular volume maps from VERDICT MRI using the PI-QUAL score and a dedicated Likert scale for artefacts

Eur J Radiol. 2023 Nov:168:111109. doi: 10.1016/j.ejrad.2023.111109. Epub 2023 Sep 22.

Authors

Saurabh Singh¹, Francesco Giganti², Louise Dickinson³, Harriet Rogers⁴, Baris Kanber⁵, Joey Clemente⁴, Hayley Pye⁶, Susan Heavey⁶, Urszula Stopka-Farooqui⁶, Edward W Johnston⁷, Caroline M Moore⁸, Alex Freeman⁹, Hayley C Whitaker¹⁰, Daniel C Alexander¹¹, Eleftheria Panagiotaki¹¹, Shonit Punwani¹²

Affiliations

¹ Centre for Medical Imaging, Division of Medicine, University College London, London, UK; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK. Electronic address: [email protected].
² Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK; Division of Surgery & Interventional Science, University College London, London, UK.
³ Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK.
⁴ Centre for Medical Imaging, Division of Medicine, University College London, London, UK.
⁵ Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, UK.
⁶ Division of Surgery & Interventional Science, University College London, London, UK; Molecular Diagnostics and Therapeutics Group, University College London, UK.
⁷ Centre for Medical Imaging, Division of Medicine, University College London, London, UK; Department of Interventional Radiology, Royal Marsden Hospital, London, UK.
⁸ Division of Surgery & Interventional Science, University College London, London, UK; Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
⁹ Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
¹⁰ Molecular Diagnostics and Therapeutics Group, University College London, UK.
¹¹ Centre for Medical Image Computing, Department of Computer Science, University College London, UK.
¹² Centre for Medical Imaging, Division of Medicine, University College London, London, UK; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK.

PMID: 37769532
DOI: 10.1016/j.ejrad.2023.111109

Abstract

Purpose: This study aimed to assess the image quality of apparent diffusion coefficient (ADC) maps derived from conventional diffusion-weighted MRI and fractional intracellular volume maps (FIC) from VERDICT MRI (Vascular, Extracellular, Restricted Diffusion for Cytometry in Tumours) in patients from the INNOVATE trial. The inter-reader agreement was also assessed.

Methods: Two readers analysed both ADC and FIC maps from 57 patients enrolled in the INNOVATE prospective trial. Image quality was assessed using the Prostate Imaging Quality (PI-QUAL) score and a subjective image quality Likert score (Likert-IQ). The image quality of FIC and ADC were compared using a Wilcoxon Signed Ranks test. The inter-reader agreement was assessed with Cohen's kappa.

Results: There was no statistically significant difference between the PI-QUAL score for FIC datasets compared to ADC datasets for either reader (p = 0.240 and p = 0.614). Using the Likert-IQ score, FIC image quality was higher compared to ADC (p = 0.021) as assessed by reader-1 but not for reader-2 (p = 0.663). The inter-reader agreement was 'fair' for PI-QUAL scoring of datasets with FIC maps at 0.27 (95% confidence interval; 0.08-0.46) and ADC datasets at 0.39 (95% confidence interval 0.22-0.57). For Likert scoring, the inter-reader agreement was also 'fair' for FIC maps at 0.38 (95% confidence interval; 0.10-0.65) and substantial for ADC maps at 0.62 (95% confidence interval; 0.39-0.86).

Conclusion: Image quality was comparable for FIC and ADC. The inter-reader agreement was similar when using PIQUAL for both FIC and ADC datasets but higher for ADC maps compared to FIC maps using the image quality Likert score.

Keywords: ADC; DWI; Image quality; Likert; PIQUAL; Prostate Cancer; VERDICT MRI.

MeSH terms

Artifacts
Diffusion Magnetic Resonance Imaging / methods
Humans
Magnetic Resonance Imaging / methods
Male
Prospective Studies
Prostate* / pathology
Prostatic Neoplasms* / diagnostic imaging
Prostatic Neoplasms* / pathology
Retrospective Studies

Grants and funding

26854/CRUK_/Cancer Research UK/United Kingdom