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AJR Am J Roentgenol. 2016 Jan;206(1):86-91. doi: 10.2214/AJR.14.14065. Epub 2015 Oct 22.

High-Resolution 3-T Endorectal Prostate MRI: A Multireader Study of Radiologist Preference and Perceived Interpretive Quality of 2D and 3D T2-Weighted Fast Spin-Echo MR Images.

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1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-372, Box 0628, San Francisco, CA 94143.
2 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
3 Joint Department of Medical Imaging, University Health Network, Mount Sinai and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
4 Department of Radiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA.
5 Department of Radiology, New York University, Langone Medical Center, New York, NY.



The goal of this study was to compare the perceived quality of 3-T axial T2-weighted high-resolution 2D and high-resolution 3D fast spin-echo (FSE) endorectal MR images of the prostate.


Six radiologists independently reviewed paired 3-T axial T2-weighted high-resolution 2D and 3D FSE endorectal MR images of the prostates of 85 men in two sessions. In the first session (n = 85), each reader selected his or her preferred images; in the second session (n = 28), they determined their confidence in tumor identification and compared the depiction of the prostatic anatomy, tumor conspicuity, and subjective intrinsic image quality of images. A meta-analysis using a random-effects model, logistic regression, and the paired Wilcoxon rank-sum test were used for statistical analyses.


Three readers preferred the 2D acquisition (67-89%), and the other three preferred the 3D images (70-80%). The option for one of the techniques was not associated with any of the predictor variables. The 2D FSE images were significantly sharper than 3D FSE (p < 0.001) and significantly more likely to exhibit other (nonmotion) artifacts (p = 0.002). No other statistically significant differences were found.


Our results suggest that there are strong individual preferences for the 2D or 3D FSE MR images, but there was a wide variability among radiologists. There were differences in image quality (image sharpness and presence of artifacts not related to motion) but not in the sequences' ability to delineate the glandular anatomy and depict a cancerous tumor.


MRI; T2-weighted MRI; artifact; prostate cancer; quality

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