Feasibility and impact of using an automated user interface for proton spectroscopy in multiparametric MRI of the prostate

Background: Multiparametric MRI including MR spectroscopy has recently gained much acceptance being a non-invasive imaging modality for the evaluation of prostate cancer. This study aimed to evaluate the reliability and effectiveness of an assisted workflow for guided and automated multiparametric MRI (mpMRI) of the prostate including MR spectroscopy (MRS) on a 3 T scanner. Fifty-six consecutive patients (age range 44–73 years, mean 63 years) with suspected prostate cancer underwent mpMRI using a surface coil in a 3 T MR scanner. Thirty-eight patients were examined using a newly developed computer-assisted workflow and a control group of 18 randomly selected patients with the conventional technique. Overall examination time, spectral quality, saturation pulse positioning, and the outcome of automatic prostate segmentation were compared. A grading of 1 to 5 was used, where 1 represents the highest and 5 the lowest quality of the respective results. Results: Both the conventional technique and the computer-assisted workflow provided good spectral quality. No significant differences were found regarding saturation pulse positioning and spectral quality (P > 0.05). However, a significant difference regarding overall examination time was found, 40.78 min versus 32.6 min for conventional and computer-assisted workflow respectively (P < 0.001). The automated scanning technique also showed satisfactory results for automated prostate segmentation. Conclusions: The computer-assisted workflow achieved good spectral quality while reducing overall examination time. This time saving effect may allow the inclusion of MRS in clinical routine.