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Rectal cancer and prostate cancer

Case Study
Prof. Matos, Celso, M.D. Brussels, Erasme Hospital

Patient history

A 77-year-old male presented for an MRI examination on the Achieva 3.0T TX at Erasme Hospital to help staging of a neoplasm of the rectum.

MR examination

Achieva 3.0T TX was used with the SENSE Torso XL coil.

Exam included the following sequences:
1. Sagittal fast TSE T2-weighted with voxel size 0.7x1x4 mm3; SENSE acceleration factor 3; TE100 ms; acquisition time 36s)
2. Axial and coronal respiratory triggered TSE T2-weighted with voxel size 0.94x0.94x4 mm3; TE 135 ms; TSE factor 23; TR 1800ms; SENSE acceleration factor 2.
3. Axial respiratory-triggered DWI with multiple b-values (0, 1000, 1500, 2000, 2500 s/mm2); TR 1500 ms; TE 90 ms; voxel size 2.5x2.5x4 mm3; SENSE acceleration factor 2.
4. 3D multivoxel spectroscopy with voxel size 3x13x9 mm3

Images

 T2W TSE ADC map
T2W TSE
ADC map
 3D multivoxel spectroscopy
3D multivoxel spectroscopy

Axial respiratory triggered T2-weighted TSE shows a rectal neoplasm with anterior wall disruption. The prostate presents heterogeneous morphology in the central zone without clear delineation of a mass.

The ADC map shows the rectal lesion and a right side central zone prostate lesion with significantly decreased ADC related to neoplasm (arrows).

Spectroscopy of the prostate tissue shows an elevated choline peak and reduced citrate in the area of restricted diffusion within the central zone. Combining DWI and 3D spectroscopy visualizes the prostate lesion in the central zone better than just using T2-weighted sequences.

Diagnosis

The findings are consistent with rectal cancer and prostate cancer.

Clinical impact of the Achieva 3.0T TX with MultiTransmit

The Achieva 3.0T TX with MultiTransmit consistently enhances image and contrast uniformity and improves reproducibility which benefits diagnosis and follow-up in oncology patients.

Combining DWI and 3D spectroscopy visualizes the prostate lesion in the central zone better than just using T2-weighted sequences.

Related reading:



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Case Study
Achieva 3.0T
Release 2, Release 3
Body, DWI, MultiTransmit, neoplasm, Oncology, Pelvis, Prostate, rectum, SENSE Torso XL coil
 

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