Comparison of high-resolution T1W 3D GRE (LAVA) with 2-point Dixon fat/water separation (FLEX) to T1W fast spin echo (FSE) in prostate cancer (PCa)

Published:December 03, 2015DOI:



      To compare T1-weighted (T1W) fast spin echo (FSE) to T1W 3-dimensional gradient recalled echo (LAVA) with fat water separation (FLEX) in prostate cancer (PCa).


      With institutional review board waiver, 39 patients underwent 3-T magnetic resonance imaging including T1W LAVA FLEX (157 s)/T1W FSE (316 s). Two radiologists assessed (a) image quality/sharpness, (b) presence/severity of artifacts, and (c) skeletal (N=22)/nodal (N=9) metastases. Results were compared using Wilcoxon signed-rank test/receiver operator characteristic analysis.


      With T1W LAVA FLEX, image quality/sharpness improved (P<.001) with less motion (P=.002–.03) and no difference in phase-encoding artifact (P>.05). One patient had moderate fat/water swap.
      Detection of skeletal metastases was unchanged (P>.05) and nodal metastases either improved (P=.002) or were comparable (P=.16) using T1W LAVA FLEX.


      T1W LAVA FLEX improves image quality, lessens motion artifact, and is comparable or improves detection of metastases in PCa with reduction in acquisition time.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Aydin H
        • Kizilgöz V
        • Tatar IG
        • Damar C
        • Ugan AR
        • Paker I
        • et al.
        Detection of prostate cancer with magnetic resonance imaging: optimization of T1-weighted, T2-weighted, dynamic-enhanced T1-weighted, diffusion-weighted imaging apparent diffusion coefficient mapping sequences and MR spectroscopy, correlated with biopsy and histopathological findings.
        J Comput Assist Tomogr. 2012; 36: 30-45
        • Park KK
        • Chung MS
        • Chung SY
        • Kim JH
        • Chung BH
        Effects of post biopsy digital rectal compression on improving prostate cancer staging using magnetic resonance imaging in localized prostate cancer.
        Yonsei Med J. 2013; 54: 81-86
        • Barrett T
        • Vargas HA
        • Akin O
        • Goldman DA
        • Hricak H
        Value of the hemorrhage exclusion sign on T1-weighted prostate MR images for the detection of prostate cancer.
        Radiology. 2012; 263: 751-757
        • Penzkofer T
        • Tempany-Afdhal CM
        Prostate cancer detection and diagnosis: the role of MR and its comparison with other diagnostic modalities—a radiologist’s perspective.
        NMR Biomed. 2014; 27: 3-15
        • Tombal B
        • Lecouvet F
        Modern detection of prostate cancer’s bone metastasis: is the bone scan era over?.
        Adv Urol. 2012;
        • Lecouvet FE
        • El Mouedden J
        • Collette L
        • Coche E
        • Danse E
        • Jamar F
        • et al.
        Can whole-body magnetic resonance imaging with diffusion-weighted imaging replace tc 99m bone scanning and computed tomography for single-step detection of metastases in patients with high-risk prostate cancer?.
        Eur Urol. 2012; 62: 68-75
        • Ma J
        Breath-hold water and fat imaging using a dual-echo two-point Dixon technique with an efficient and robust phase-correction algorithm.
        Magn Reson Med. 2004; 52: 415-419
        • Beddy P
        • Rangarajan RD
        • Kataoka M
        • Moyle P
        • Graves MJ
        • Sala E
        T1-weighted fat-suppressed imaging of the pelvis with a dual-echo Dixon technique: initial clinical experience.
        Radiology. 2011; 258: 583-589
        • Li XH
        • Zhu J
        • Zhang XM
        • Ji YF
        • Chen TW
        • Huang XH
        • et al.
        Abdominal MRI at 3.0 T: LAVA-flex compared with conventional fat suppression T1-weighted images.
        J Magn Reson Imaging. 2014; 40: 58-66
        • Ma J
        • Jackson EF
        • Kumar A J
        • Ginsberg LE
        Improving fat-suppressed T2-weighted imaging of the head and neck with 2 fast spin-echo Dixon techniques: initial experiences.
        Am J Neuroradiol. 2009; 30: 42-45
        • Costelloe CM
        • Madewell JE
        • Kundra V
        • Harrell RK
        • Bassett RL
        • Ma J
        Conspicuity of bone metastases on fast Dixon-based multisequence whole-body MRI: clinical utility per sequence.
        Magn Reson Imaging. 2013; 31: 669-675
        • Barentsz JO
        • Richenberg J
        • Clements R
        • Choyke P
        • Verma S
        • Villeirs G
        • et al.
        ESUR prostate MR guidelines 2012.
        Eur Radiol. 2012;
        • Eberhardt SC
        • Carter S
        • Casalino DD
        • Merrick G
        • Frank SJ
        • Gottschalk AR
        • et al.
        ACR appropriateness criteria prostate cancer—pretreatment detection, staging, and surveillance.
        J Am Coll Radiol. 2013; 10: 83-92
        • Costa DN
        • Pedrosa I
        • Donato F
        • Roehrborn CG
        • Rofsky NM
        MR imaging–transrectal US fusion for targeted prostate biopsies: implications for diagnosis and clinical management.
        RadioGraphics. 2015; 35: 696-708
        • Lim C
        • Quon J
        • McInnes M
        • Shabana WM
        • El-Khodary M
        • Schieda N
        Does a cleansing enema improve image quality of 3 T surface coil multiparametric prostate MRI?.
        J Magn Reson Imaging. 2014;
        • Wan X
        • Parker DL
        • Lee JN
        • Buswell HR
        • Gullberg GT
        Reduction of phase error ghosting artifacts in thin slice fast spin-echo imaging.
        Magn Reson Med. 1995; 34: 632-638
        • Berglund J
        • Johansson L
        • Ahlström H
        • Kullberg J
        Three-point Dixon method enables whole-body water and fat imaging of obese subjects.
        Magn Reson Med. 2010; 63: 1659-1668
        • Czervionke LF
        • Daniels DL
        • Wehrli FW
        • Mark LP
        • Hendrix LE
        • Strandt Ja
        • et al.
        Magnetic susceptibility artifacts in gradient-recalled echo MR imaging.
        Am J Neuroradiol. 1988; 9: 1149-1155
        • Costelloe CM
        • Kundra V
        • Ma J
        • Chasen BA
        • Rohren EM
        • Bassett RL
        • et al.
        Fast dixon whole-body MRI for detecting distant cancer metastasis: a preliminary clinical study.
        J Magn Reson Imaging. 2012; 35: 399-408
        • Schwartz LH
        • Bogaerts J
        • Ford R
        • Shankar L
        • Therasse P
        • Gwyther S
        • et al.
        Evaluation of lymph nodes with RECIST 1.1.
        Eur J Cancer. 2009; 45: 261-267
        • Low RN
        • Austin MJ
        • Ma J
        Fast spin-echo triple echo dixon: initial clinical experience with a novel pulse sequence for simultaneous fat-suppressed and nonfat-suppressed T2-weighted spine magnetic resonance imaging.
        J Magn Reson Imaging. 2011; 33: 390-400
        • Huellner MW
        • Appenzeller P
        • Kuhn FP
        • Husmann L
        • Pietsch CM
        • Burger IA
        • et al.
        Whole-body nonenhanced PET/MR versus PET/CT in the staging and restaging of cancers: preliminary observations.
        Radiology. 2014; 273: 859-869
        • Sankineni S
        • Brown AM
        • Fascelli M
        • Law YM
        • Pinto PA
        • Choyke PL
        • et al.
        Lymph node staging in prostate cancer.
        Curr Urol Rep. 2015; 16: 30
        • Sala E
        • Rockall A
        • Rangarajan D
        • Kubik-Huch Ra
        The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis.
        Eur J Radiol. 2010; 76: 367-385
        • Klessen C
        • Rogalla P
        • Taupitz M
        Local staging of rectal cancer: the current role of MRI.
        Eur Radiol. 2007; 17: 379-389