Metastatic nodes in prostate cancer are associated with poor prognosis. Conventional MRI, relying on short-axis diameter (SAD) suffers from poor accuracy in identifying metastatic nodes. In this study, we compare fat fraction signal from MRI mDixon acquisitions (FF) with apparent diffusion coefficients of nodes and quantitative contrast-enhanced two-point mDixon T1 images (CE-mDixon), in discriminating between benign and metastatic nodes using 18F-Choline PET-CT as reference standard. We showed that FF and CE-mDixon discriminate benign from involved lymph nodes that are small in size unlike SAD or ADC of nodes; FF, not necessitating contrast agents, holds promise as a clinical tool.
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