Performance of an Automated Workflow for Magnetic Resonance Imaging of the Prostate: Comparison With a Manual Workflow.

Objectives: The aim of this study was to evaluate the performance of an automated workflow for multiparametric magnetic resonance imaging (mpMRI) of the prostate compared with a manual mpMRI workflow.

Materials And Methods: This retrospective study was approved by the local ethics committee. Two MR technicians scanned 2 healthy volunteers with a prototypical highly automated workflow (Siemens Healthineers GmbH, Erlangen, Germany) and with a manually adjusted scan protocol each. Thirty patients (mean age ± standard deviation, 68 ± 11 years; range, 41-93 years) with suspected prostate cancer underwent mpMRI on a 3 T MRI scanner. Fifteen patients were examined with the automated workflow and 15 patients with a conventional manual workflow. Two readers assessed image quality (contrast, zone distinction, organ margins, seminal vesicles, lymph nodes), organ coverage, orientation (T2w sequences), and artifacts (motion, susceptibility, noise) on a 5-point scale (1, poor; 5, excellent). Examination time and MR technicians' acceptance were compared between both groups. Interreader agreement was evaluated with Cohen's kappa (κ).

Results: The automated workflow proved consistent for sequence orientation and image quality in the intraindividual comparisons. There were no significant differences in examination time (automated vs manual; median 26 vs 28 minutes; interquartile range [IQR], 25-28 minutes each; P = 0.57), study volume coverage, artifacts, or scores for T2w sequence orientation (5 vs 4 each; P > 0.3). Overall image quality was superior for automated MRI (4.6 vs 3.8; IQR, 3.9-4.8 vs 3.2-4.3; P = 0.002), especially concerning organ delineation and seminal vesicles (P = 0.045 and P = 0.013). The acceptance score was higher for the manual workflow (median, 10 vs 8; IQR, 10 vs 7-10; P = 0.002). General interreader agreement was excellent (κ = 0.832; P < 0.001).

Conclusions: The automated workflow for prostate MRI ensures accurate sequence orientation and maintains high image quality, whereas examination time remained unaffected compared with the manual procedure in our institution.