Magnetic resonance elastography of the prostate in patients with lower urinary tract symptoms: feasibility of the modified driver at high multi-frequencies.

Purpose: To demonstrate the feasibility and diagnostic value of high-frequency magnetic resonance elastography (MRE) for evaluation of prostatic disease in patients with lower urinary tract symptoms (LUTS).

Methods: 41 patients who underwent preoperative prostate MRI and MRE with a modified driver were enrolled retrospectively from May 2016 to September 2021. All were included in the assessment of MRE image quality, using a qualitative visual inspection and a quantitative confidence map. 35 patients (prostate cancer (PCa), n = 13; non-PCa, n = 22) undergoing prostatectomy or biopsy were evaluated for the diagnostic performance of stiffness values. The confidence values and the stiffness values were analyzed by one-way analysis of variance (ANOVA) and independent samples T test, respectively. Area under the receiver operating characteristic (AUROC) analysis was performed.

Results: Through the qualitative analysis, all MRE acquisitions were successful at 60, 90, 120 and 150 Hz. The quantitative confidence values were significantly lower at 60 Hz (0.683 ± 0.055) and 90 Hz (0.762 ± 0.048) than that at 120 Hz (0.814 ± 0.049) and 150 Hz (0.840 ± 0.049), all P < 0.001. The stiffness of PCa was higher than non-PCa at 90 Hz (P = 0.008), 120 Hz (P < 0.001) and 150 Hz (P < 0.001). The AUCs were 0.773, 0.881 and 0.944, respectively.

Conclusion: Prostate MRE using the modified driver is feasible at 60-150 Hz and image quality is better at higher frequencies. Prostate MRE may be useful and helpful to evaluate prostate diseases in patients with LUTS at higher frequencies; however, further study may be warranted with larger population in future.