Everyman's prostate phantom: kiwi-fruit substitute for human prostates at magnetic resonance imaging, diffusion-weighted imaging and magnetic resonance spectroscopy

Eur Radiol. 2017 Aug;27(8):3362-3371. doi: 10.1007/s00330-016-4706-7. Epub 2017 Jan 5.

Abstract

Objectives: To apply an easy-to-assemble phantom substitute for human prostates in T2-weighted magnetic resonance imaging (T2WI), diffusion-weighted imaging (DWI) and 3D magnetic resonance spectroscopy (MRS).

Methods: Kiwi fruit were fixed with gel hot and cold compress packs on two plastic nursery pots, separated by a plastic plate, and submerged in tap water inside a 1-L open-spout plastic watering can for T2WI (TR/TE 7500/101 ms), DWI (5500/61 ms, ADC b50-800 s/mm2 map) and MRS (940/145 ms) at 3.0 T, with phased array surface coils. One green kiwi fruit was additionally examined with an endorectal coil. Retrospective comparison with benign peripheral zone (PZ) and transitional zone (TZ) of prostate (n = 5), Gleason 6-7a prostate cancer (n = 8) and Gleason 7b-9 prostate cancer (n = 7) validated the phantom.

Results: Mean contrast between central placenta (CP) and outer pericarp (OP, 0.346-0.349) or peripheral placenta (PP, 0.364-0.393) of kiwi fruit was similar to Gleason 7b-9 prostate cancer and PZ (0.308) in T2WI. ADC values of OP and PP (1.27 ± 0.07-1.37 ± 0.08 mm2/s × 10-3) resembled PZ and TZ (1.39 ± 0.17-1.60 ± 0.24 mm2/s × 10-3), while CP (0.91 ± 0.14-0.99 ± 0.10 mm2/s × 10-3) resembled Gleason 7b-9 prostate cancer (1.00 ± 0.25 mm2/s × 10-3). MR spectra showed peaks of citrate and myo-inositol in kiwi fruit, and citrate and "choline+creatine" in prostates. The phantom worked with an endorectal coil, too.

Conclusions: The kiwi fruit phantom reproducibly showed zones similar to PZ, TZ and cancer in human prostates in T2WI and DWI and two metabolite peaks in MRS and appears suitable to compare different MR protocols, coil systems and scanners.

Key points: • Kiwi fruit appear suitable as phantoms for human prostate in MR examinations. • Kiwi fruit show zonal anatomy like human prostates in T2-weighted MRI and DWI. • MR spectroscopy reliably shows peaks in kiwi fruit (citrate/inositol) and human prostates (citrate/choline+creatine). • The kiwi fruit phantom works both with and without an endorectal coil. • EU regulation No. 543/2011 specifies physical and biochemical properties of kiwi fruit.

Keywords: Diffusion-weighted imaging; Magnetic resonance imaging; Magnetic resonance spectroscopy; Phantom; Prostate cancer.

MeSH terms

  • Aged
  • Choline / metabolism
  • Creatine / metabolism
  • Diffusion Magnetic Resonance Imaging / methods
  • Fruit*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Spectroscopy / methods
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Phantoms, Imaging*
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / pathology
  • Reproducibility of Results
  • Retrospective Studies

Substances

  • Creatine
  • Choline