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

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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.

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Abbreviations

ADC:

apparent diffusion coefficient

CP:

central placenta of kiwi fruit

DWI:

diffusion-weighted imaging

TZ:

transitional zone of human prostate

T2WI:

T2-weighted magnetic resonance imaging

MRS:

magnetic resonance spectroscopy

OP:

outer pericarp of kiwi fruit

PCA:

prostate cancer

PP:

peripheral placenta of kiwi fruit

PZ:

peripheral zone of human prostate

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Acknowledgements

The scientific guarantor of this publication is Ullrich G. Mueller-Lisse, MD, MBA. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: prospective experimental phantom study, retrospective correlation with patient data, performed at one institution. The authors of this manuscript thank Gregor Thoermer, PhD, Heinrich von Busch, PhD, and Peter Kreissler, PhD, of Siemens Healthineers, Germany, for valuable technical advice. This manuscript includes results of doctoral thesis work by Sophie Murer at the Faculty of Medicine of the University of Munich (“Ludwig-Maximilians-Universität”, LMU), Germany.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, University of Munich (“Ludwig-Maximilians-Universität”, LMU), Ziemssenstrasse 1, D-80336, Muenchen, Germany

    Ullrich G. Mueller-Lisse, Sophie Murer, Marissa Kuhn, Juergen Scheidler & Michael Scherr

  2. Department of Urology, Faculty of Medicine, University of Munich (“Ludwig-Maximilians-Universität”, LMU), Muenchen, Germany

    Ulrike L. Mueller-Lisse

  3. Department of Urology, Interdisciplinary Oncology Centre Munich (IOZ), Munich, Germany

    Ulrike L. Mueller-Lisse

  4. Radiology Centre Munich (RZM), München, Germany

    Juergen Scheidler

  5. Department of Radiology, BG Unfallklinik Murnau, Murnau am Staffelsee, Germany

    Michael Scherr

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  1. Ullrich G. Mueller-Lisse
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Correspondence to Ullrich G. Mueller-Lisse.

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Mueller-Lisse, U.G., Murer, S., Mueller-Lisse, U.L. et al. Everyman’s prostate phantom: kiwi-fruit substitute for human prostates at magnetic resonance imaging, diffusion-weighted imaging and magnetic resonance spectroscopy. Eur Radiol 27, 3362–3371 (2017). https://doi.org/10.1007/s00330-016-4706-7

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