Design and characterization of tissue-mimicking gel phantoms for diffusion kurtosis imaging.

PURPOSE: The aim of this work was to create tissue-mimicking gel phantoms appropriate for diffusion kurtosis imaging (DKI) for quality assurance, protocol optimization, and sequence development. METHODS: A range of agar, agarose, and polyvinyl alcohol phantoms with concentrations ranging from 1.0% to 3.5%, 0.5% to 3.0%, and 10% to 20%, respectively, and up to 3 g of glass microspheres per 100 ml were created. Diffusion coefficients, excess kurtosis values, and relaxation rates were experimentally determined. RESULTS: The kurtosis values for the plain gels ranged from 0.05 with 95% confidence interval (CI) of (0.029,0.071) to 0.216(0.185,0.246), well below the kurtosis values reported in the literature for various tissues. The addition of glass microspheres increased the kurtosis of the gels with values up to 0.523(0.465,0.581) observed for gels with the highest concentration of microspheres. Repeat scans of some of the gels after more than 6 months of storage at room temperature indicate changes in the diffusion parameters of less than 10%. The addition of the glass microspheres reduces the apparent diffusion coefficients (ADCs) and increases the longitudinal and transverse relaxation rates, but the values remain comparable to those for plain gels and tissue, with ADCs observed ranging from 818(585,1053) × 10-6  mm2 /s to 2257(2118,2296) × 10-6  mm2 /s, R1 values ranging from 0.34(0.32,0.35) 1/s to 0.51(0.50,0.52) 1/s, and R2 values ranging from 9.69(9.34,10.04) 1/s to 33.07(27.10, 39.04) 1/s. CONCLUSIONS: Glass microspheres can be used to effectively modify diffusion properties of gel phantoms and achieve a range of kurtosis values comparable to those reported for a variety of tissues.

Assessment of the feasibility of using transrectal ultrasound for postimplant dosimetry in low-dose-rate prostate brachytherapy.

A study was performed to establish whether transrectal ultrasound (TRUS)-based postimplant dosimetry (PID) is both practically feasible and comparable to computed tomography (CT)-based PID, recommended in current published guidelines. In total, 22 patients treated consecutively at a single cancer center with low-dose-rate (LDR) brachytherapy for early-stage prostate cancer had a transrectal ultrasound performed immediately after implant (d0-TRUS) and computed tomography scan 30 days after implant (d30-CT). Postimplant dosimetry planning was performed on both image sets and the results were compared. The interobserver reproducibility of the transrectal ultrasound postimplant dosimetry planning technique was also assessed. It was noticed that there was no significant difference in mean prostate D90 (136.5Gy and 144.4Gy, p = 0.2197), V100 (86.4% and 89.1%, p = 0.1480) and V150 (52.0% and 47.8%, p = 0.1657) for d30-CT and d0-TRUS, respectively. Rectal doses were significantly higher for d0-TRUS than d30-CT. Urethral doses were available with d0-TRUS only. We have shown that d0-TRUS PID is a useful tool for assessing the quality of an implant after low-dose-rate prostate brachytherapy and is comparable to d30-CT PID. There are clear advantages to its use in terms of resource and time efficiency both for the clinical team and the patient.