5 T versus 3 T MRI for prostate cancer: an intra-individual prospective comparison of image quality and diagnostic performance.

[BACKGROUND] To prospectively compare the image quality and diagnostic performance of ultra-high-field 5 T MRI with that of standard 3 T in patients with suspected prostate cancer (PCa).

[METHODS] Sixty-seven consecutive patients received prostate scan at both 5 T and 3 T MRI systems. Two radiologists independently evaluated the images in a double-blind manner. A head-to-head comparison of 5 T and 3 T MRI was conducted from both qualitative and quantitative perspectives. Pathological results from prostate biopsy and radical prostatectomy were used as the gold standard to evaluate the diagnostic performance.

[RESULTS] 5 T MRI demonstrated superior image quality and enhanced visualization of prostatic anatomical structures, including prostatic capsule, seminal vesicle and neurovascular bundles. The lesion delineation was significantly improved in 5 T MRI. The elevated field strength resulted in a significantly higher signal-to-noise ratio, contrast-to-noise ratio, edge rise distance and lesion slope profile in both T2WI and DWI sequences without introducing additional artifacts. Moreover, 5 T MRI demonstrated improved diagnostic performance for biopsy outcomes and pathological features than 3 T.

[CONCLUSION] 5 T MRI effectively improves PCa assessment compared to 3 T. Our study provides preliminary evidence for the feasibility of 5 T MRI in PCa diagnosis and evaluation.