The effect of gadolinium-based contrast agent administration on magnetic resonance fingerprinting-based T(1) relaxometry in patients with prostate cancer

Magnetic resonance fingerprinting (MRF) is a rapidly developing fast quantitative mapping technique able to produce multiple property maps with reduced sensitivity to motion. MRF has shown promise in improving the diagnosis of clinically significant prostate cancer but requires further validation as part of a prostate multiparametric (mp) MRI protocol. mpMRI protocol mandates the inclusion of dynamic contrast enhanced (DCE) imaging, known for its significant T(1) shortening effect. MRF could be used to measure both pre- and post-contrast T(1) values, but its utility must be assessed. In this proof-of-concept study, we sought to evaluate the variation in MRF T(1) measurements post gadolinium-based contrast agent (GBCA) injection and the utility of such T(1) measurements to differentiate peripheral and transition zone tumours from normal prostatic tissue. We found that the T(1) variation in all tissues increased considerably post-GBCA following the expected significant T(1) shortening effect, compromising the ability of MRF T(1) to identify transition zone lesions. We, therefore, recommend performing MRF T(1) prior to DCE imaging to maintain its benefit for improving detection of both peripheral and transition zone lesions while reducing additional scanning time. Demonstrating the effect of GBCA on MRF T(1) relaxometry in patients also paves the way for future clinical studies investigating the added value of post-GBCA MRF in PCa, including its dynamic analysis as in DCE-MRF.