Performance of an Automated Workflow for Magnetic Resonance Imaging of the Prostate Comparison With a Manual Workflow

Objectives The aim of this study was to evaluate the performance of an automated workflow for multiparametric magnetic resonance imaging (mpMRI) of the prostate compared with a manual mpMRI workflow. Materials and Methods This retrospective study was approved by the local ethics committee. Two MR technicians scanned 2 healthy volunteers with a prototypical highly automated workflow (Siemens Healthineers GmbH, Erlangen, Germany) and with a manually adjusted scan protocol each. Thirty patients (mean age +/- standard deviation, 68 +/- 11 years; range, 41-93 years) with suspected prostate cancer underwent mpMRI on a 3 T MRI scanner. Fifteen patients were examined with the automated workflow and 15 patients with a conventional manual workflow. Two readers assessed image quality (contrast, zone distinction, organ margins, seminal vesicles, lymph nodes), organ coverage, orientation (T2w sequences), and artifacts (motion, susceptibility, noise) on a 5-point scale (1, poor; 5, excellent). Examination time and MR technicians' acceptance were compared between both groups. Interreader agreement was evaluated with Cohen's kappa (kappa). Results The automated workflow proved consistent for sequence orientation and image quality in the intraindividual comparisons. There were no significant differences in examination time (automated vs manual; median 26 vs 28 minutes; interquartile range [IQR], 25-28 minutes each; P = 0.57), study volume coverage, artifacts, or scores for T2w sequence orientation (5 vs 4 each; P > 0.3). Overall image quality was superior for automated MRI (4.6 vs 3.8; IQR, 3.9-4.8 vs 3.2-4.3; P = 0.002), especially concerning organ delineation and seminal vesicles (P = 0.045 and P = 0.013). The acceptance score was higher for the manual workflow (median, 10 vs 8; IQR, 10 vs 7-10; P = 0.002). General interreader agreement was excellent (kappa = 0.832; P < 0.001). Conclusions The automated workflow for prostate MRI ensures accurate sequence orientation and maintains high image quality, whereas examination time remained unaffected compared with the manual procedure in our institution.