Ultra-High b-Value Diffusion-Weighted MRI for the Detection of Prostate Cancer With 3-T MRI

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Abstract

Purpose

To determine, with histopathological findings of radical prostatectomy as reference, whether diffusion-weighted imaging (DWI) using b = 2000 s/mm2 for 3-T magnetic resonance imaging (MRI) is superior to the use of b = 1000 s/mm2 for prostate cancer detection.

Materials and Methods

This study evaluated 73 patients with biopsy-proven prostate cancer. All patients underwent preoperative 3-T MRI using T2-weighted imaging (T2WI) and DWI (b = 0, 1000, 2000 s/mm2). The following three sets of images were evaluated separately by two radiologists: protocol A (T2WI alone), protocol B (T2WI and DWI with b = 1000 s/mm2), and protocol C (T2WI and DWI with b = 2000 s/mm2). For estimation of diagnostic capability, area under the receiver operating characteristic (ROC) curve (AUC) was calculated.

Results

A total of 341 cancer foci were found in the prostectomy specimens of 73 patients. Reader 1 rated AUCs of the three sets as; A 0.66, B 0.77, C 0.80. ROC analysis showed significant differences among the three protocols (A vs. B vs. C: P < 0.0001, A vs. B: P < 0.0001, B vs. C: P < 0.0001).

Conclusion

The use of b = 2000 s/mm2 for DWI with 3-T MRI is diagnostically superior to that of b = 1000 s/mm2 for prostate cancer detection. J. Magn. Reson. Imaging 2013;38:154–160. © 2012 Wiley Periodicals, Inc.

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