Urogenital

European Radiology

, Volume 21, Issue 1, pp 188-196

First online:

Ultra-high-b-value diffusion-weighted MR imaging for the detection of prostate cancer: evaluation in 201 cases with histopathological correlation

  • Kazuhiro KatahiraAffiliated withDepartment of Radiology, Kumamoto Chuo Hospital Email author 
  • , Taro TakaharaAffiliated withDepartment of Radiology, University Medical Center Utrecht
  • , Thomas C. KweeAffiliated withDepartment of Radiology, University Medical Center Utrecht
  • , Seitaro OdaAffiliated withDepartment of Radiology, Kumamoto Chuo Hospital
  • , Yasuko SuzukiAffiliated withDepartment of Radiology, Kumamoto Chuo Hospital
  • , Shoji MorishitaAffiliated withDepartment of Radiology, Kumamoto Chuo Hospital
  • , Kosuke KitaniAffiliated withDepartment of Urology, Kumamoto Chuo Hospital
  • , Yasuyuki HamadaAffiliated withDepartment of Urology, Kumamoto Chuo Hospital
  • , Mitsuhiko KitaokaAffiliated withDepartment of Pathology, Kumamoto Chuo Hospital
    • , Yasuyuki YamashitaAffiliated withDepartment of Radiology, University of Kumamoto

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Abstract

Purpose

To assess the diagnostic performance of diffusion-weighted magnetic resonance (MR) imaging (DWI) for prostate cancer detection, using different b-values.

Methods

A total of 201 patients who underwent MR imaging before total prostatectomy were evaluated. MR images were independently assessed by three radiologists. Three combinations of sequences were separately evaluated, as follows: group 1 [T2-weighted images (T2WI) alone], group 2 (T2WI and DWI with a b-value of 1,000 s/mm2), group 3 (T2WI and DWI with a b-value of 2,000 s/mm2). Whole-mount-section histopathological examination was the reference standard. Areas under the receiver operating characteristic curve (AUCs) and diagnostic performance parameters were determined.

Results

The sensitivity, specificity, and AUC for the detection of prostate cancer were as follows: 52.2%, 80.7%, and 0.694 in group 1; 61.2%, 82.6%, and 0.755 in group 2; 73.2%, 89.7%, and 0.842 in group 3. Group 3 achieved the highest diagnostic performance, followed by group 2 (P < 0.05). In the transition zone, the specificity was lower (P < 0.001) for group 2 (82.2%) than for group 1 (86.2%).

Conclusion

The addition of diffusion-weighted images with a b-value of 2,000 s/mm2 to T2WI can improve the diagnostic performance of MR imaging in prostate cancer detection.

Keywords

Prostate cancer Diffusion-weighted imaging Ultra-high b-value MRI Histopathological correlation