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Diffusion-weighted imaging in prostate cancer

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Abstract

Diffusion-weighted imaging (DWI), a key component in multiparametric MRI (mpMRI), is useful for tumor detection and localization in clinically significant prostate cancer (csPCa). The Prostate Imaging Reporting and Data System versions 2 and 2.1 (PI-RADS v2 and PI-RADS v2.1) emphasize the role of DWI in determining PIRADS Assessment Category in each of the transition and peripheral zones. In addition, several recent studies have demonstrated comparable performance of abbreviated biparametric MRI (bpMRI), which incorporates only T2-weighted imaging and DWI, compared with mpMRI with dynamic contrast-enhanced MRI. Therefore, further optimization of DWI is essential to achieve clinical application of bpMRI for efficient detection of csPC in patients with elevated PSA levels. Although DWI acquisition is routinely performed using single-shot echo-planar imaging, this method suffers from such as susceptibility artifact and anatomic distortion, which remain to be solved. In this review article, we will outline existing problems in standard DWI using the single-shot echo-planar imaging sequence; discuss solutions that employ newly developed imaging techniques, state-of-the-art technologies, and sequences in DWI; and evaluate the current status of quantitative DWI for assessment of tumor aggressiveness in PC.

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Authors and Affiliations

  1. Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki city, Okayama, 701-0192, Japan

    Tsutomu Tamada, Yuichi Kojima, Ayumu Kido & Akira Yamamoto

  2. Philips Japan, Konan 2-13-37, Minato-ku, Tokyo, Japan

    Yu Ueda

  3. Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshiko Ueno

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  1. Tsutomu Tamada
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  2. Yu Ueda
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  3. Yoshiko Ueno
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  4. Yuichi Kojima
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Drafting of manuscript: TT, YU, YK, and AK. Critical revision: YU, YU, and AY.

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Correspondence to Tsutomu Tamada.

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Tamada, T., Ueda, Y., Ueno, Y. et al. Diffusion-weighted imaging in prostate cancer. Magn Reson Mater Phy 35, 533–547 (2022). https://doi.org/10.1007/s10334-021-00957-6

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