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MRI for prostate cancer: can computed high b-value DWI replace native acquisitions?

Abstract

Objective

To compare computed high b-value diffusion-weighted images (c-DWI) derived from low b-value DWI images and acquired high b-value DWI (a-DWI), in overall image quality and prostate cancer detection rate.

Materials and methods

A total of 124 consecutive men with suspected prostate cancer (PCa) underwent diagnosis prostate MRI on a 3.0 T MR system using a 32-channel phased-array torso coil. Among them, 63 underwent prostate biopsy. MRI protocol included 3DT2w images, high resolution Fov Optimized and Constrained Undistorted Single-Shot (FOCUS™) DWI images with b-values of 100, 400, 800, and 2000 s/mm2 and dynamic contrast enhanced images. C-DWI images (2000 and 2500 s/mm2) were derived from the three lower acquired b-value DWI images using a mono-exponential diffusion decay. C-DWI and acquired high b-value DWI (a-DWI) (2000 s/mm2) were compared for image quality (background signal suppression, anatomic clarity, ghosting, distortion) and tumor conspicuity by four radiologists.

Results

C-DWIs demonstrated higher rating than a-DWIs for overall image quality despite worsened ghosting. In patients with a biopsy, similar detection rate was observed while conspicuity was better with c-DWI (p < 0.001). Non-acquisition of high b-value a-DWI reduced total acquisition time by 220 s per patient.

Conclusion

C-DWI provides a substantial reduction in acquisition time while maintaining comparable prostate cancer detection rate and improving global image quality.

Key Points

• Computed DWI improves global quality of prostate MRI.

• Computed DWI improves analysis of DWI images with decrease acquisition time.

• Computed DWI provides greater background suppression of parenchyma and improves conspicuity of suspicious lesion.

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Abbreviations

a-b2000:

Acquired b 2000 images

a-DWI:

Acquired diffusion-weighted images

ADC:

Apparent diffusion coefficient

AUC:

Area under the receiver operating curves

c-b2000:

Computed b 2000 images

c-b2500:

Computed b 2500 images

c-DWI:

Computed diffusion-weighted images

DCE:

Dynamic contrast-enhanced

DRE:

Digital rectal examination

DWI:

Diffusion-weighted imaging

IQR:

Interquartile range

mp-MRI:

Multiparametric magnetic-resonance imaging

NA:

Non-applicable

PB:

Prostate biopsy

PCa:

Prostate cancer

PSA:

Prostate serum antigen

PZ:

Peripheral zone

ROI:

Region of interest

SB:

Standard biopsy

SNR:

Signal-to-noise ratio (SNR)

T2W:

T2-weighted

TB:

Targeted biopsy

TRUS:

Transrectal ultrasonographic

TZ:

Transitional zone

US:

Ultrasound

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Author information

Correspondence to Raphaele Renard-Penna.

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Guarantor

The scientific guarantor of this publication is Dr Raphaele Renard-Penna.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• performed at one institution

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Jendoubi, S., Wagner, M., Montagne, S. et al. MRI for prostate cancer: can computed high b-value DWI replace native acquisitions?. Eur Radiol 29, 5197–5204 (2019). https://doi.org/10.1007/s00330-019-06085-z

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Keywords

  • Prostatic neoplasms
  • Diagnostic imaging
  • Magnetic resonance imaging
  • Diffusion-weighted MRI