Prostate cancer is the second most common cause of cancer deaths in men in Western Europe and the United States. For detection of prostate cancer, prostate specific antigen (PSA) testing, endorectal ultrasound and ultrasound guided biopsy are frequently employed. The most important aspect of prostate cancer staging is the differentiation between organ-confined and non-organ-confined disease. The presence of locally advanced prostate cancer affects the choice of treatment. Therefore multimodality diagnostic is very important for the detection and staging of the prostate cancer. Thereby diffusion-weighted imaging...

26 patients (median age 68 years, age range 53 to 80 years) with biopsy proven prostate cancer were examined with diffusion weighted MRI with a circular polarized surface coil at 3 Tesla before radical prostatectomy. An endorectal coil was not employed. For the anatomic overview a multiplanar T2-weighted MRI was acquired in each patient (figure 1). Five different b-values (b = 0, 800, 1000, 1500, 2000 s/mm2, figure 2) were used and 4 different ADC maps (Figure 3) were calculated out of the different b-values...

The mean value PSA level of the study group was 11,4 ng/ml (standard deviation 7,24 ng/ml) and the median Gleason score was 6. 15 out of 26 patients (57.7 %) displayed one or more areas of restricted water diffusion. With increasing b-levels the cancer lesion with inherent restricted water diffusion becomes more distinguishable from the surrounding healthy tissue. Also, with increasing b-levels, the anatomical depiction of the gland is more difficult (figure 2). Therefore, two independent radiologists rated the b-level of 1500 mm2/s to be...

In our study group, restriction of water diffusion was an inconsistent feature in biopsy proven prostate cancer. Assessment of tumor aggressiveness by means of DWI was not possible as there was no correlation between Gleason scores and calculated ADC values. The b-value rated as best to detect cancer foci was 1500 s/mm2.

Clinical utility of apparent diffusion coefficient values obtained using high b-value when diagnosing prostate cancer using 3 tesla MRI: comparison between ultra-high b-value (2000 s/mm²) and standard high b-value (1000 s/mm²). Kitajima K, Takahashi S, Ueno Y, Yoshikawa T, Ohno Y, Obara M, Miyake H, Fujisawa M, Sugimura K.. J Magn Reson Imaging. 2012 Jul;36(1):198-205. Prostate cancer: Utility of diffusion-weighted imaging as a marker of side-specific risk of extracapsular extension. Rosenkrantz AB, Chandarana H, Gilet A, Deng FM, Babb JS, Melamed J, Taneja SS.. J...