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Keywords:
Genital / Reproductive system male, Oncology, Pelvis, MR, MR-Functional imaging, MR-Diffusion/Perfusion, Observer performance, Localisation, Neoplasia, Cancer
Authors:
M.-R. Kwon, C. K. Kim, J. J. Park, J. G. Kim, J. Lee, S. Y. Yang, M. Seong; Seoul/KR
DOI:
10.1594/ecr2017/C-2874
Aims and objectives
The Prostate Imaging‒Reporting and Data System version 2 (PI-RADS v2) guidelines designated diffusion-weighted imaging (DWI) as the dominant sequence in prostate magnetic resonance imaging (MRI) for guiding localization and risk assessment of focal peripheral zone (PZ) lesion [1].
The guidelines introduced and advised to use the “high b-values” (> 1400 s/mm2) images routinely,
if the signal-to-noise (SNR) adequate.
Several recent studies have reported that DWI using b= 1500‒2500 s/mm2 was optimal and superior to conventional DWI using b = 1000 s/mm2 (DWI1000) [2-9].
Although higher b-value DWI has greater benign tissue suppression and improves detection of clinically significant cancer (CSC),
it reduces the SNR,
increases the susceptibility artifacts and image distortion resulting from increased eddy currents [10].
Thus,
a large number of studies for prostate MRI have used conventional DWI (usually the highest b = 800 or 1000 s/mm2).
Accordingly,
it is questionable that the higher b-value DWI (> 1000 s/mm2) has really greater diagnostic performance in the evaluation of prostate cancer than conventional b-value DWI in daily practice.
To our knowledge,
no studies have compared the diagnostic value of higher (> 1000 s/mm2) DWI from conventional b-value DWI (b = 1000 s/mm2) regarding PI-RADS v2 scoring.
The purpose of this study was to retrospectively investigate the variability of higher b-value DWI (b =1500 s/mm2,
DWI1500) and DWI1000 scoring for PI-RADS v2 in evaluating prostate cancer.