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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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High-resolution diffusion-weighted imaging of the prostate.

Milica Medved1, Fatma N Soylu-Boy, Ibrahim Karademir

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AJR. American Journal of Roentgenology
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Higher spatial resolution in prostate diffusion-weighted imaging (DWI) improves image quality and lesion detection, despite lower signal-to-noise ratios. This enhanced prostate MRI technique may increase sensitivity for detecting small prostate cancers.

Keywords:
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Area of Science:

  • Radiology
  • Medical Imaging
  • Oncology

Background:

  • Prostate cancer diagnosis relies on Magnetic Resonance Imaging (MRI).
  • Diffusion-weighted imaging (DWI) is crucial for prostate cancer detection.
  • Optimizing DWI spatial resolution is key for improving diagnostic accuracy.

Purpose of the Study:

  • To assess the impact of increased spatial resolution in prostate DWI protocols.
  • To evaluate changes in image quality and lesion conspicuity with higher resolution.

Main Methods:

  • Two DWI protocols were compared in 29 prostate cancer patients: standard (6.7 mm³ voxels) and high-resolution (3.1 mm³ voxels).
  • Radiologists subjectively scored lesion conspicuity, internal architecture, and image quality.
  • Apparent diffusion coefficient (ADC) values were measured and correlated with Gleason scores.

Main Results:

  • High-resolution DWI showed a 40% lower signal-to-noise ratio but yielded 19% higher reader scores for image quality.
  • Average ADC values were 8% higher with high-resolution DWI; cancer-to-normal tissue ADC contrast remained unchanged.
  • A marginally significant correlation was found between cancer ADC values and Gleason scores (p=0.05).

Conclusions:

  • The benefits of higher spatial resolution in prostate DWI outweigh reduced signal-to-noise ratios.
  • Enhanced spatial resolution may improve sensitivity for detecting small or sparse prostate cancers.
  • Clinicians may consider adopting higher-spatial-resolution DWI sequences for prostate MRI.