Computed high b-value diffusion-weighted imaging improves lesion contrast and conspicuity in prostate cancer

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Prostate cancer detection relies on imaging techniques.
• Standard apparent diffusion coefficient (ADC) maps have limitations in differentiating tumors from background tissue.
• Computed diffusion-weighted imaging (cDWI) offers potential for improved contrast.

Purpose of the Study:

• To evaluate if very high b-value cDWI improves contrast between prostate cancer foci and background tissue compared to standard ADC maps.
• To determine if this enhanced contrast aids in improving tumor detection in prostate cancer.

Main Methods:

• Very high b-value cDWI series (up to b4000) were acquired for 14 high-grade prostate cancer patients.
• Contrast-to-noise ratios (CNRs) and CNR-to-ADC ratios were calculated.
• Three blinded readers assessed tumor conspicuity on a five-point scale.

Main Results:

• Tumor CNR significantly increased with higher b-values, reaching an average CNR of 75.1 at b4000 (ADC map average CNR: 10.0).
• CNR/ADC ratios exceeded 1 for cDWI at b1500 and higher, peaking at 6.5 for cDWI4000.
• Subjective tumor conspicuity scores were significantly higher for cDWI (b2000-4000) compared to ADC maps (P < 0.05).

Conclusions:

• Very high b-value cDWI provides superior contrast for distinguishing prostate cancer from surrounding tissue compared to standard ADC maps.
• The enhanced contrast achieved with cDWI leads to improved subjective tumor conspicuity, aiding in detection.