[Application study of qualitatively diagnosing prostate cancer using ultrahigh b-value DWI]

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Accurate diagnosis of prostate cancer is crucial for effective treatment planning.
• Diffusion-weighted imaging (DWI) is an important tool in prostate cancer assessment.
• Exploring advanced DWI techniques like ultrahigh b-value DWI may enhance diagnostic capabilities.

Purpose of the Study:

• To evaluate the diagnostic value of ultrahigh b-value DWI in prostate cancer detection.
• To compare the performance of ultrahigh b-value DWI against high b-value DWI and T2WI.
• To assess diagnostic accuracy in both peripheral and transition zones of the prostate.

Main Methods:

• 84 patients (39 prostate cancer, 45 benign prostatic hyperplasia) underwent T2WI, high b-value DWI (b=1000 s/mm²), and ultrahigh b-value DWI (b=2000 s/mm²).
• Two radiologists independently scored images using PI-RADS V2 criteria.
• Diagnostic performance was assessed by comparing imaging scores with biopsy results, analyzing Area Under the ROC Curve (AUC) and inter-reader agreement.

Main Results:

• Ultrahigh b-value DWI showed statistically significant improvement in AUC compared to T2WI for both peripheral and transitional zone cancers.
• No significant difference in AUC was observed between ultrahigh b-value DWI and high b-value DWI.
• Ultrahigh b-value DWI demonstrated perfect inter-reader agreement for all lesions, peripheral zone, and transition zone lesions.

Conclusions:

• Ultrahigh b-value DWI exhibits superior diagnostic performance for prostate cancer in both peripheral and transition zones.
• This advanced DWI technique surpasses both high b-value DWI and T2WI in diagnostic accuracy.
• The findings support the integration of ultrahigh b-value DWI into routine prostate cancer imaging protocols.