Comparative study between monoexponential and biexponential diffusion weighted imaging sequences in multiparametric...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Multiparametric prostate magnetic resonance imaging (mpMRI) is crucial for diagnosing prostate cancer.
• Diffusion-weighted imaging (DWI) is a key component of mpMRI.
• Evaluating novel DWI protocols is essential for improving diagnostic accuracy.

Purpose of the Study:

• To compare the image quality of a new biexponential DWI protocol against the standard monoexponential DWI protocol in mpMRI of the prostate.
• To assess both qualitative and quantitative parameters of image quality.

Main Methods:

• Prospective data collection with cross-sectional analysis of 66 patients with suspected prostate cancer.
• Two independent readers evaluated images based on six qualitative and three quantitative criteria.
• Statistical analysis included Gwet's coefficient, Stuart-Maxwell test, and Wilcoxon test.

Main Results:

• The monoexponential protocol demonstrated superior qualitative image quality in most categories, with significant differences in global quality and signal-to-noise ratio (SNR).
• Quantitative analysis revealed the monoexponential protocol had less image distortion (anteroposterior diameter variability) and a better estimated SNR.
• Good to excellent inter-observer agreement was achieved for most subjective criteria.

Conclusions:

• The standard monoexponential diffusion sequence yielded qualitatively and quantitatively superior image quality compared to the biexponential diffusion sequence in prostate mpMRI.
• The findings suggest the monoexponential protocol remains the preferred choice for prostate DWI based on current image quality metrics.