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Assessment of Diffusion and Perfusion01:17

Assessment of Diffusion and Perfusion

Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
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Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...

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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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Clinical Value of a Novel Apparent Diffusion Coefficient-Based Bi-Color Map for Detecting Clinically Significant

Mitsuo Okada1, Yoichi Araki2, Yosuke Hirasawa1

  • 1Department of Urology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 1600023, Japan.

Cancers
|June 12, 2026
PubMed
Summary

A novel apparent diffusion coefficient (ADC)-based bi-color map aids in detecting clinically significant prostate cancer (csPC). This tool enhances lesion identification and risk stratification, potentially improving diagnosis in men with prostate cancer.

Keywords:
diagnosisdiffusion magnetic resonance imagingmagnetic resonance imagingprostatic neoplasmsretrospective studies

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Minimum apparent diffusion coefficient (ADC) values are established independent predictors of clinically significant prostate cancer (csPC).
  • Conventional MRI assessment can sometimes overlook suspicious lesions.
  • There is a need for improved methods to identify and characterize csPC.

Purpose of the Study:

  • To develop and evaluate a novel ADC-based bi-color map for identifying csPC.
  • To assess the utility of this map in improving lesion detection and risk stratification.
  • To compare the diagnostic performance of the map with existing MRI criteria.

Main Methods:

  • Retrospective analysis of 108 targeted prostate biopsy cases and 93 radical prostatectomy cases.
  • Assessment of ADC-based bi-color map positivity in relation to csPC in lesions with Prostate Imaging-Reporting and Data System (PI-RADS) scores ≥ 3.
  • Evaluation of additional color map-positive lesions not meeting PI-RADS ≥ 3 criteria in the prostatectomy cohort.

Main Results:

  • The ADC-based bi-color map identified csPC in lesions both within and outside PI-RADS ≥ 3 categories.
  • In the biopsy cohort, csPC detection was significantly higher in color map-positive lesions (70.0%) compared to PI-RADS ≥ 3 lesions overall (41.4%).
  • The map demonstrated particular value in PI-RADS 4 lesions, significantly improving csPC detection rates (74.4% vs. 23.3%).
  • In the prostatectomy cohort, 58.6% of color map-positive lesions were confirmed as csPC, including 67.1% of those not initially classified as PI-RADS ≥ 3.

Conclusions:

  • The ADC-based bi-color map shows promise for enhancing lesion highlighting in prostate MRI.
  • This novel tool may improve risk stratification for csPC.
  • The bi-color map could help identify suspicious lesions that might be missed by conventional MRI assessment.