Squared diffusion-weighted imaging for improving the detection of clinically significant prostate cancer

Abstract Aim of this study was to proof the concept of optimizing the contrast between prostate cancer (PC) and healthy tissue by DWI post-processing using a quadrature method. DWI post-processing was performed on 30 patients (median age 67 years, prostate specific antigen 8.0 ng/ml) with PC and cle...

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Main Authors: Birte Valentin, Lars Schimmöller, Matthias Boschheidgen, Tim Ullrich, Thomas Andreas Thiel, Alexandra Ljimani, Jan Philipp Radtke, Thomas Benkert, Peter Albers, Gerald Antoch, Hans-Jörg Wittsack, Michael Quentin
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-86068-x
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Summary:Abstract Aim of this study was to proof the concept of optimizing the contrast between prostate cancer (PC) and healthy tissue by DWI post-processing using a quadrature method. DWI post-processing was performed on 30 patients (median age 67 years, prostate specific antigen 8.0 ng/ml) with PC and clear MRI findings (PI-RADS 4 and 5). Multiparametric MRI was performed at 3 Tesla. A multi-shot readout segmentation (rs-EPI) plus zoomed single-shot imaging (z-EPI) sequence was used in 15 patients (group 1) and a single-shot echo-planar imaging (ss-EPI) plus rs-EPI sequence in 15 patients (group 2). B-value images (b1000 and b1800/2000) were squared and then evaluated objectively software-based and subjectively using a 5-point. The squared DWI technique showed a significantly higher contrast ratio (CR) for ss-EPI b1800 (p < 0.001), rs-EPI b1000 (p < 0.001), rs-EPI b1800 (p < 0.001), z-EPI b1000 (p = 0.008) and for z-EPI b2000 (p < 0.001). After post-processing, a significant improvement in the subjective assessment of image quality was observed for rs-EPI b1000 (p < 0.001), rs-EPI b1800 (p < 0.001) and z-EPI b1000 (p < 0.001). The application of the square post-processing to DWI results in a significant improvement in the CR between PC and healthy tissue, especially at high b-values of ss-EPI or re-EPI. This method may help to improve the detection and differentiation of PC lesions.
ISSN:2045-2322