Korean J Radiol.  2018 Oct;19(5):832-837. 10.3348/kjr.2018.19.5.832.

Computed Diffusion-Weighted Imaging in Prostate Cancer: Basics, Advantages, Cautions, and Future Prospects

• Ueno YR
• Tamada T
• Takahashi
• Tanaka U
• Sofue K
• Kanda T
• Nogami M
• Ohno Y
• Hinata N
• Fujisawa M
• Murakami T

• KMID: 2418545
• DOI: http://doi.org/10.3348/kjr.2018.19.5.832

Abstract

Computed diffusion-weighted MRI is a recently proposed post-processing technique that produces b-value images from diffusion-weighted imaging (DWI), acquired using at least two different b-values. This article presents an argument for computed DWI for prostate cancer by viewing four aspects of DWI: fundamentals, image quality and diagnostic performance, computing procedures, and future uses.

Keyword

Prostate cancer; MRI; Computed diffusion-weighted imaging; b-value; Apparent diffusion coefficient

MeSH Terms

Magnetic Resonance Imaging
Prostate*
Prostatic Neoplasms*

Figure

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  Fig. 1 Schema of computed DWI. For example, DW images at b-values of 0 s/mm2 and 1000 s/mm2 can be used for computation of DW images at b-value of 2000 s/mm2 using estimated apparent diffusion coefficient values based on mono-exponential model. DWI = diffusion weighted imaging

• 

  Fig. 2 Theory of advantage of computed DWI. Computed DWI potentially suppresses background noise, maintaining lesion signal and leading to better contrast of cancerous lesion.

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  Fig. 3 Computed DWI of prostate cancer. With acquired DWI at b = 1000 s/mm2 (A), bilateral lobes of PZ show abnormal signal intensity (arrow and arrowhead). With both acquired DWI at b = 1000 s/mm2 (B) and computed DWI at b = 2000 s/mm2 (C), left lobe of PZ shows abnormal signal intensity (arrows), whereas right lobe of PZ shows normal signal (arrowheads). Pathological specimen confirmed prostate cancer with GS 4 + 3 in left side of PZ (delineated by solid line, D) and no cancer in right side of PZ. PZ = peripheral zone

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  Fig. 4 High spatial-resolution computed DWI. Abnormal signal in right side of PZ is shown on T2WI (arrow, A). With normal resolution DWI at b = 2000 s/mm2 (arrow, B), abnormal signal in right side of PZ is depicted but is distorted compared to T2WI. With high resolution computed DWI at b = 2000 s/mm2 (arrow, C), abnormal signal in right side of PZ is shown clearly and less distorted. In this image, boundary of prostate is also depicted. Pathological specimen revealed cancer with GS 3 + 4 in right side of PZ (delineated by red line, D). Although there was small tumor with GS 3 + 3 on left side of PZ, it was not depicted on magnetic resonance imaging (delineated by blue line, D). T2WI = T2-weighted imaging

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