Signal Intensity of High B-value Diffusion-weighted Imaging for the Detection of Prostate Cancer

A Rezaeian, M J Tahmasebi Birgani, N Chegeni, M Sarkarian, M Gh Hanafi, Gh Akbarizadeh


Background: Diffusion-weighted imaging (DWI) is a main component of multiparametric MRI for prostate cancer detection. Recently, high b value DWI has gained more attention because of its capability for tumor characterization.

Objective: To assess based on histopathological findings of transrectal ultrasound (TRUS)-guided prostate biopsy as a reference, an increase in signal intensity of prostatic lesions in comparison with normal background tissue on high b-value diffusion-weighted images could be a sign of malignancy.

Material and Methods: Fifty-three consecutive patients retrospectively included in the study. All patients underwent routine TRUS-guided prostate biopsies involving 12 cores after the magnetic resonance imaging (MRI) examinations. In seventeen patients (n =35 lesions), the prostate cancer was histologically confirmed by TRUS-guided prostate biopsy. The biopsy results of other patients were negative. Signal intensities on the high b-value (1600 s/mm2) images of the peripheral zone, the central gland, and the defined lesions were evaluated using region of interest-based measurements. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for prostate cancer detection using signal intensity of high b value diffusion-weighted images were calculated.

Results: In the patients with confirmed prostate cancer, fourteen had visually increased SI on the high b-value images. The SI of lesions for these patients was higher than the SI of peripheral zone (22±18%) or central gland (31±20%). In patients with a negative biopsy, eight had visually increased SI on the high b-value images. The SI of lesions for these patients was 23±21% and 35±18% higher than the SI in the peripheral zone and the central gland, respectively. The sensitivity, specificity, PPV, and NPV for prostate cancer using SI of high b value DWI were 71, 87, 62, and 87 %, respectively.

Conclusion: Visually increased SI on the high b-value images can be an indication of malignancy, although some benign lesions also show this increase in signal intensity.


Diffusion Magnetic Resonance Imaging ● Prostatic Neoplasms ● Predictive Value of Tests

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eISSN: 2251-7200        JBPE NLM ID: 101589641

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                                                                        Chairman and Editor in Chief

                                                                              Dr. Alireza Mehdizadeh

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