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Diffusion‐weighted imaging of the prostate: Comparison of b1000 and b2000 image sets for index lesion detection

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TLDR
To compare tumor detection on acquired diffusion‐weighted (DW) images and apparent diffusion coefficient (ADC) maps, obtained using b‐values of 1000 s/mm2 and 2000 s/ mm2 are compared, using radical prostatectomy as the reference.
Abstract
Purpose: To compare tumor detection on acquired diffusion-weighted (DW) images and apparent diffusion coefficient (ADC) maps, obtained using b-values of 1000 s/mm2 and 2000 s/mm2, using radical prostatectomy as the reference. Materials and Methods: In all, 29 prostate cancer patients who underwent 3T magnetic resonance imaging (MRI) including DW imaging using b-values of 1000 s/mm2 and 2000 s/mm2 were included. Two radiologists independently evaluated four image sets during different sessions and recorded the location and diameter of the dominant lesion: DW images acquired using b-values of 1000 s/mm2 and 2000 s/mm2 and ADC maps calculated using maximal b-values of 1000 s/mm2 and 2000 s/mm2. Findings were correlated with the location and diameter of the dominant lesion at prostatectomy. Tumor-to-PZ contrast was also calculated, unblinded to pathology. Results: Both readers achieved significantly higher sensitivity for DW images obtained using a b-value of 2000 s/mm2 than 1000 s/mm2 (P < 0.001), although there was no difference in sensitivity between ADC maps calculated using the two b-values (P ≥ 0.309). Tumor-to-PZ contrast was higher for DW images using a b-value of 2000 s/mm2 (P = 0.067), although it was not different between the two corresponding ADC maps (P = 0.544). For both readers, correlations with tumor diameters were higher for either ADC map (r = 0.59–0.73) than for either acquired DW image set (r = 0.03–0.57). Conclusion: Use of a b-value of 2000 s/mm2 compared with a b-value of 1000 s/mm2 resulted in improved tumor sensitivity and higher tumor-to-PZ contrast on the acquired DW images, although performance of the ADC maps corresponding with the two b-values was similar. Correlation with tumor size was greater for either ADC map than for either acquired DW image set. J. Magn. Reson. Imaging 2013;38:694–700. © 2013 Wiley Periodicals, Inc.

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PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2

TL;DR: The Prostate Imaging - Reporting and Data System Version 2 (PI-RADS™ v2) simplifies and standardizes terminology and content of reports, and provides assessment categories that summarize levels of suspicion or risk of clinically significant prostate cancer that can be used to assist selection of patients for biopsies and management.
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Body diffusion kurtosis imaging: Basic principles, applications, and considerations for clinical practice

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Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI.

TL;DR: It is important that the radiologist involved in the interpretation of prostate MRI be aware of these pitfalls that will be encountered during routine clinical practice, and awareness can contribute to improved diagnostic performance in MRI interpretation.
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Prostate Imaging Reporting and Data System and Likert Scoring System: Multiparametric MR Imaging Validation Study to Screen Patients for Initial Biopsy

TL;DR: PI-RADS provided the site-specific stratified risk of cancer-positive cores in biopsy-naive men with normal DRE results and elevated PSA levels and there was no significant difference between summed PI-R ADS scores of 9 or greater and Likert scale scores of 3 or greater in the detection of cancer in the peripheral zone.
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Transition Zone Prostate Cancer: Revisiting the Role of Multiparametric MRI at 3 T

TL;DR: In this article, the authors evaluate the impact of multiparametric prostate MRI, including diffusion-weighted imaging (DWI) performed using different b values as well as dynamic contrast-enhanced MRI (DCE-MRI) on the accuracy, sensitivity, and specificity for transition zone (TZ) tumor detection and localization.
References
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Journal ArticleDOI

Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer

TL;DR: Serum PSA level, PSA density, and needle biopsy pathologic findings are accurate predictors of tumor extent and it may be reasonable to follow up some patients whose tumors are most likely insignificant with serial PSA measurements and repeated biopsies.
Journal ArticleDOI

Copy number analysis indicates monoclonal origin of lethal metastatic prostate cancer

TL;DR: It is shown through a high-resolution genome-wide single nucleotide polymorphism and copy number survey that most, if not all, metastatic prostate cancers have monoclonal origins and maintain a unique signature copy number pattern of the parent cancer cell while also accumulating a variable number of separate subclonally sustained changes.
Journal ArticleDOI

Prostate Cancer: Multiparametric MR Imaging for Detection, Localization, and Staging

TL;DR: Suggestions for a general minimal protocol for multiparametric MR imaging of the prostate based on the literature and the authors' experience are presented and support techniques, such as computer-aided diagnosis, are needed to obtain a fast, cost-effective, easy, and more reproducible prostate cancer diagnosis.
Journal ArticleDOI

Combined T2-Weighted and Diffusion-Weighted MRI for Localization of Prostate Cancer

TL;DR: Combined T2 and DWI MRI is better than T2 imaging alone in the detection of significant cancer within the peripheral zone of the prostate.
Journal ArticleDOI

Relationship between Apparent Diffusion Coefficients at 3.0-T MR Imaging and Gleason Grade in Peripheral Zone Prostate Cancer

TL;DR: ADCs at 3.0 T showed an inverse relationship to Gleason grades in peripheral zone prostate cancer and a high discriminatory performance was achieved in the differentiation of low-, intermediate-, and high-grade cancer.
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