Volume 74, Issue 2 , Pages 399-403, 1 June 2009
Usefulness of Diffusion-Weighted Imaging in the Localization of Prostate Cancer
Purpose
Advances in high-precision radiation therapy techniques for patients with prostate cancer permit selective escalation of the radiation dose delivered to the dominant intraprostatic lesion and improve the therapeutic ratio. We evaluated the value of diffusion-weighted imaging (DWI) for dominant intraprostatic lesion assessment.
Methods and Materials
The study population consisted of 23 patients with early prostate cancer. Before undergoing total prostatectomy, they were evaluated by means of magnetic resonance imaging, including DWI. T2-weighted imaging (T2WI) with and without DWI were retrospectively assessed by six independent observers. Imaging findings were compared with pathologic results from whole prostate specimens on a lesion-by-lesion basis.
Results
Pathologic study identified 43 lesions in 23 patients. On magnetic resonance imaging, the six observers correctly identified 11–22 of 43 lesions (sensitivity, 26–51%) on T2WI alone and 20–31 (sensitivity, 47–72%) on T2WI plus DWI. Positive predictive values were 42–73% on T2WI alone and 58–80% on T2WI plus DWI. For all observers, detection was higher on combined T2WI and DWI than on T2WI alone.
Conclusion
Because the addition of DWI to T2WI improves the detectability of prostate cancer, DWI may offer a promising new approach for radiation therapy planning.
Prostate cancer, dominant intraprostatic lesion (DIL), diffusion-weighted imaging (DWI), interobserver difference
To access this article, please choose from the options below
H.K., Y.H., and R.M. chaired the study and designed it in collaboration with colleagues from various subspecialties (Y.H., Urology; M.K., Pathology; T.H. and K.A., Radiology; S.M. and R.N., Radiation Oncology). Y.Y., Chair, Diagnostic Radiology, reviewed the initial manuscript drafts and suggested helpful changes. K.K., M.K., Y.S., and K.K. were principal investigators and supplied the individual clinical data.
Conflict of interest: none.
PII: S0360-3016(08)03302-6
doi:10.1016/j.ijrobp.2008.08.017
© 2009 Elsevier Inc. All rights reserved.
Volume 74, Issue 2 , Pages 399-403, 1 June 2009
