title: Increased signal intensity of prostate lesions on high b-value diffusion-weighted images as a predictive sign of malignancy.
abstract: OBJECTIVE
  The evaluation of lesions detected in prostate magnetic resonance imaging (MRI) with increased signal intensity (SI) on high b-value diffusion-weighted images as a sign of malignancy.
  
  
  METHODS
  One hundred and three consecutive patients with prostate MRI examination and MRI-guided in-bore biopsy were retrospectively included in the study. MRI-guided in-bore biopsy histologically confirmed prostate cancer in 50 patients (n = 92 lesions). The other 53 patients (n = 122 lesions) had negative bioptical results.
  
  
  RESULTS
  In patients with histologically confirmed prostate cancer, 46 of the 92 lesions had visually increased SI on the high b-value images compared with the peripheral zone (SI = +27 ± 16%) or the central gland (SI = +37 ± 19%, P < 0.001 respectively). In patients with a negative biopsy, ten of the 122 lesions had visually increased SI (compared with the peripheral zone, SI = +29 ± 18%, and with the central gland, SI = +41 ± 15%, P < 0.001 respectively). Neither the apparent diffusion coefficient (ADC) values nor the Gleason Score of lesions with increased SI were significantly different from lesions without increased SI.
  
  
  CONCLUSIONS
  Visually increased SI on the high b-value images of diffusion-weighted imaging using standard b-values is a sign of malignancy but can occasionally also be a feature of benign lesions. However, it does not indicate more aggressive tumours.
  
  
  CONCLUSIONS
  • Diffusion weighted magnetic resonance imaging is increasingly used to diagnose prostatic cancer • Reduced signal intensity (SI) on apparent diffusion coefficient (ADC) mapping is characteristic • Prostatic tumours usually exhibit increased SI on high b-value images • But benign lesions can also yield increased SI on high b-value images.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstr. 5, 40225, Dusseldorf, Germany, Michael.Quentin@med.uni-duesseldorf.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Quentin
authors.forename: Lars
authors.initials: L
authors.lastname: Schimmöller
authors.forename: Christian
authors.initials: C
authors.lastname: Arsov
authors.forename: Robert
authors.initials: R
authors.lastname: Rabenalt
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Peter
authors.initials: P
authors.lastname: Albers
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies