title: Intravoxel incoherent motion (IVIM) diffusion imaging in prostate cancer - what does it add?
abstract: OBJECTIVE
  To compare 2 previously presented algorithms for extracting parameters from intravoxel incoherent motion (IVIM) studies and investigate them in the context of tissue differentiation.
  
  
  METHODS
  Magnetic resonance imaging (MRI) was performed in 23 patients without histologically proven prostate carcinoma (PCa) and 27 patients with histologically proven PCa. Two methods were used to determine IVIM parameters (f, D, D*). Receiver operating characteristic analysis was performed for IVIM parameters and apparent diffusion coefficient for discrimination of prostate tissue.
  
  
  RESULTS
  The IVIM parameters showed no significant difference between patients without PCa and normal areas in patients with PCa (r = 0.46-0.99). Results for D were not significantly different for both methods (P = 0.22), whereas f from method 1 was significantly higher than the f from method 2 (P < 0.05). The diffusion parameters D (both methods) and apparent diffusion coefficient could discriminate between tumor and normal areas (receiver operating characteristic analysis, area under the curve, ≥0.90). Additionally, in subgroup analysis, only D was able to discriminate between low- and high-grade PCa.
  
  
  CONCLUSIONS
  For tumor detection, IVIM diffusion does not yield a clear added value, but the perfusion-free diffusion constant D may hold potential for improved image-based tumor grading.
authors.affiliation: From the *Department of Urology, University Hospital Heidelberg, Heidelberg, Germany; †Department of Radiology, ‡Quantitative Imaging-based Disease Characterization, and §Medical and Biological Informatics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Timur H
authors.initials: TH
authors.lastname: Kuru
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Roethke
authors.forename: Bram
authors.initials: B
authors.lastname: Stieltjes
authors.forename: Klaus
authors.initials: K
authors.lastname: Maier-Hein
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: Boris A
authors.initials: BA
authors.lastname: Hadaschik
authors.forename: Michael
authors.initials: M
authors.lastname: Fenchel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D002086:Butylscopolammonium Bromide; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009038:Motion; D015588:Observer Variation; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D002086:Butylscopolammonium Bromide