title: 3D high-resolution diffusion-weighted MRI at 3T: Preliminary application in prostate cancer patients undergoing active surveillance protocol for low-risk prostate cancer.
abstract: OBJECTIVE
  To improve spatial resolution and image quality of diffusion-weighted (DW) MRI in detecting low-risk prostate cancer (lrPC) in patients undergoing active surveillance protocol (AS-PC), we propose the application of a diffusion-prepared balanced steady-state free precession (bSSFP) technique capable of multishot acquisition.
  
  
  METHODS
  Diffusion-prepared bSSFP was compared with single-shot DW echo planar imaging (SS-DW-EPI) at two prescribed resolutions (2.1 × 2.1 × 3.5mm(3) , 0.9 × 0.9 × 3.5 mm(3) ) in nine healthy subjects and nine AS-PC patients. Geometric distortion and susceptibility artifacts were quantitatively assessed in all subjects. In AS-PC patients, lesion detection via blinded multiparametric MRI including T1-weighted, T2-weighted, dynamic contrast-enhanced imaging, and along with either of two DW methods were evaluated against 12-point biopsy.
  
  
  RESULTS
  Geometric distortion and susceptibility artifacts were significantly less for diffusion-prepared bSSFP at both prescribed spatial resolutions than SS-DW-EPI. Apparent diffusion coefficients of healthy prostate tissue were concordant between the two DW methods at both spatial resolutions. In AS-PC patients, multiparametric MRI with diffusion-prepared bSSFP had greater sensitivity (94%, 63%), accuracy (76%, 67%), positive-predictive value (54%, 48%), negative-predictive value (97%, 82%), and area under the curve (0.80, 0.67) than with SS-DW-EPI.
  
  
  CONCLUSIONS
  The proposed diffusion-prepared technique with higher spatial resolution and improved image quality over SS-DW-EPI resulted in better multiparametric MRI detection of lrPC in AS-PC patients.
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Nguyen
authors.affiliation: Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Ali-Reza
authors.initials: AR
authors.lastname: Sharif-Afshar
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Yibin
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Sidney
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Siemens Healthcare, Los Angeles, California, USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Bi
authors.affiliation: Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Lucas
authors.initials: L
authors.lastname: Payor
authors.affiliation: Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Rola
authors.initials: R
authors.lastname: Saouaf
authors.affiliation: Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Hyung
authors.initials: H
authors.lastname: Kim
authors.affiliation: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
mesh_terms: D000328:Adult; D016477:Artifacts; D001706:Biopsy; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media
keywords: MRI; bSSFP; diffusion preparation; diffusion-weighted; prostate cancer