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Sandy Srinivas, MD


Using Diffusion-Weighted MRI in Assessing Suspected Prostate Cancer

By: Joshua Swore, PhD
Posted: Wednesday, May 17, 2023

With further development, diffusion-weighted MRI may prove to be a useful tool to identify patients suspected of having cancer, particularly prostate cancer, according to an article published in Frontiers in Oncology. “In addition to its role in the assessment of suspected cancers, [MRI] is advocated as a monitoring tool in active surveillance of cancers for which treatment is deferred,” said Knut H. Hole, MD PhD, of the University of Oslo, and colleagues. “Moreover, there is a growing interest in prostate cancer screening with MRI. These developments place increasing strain on MRI accessibility and costs and generate a need for simplifying and shortening the examination.”

The proof-of-concept study included 129 consecutive patients with suspicion of prostate cancer. All patients underwent a Prostate Imaging Reporting & Data System (PI-RADS)-based, MRI-directed pathway for diagnosis. All patients underwent a multiparametric MRI as well. Using the results of diffusion-weighted MRI images, two radiologists categorized findings as positive, equivocal, or negative for cancer. They then interpreted the multiparametric MRI and assigned an associated PI-RADS score. Finally, a third reader categorized the diffusion-weighted MRI-alone exams.

The authors reported that 22.5% of patients who underwent diffusion-weighted MRI-alone exams were classified as negative; 29.5%, as equivocal; and 48.1%, as positive. A total of 56 patients with PI-RADS scores of 4 to 5 underwent multiparametric MRI, 55 of whom were categorized as positive when using diffusion-weighted MRI alone. Furthermore, all patients diagnosed with cancer were successfully identified using diffusion-weighted MRI alone. The authors noted that this tool has high sensitivity in identifying patients with cancer, but there are some disagreements when identifying negative and equivocal findings.

Disclosure: The study authors reported no conflicts of interest.

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