Prostate cancer: Utility of fusion of T2‐weighted and high b‐value diffusion‐weighted images for peripheral zone tumor detection and localization

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Abstract
Purpose: To retrospectively assess the utility of fusion of T2‐weighted images (T2WI) and high b‐value diffusion‐weighted images (DWI) for prostate cancer detection and localization.Materials and Methods: In this IRB‐approved HIPAA‐compliant study, 42 patients with prostate cancer underwent MRI including multiplanar T2WI and axial DWI before prostatectomy. Two independent radiologists first assessed multiplanar T2WI and axial DWIb‐1000 images and recorded whether tumor was present in each sextant. Axial T2WI was then fused with axial DWIb‐1000 images, and the radiologists re‐evaluated each sextant for tumor. Accuracy was compared using generalized estimating equations based on a binary logistic regression model.Results: The accuracy, sensitivity, specificity, PPV, and NPV for tumor detection on a sextant‐basis using separate and fused image sets was 65.1%, 50.8%, 78.0%, 67.8%, and 63.6% and 71.0%, 60.8%, 80.3%, 73.7%, and 69.3%, respectively, for reader 1, and 54.0%, 42.5%, 64.4%, 52.0%, and 55.2%, and 61.1%, 56.7%, 65.2%, 59.6%, and 62.3%, respectively, for reader 2. The improvements in accuracy, sensitivity, and NPV using fused images were statistically significant for both readers, as was the improvement in PPV for reader 2 (P ranging from P ranging from <0.001 to 0.099).Conclusion: Fusion of T2WI and high b‐value DWI resulted in significant improvements in sensitivity and accuracy for tumor detection on a sextant‐basis, with similar specificity. J. Magn. Reson. Imaging 2011;.

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