Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2015; 7(8): 184-188
Published online Aug 28, 2015. doi: 10.4329/wjr.v7.i8.184
Updates in advanced diffusion-weighted magnetic resonance imaging techniques in the evaluation of prostate cancer
Hebert Alberto Vargas, Edward Malnor Lawrence, Yousef Mazaheri, Evis Sala
Hebert Alberto Vargas, Edward Malnor Lawrence, Yousef Mazaheri, Evis Sala, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Author contributions: Vargas HA drafted the manuscript; all authors participated in the literature search, summary and interpretation; all authors edited and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hebert Alberto Vargas, MD, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av., New York, NY 10065, United States. vargasah@mskcc.org
Telephone: +1-212-6392000
Received: February 28, 2015
Peer-review started: March 2, 2015
First decision: March 20, 2015
Revised: June 2, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: August 28, 2015
Processing time: 184 Days and 17.9 Hours
Abstract

Diffusion-weighted magnetic resonance imaging (DW-MRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer. It has been proven valuable as a functional tool for qualitative and quantitative analysis of prostate cancer beyond anatomical MRI sequences such as T2-weighted imaging. This review discusses ongoing controversies in DW-MRI acquisition, including the optimal number of b-values to be used for prostate DWI, and summarizes the current literature on the use of advanced DW-MRI techniques. These include intravoxel incoherent motion imaging, which better accounts for the non-mono-exponential behavior of the apparent diffusion coefficient as a function of b-value and the influence of perfusion at low b-values. Another technique is diffusion kurtosis imaging (DKI). Metrics from DKI reflect excess kurtosis of tissues, representing its deviation from Gaussian diffusion behavior. Preliminary results suggest that DKI findings may have more value than findings from conventional DW-MRI for the assessment of prostate cancer.

Keywords: Prostate cancer; Diffusion-weighted imaging; Diffusion kurtosis imaging; Magnetic resonance imaging; Include intravoxel incoherent motion

Core tip: Diffusion-weighted magnetic resonance imaging (DW-MRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer. In this review we discuss the ongoing controversies in DW-MRI acquisition, including the optimal number of b-values to be used for prostate DWI, and summarize the current literature on the use of advanced DW-MRI techniques such as intravoxel incoherent motion imaging and diffusion kurtosis imaging.