Application of an inline synthetic high b-value reduced filed-of-view diffusion weighted imaging on differentiation prostate cancer from benign prostatic hyperplasia

Abstract Background : This study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b-value diffusion weighted images (rFOV-syDWIs) in the clinical application of prostate cancer based on image quality and diagnostic efficacy. Methods : We retrospectively evaluated the data of 52 patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) who visited our hospital from July to December 2021. All patients underwent rFOV-DWI scans, including a 13b-protocol: b =0, 25, 50, 75, 100, 150, 200, 400, 600, 1000, 1000, 1200 and 1500 s/mm2 and a 5b-protocol: b =0, 100, 400, 800,1500 s/mm2. rFOV-syDWIs with b values of 1000 (rFOV-syDWIb=1000) and 1500 (rFOV-syDWIb=1500) were generated from two different multiple-b-value image data sets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by Levene test and Shapiro–Wilk test, the inter-modality differences of quantitative measurements were respectively examined by Wilcoxon signed rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann-Whitney U test. In addition, comparisons of the performance efficacy of ADCs in differentiation of patients with PCa from BPH were examined using ROC curves. Results : Higher inter-reader agreement, CRs was found higher in 13b-protocol and 5b-protocol rFOV-syDWIb=1000/1500 compared to 13b-protocol rFOV-sDWIb=1000/1500 (P<0.05). AUCs of mean and median obtained from 5b-protocol syADCb=1000/1500 were equal or higher than those from13b-protocol syADCb=1000/1500. Conclusions : rFOV-syDWIs provided better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shortened scan time and synthetic ADCs offered reliable diagnosis value as scanned 13b-protocol DWIs.