• Stefanie J Hectors, Daniela Said, Jeffrey Gnerre, Ashutosh Tewari, and Bachir Taouli.
• BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• J Magn Reson Imaging. 2020 Jul 1; 52 (1): 271-279.

BackgroundLuminal water imaging (LWI), a multicomponent T2 mapping technique, has shown promise for prostate cancer (PCa) detection and characterization.PurposeTo 1) quantify LWI parameters and apparent diffusion coefficient (ADC) in PCa and benign peripheral zone (PZ) tissues; and 2) evaluate the diagnostic performance of LWI, ADC, and PI-RADS parameters for differentiation between low- and high-grade PCa lesions.Study TypeProspective.SubjectsTwenty-six PCa patients undergoing prostatectomy (mean age 59 years, range 46-72 years).Field Strength/SequenceMultiparametric MRI at 3.0T, including diffusion-weighted imaging (DWI) and LWI T2 mapping.AssessmentLWI parameters and ADC were quantified in index PCa lesions and benign PZ.Statistical TestsDifferences in MRI parameters between PCa and benign PZ were assessed using Wilcoxon signed tests. Spearman correlation of pathological grade group (GG) with LWI parameters, ADC, and PI-RADS was evaluated. The utility of each of the parameters for differentiation between low-grade (GG ≤2) and high-grade (GG ≥3) PCa was determined by Mann-Whitney U tests and ROC analyses.ResultsTwenty-six index lesions were analyzed (mean size 1.7 ± 0.8 cm, GG: 1 [n = 1; 4%], 2 [n = 14, 54%], 3 [n = 8, 31%], 5 [n = 3, 12%]). LWI parameters and ADC both showed high diagnostic performance for differentiation between benign PZ and PCa (highest area under the curve [AUC] for LWI parameter T2,short [AUC = 0.98, P < 0.001]). The LWI parameters luminal water fraction (LWF) and amplitude of long T2 component Along significantly correlated with GG (r = -0.441, P = 0.024 and r = -0.414, P = 0.036, respectively), while PI-RADS, ADC, and the other LWI parameters did not (P = 0.132-0.869). LWF and Along also showed significant differences between low-grade and high-grade PCa (AUC = 0.776, P = 0.008 and AUC = 0.758, P = 0.027, respectively). Maximum diagnostic performance for discrimination of high-grade PCa was found with combined LWI parameters (AUC 0.891, P = 0.001).Data ConclusionLWI parameters, in particular in combination, showed superior diagnostic performance for differentiation between low-grade and high-grade PCa compared to ADC and PI-RADS assessment. J. Magn. Reson. Imaging 2020;52:271-279.© 2020 International Society for Magnetic Resonance in Medicine.

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