• Byung Kwan Park, Hyun Moo Lee, Chan Kyo Kim, Han Yong Choi, and Jong Wook Park.
• Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
• Invest Radiol. 2008 Nov 1; 43 (11): 789-93.

ObjectiveTo assess the use of diffusion-weighted imaging (DWI) at 3 Tesla (T) for lesion localization in patients with a high risk of prostate cancer before a rebiopsy.Materials And MethodsA total of 43 patients (age range, 40-80 years; mean age, 62.6 years) who had previously undergone a transrectal ultrasound (TRUS)-guided biopsy that was negative and continued to have a persistent elevated prostate specific antigen level underwent DWI with b = 0 s/mm and b = 1000 s/mm before a rebiopsy. We located the area of the lowest apparent diffusion coefficient values and performed a target biopsy of that area, followed by a systematic biopsy under TRUS guidance. We evaluated the cancer detection rate, tumor location, and lesion visibility on T2-weighted imaging (T2WI) in patients with biopsy-proven cancers.ResultsProstate cancer was detected in 17 (39.5%) patients, and was more predominant in the transitional zone (76.4%, 13/17) than in the peripheral zone (23.6%, 4/17) (P < 0.05). Of the 17 cancers detected on DWI, 6 lesions were seen on T2WI.ConclusionDWI in addition to T2WI at 3 T has the potential to provide important information on lesion localization in patients that had both previous negative TRUS biopsy and persistently elevated prostate specific antigen levels before a repeated biopsy.

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