Diffusion and Perfusion MR Imaging of the Prostate
Section snippets
Diffusion and Prostate Cancer
Water molecules exhibit random motion in tissue, related to temperature (Brownian effect).1 DWI can quantify this water motion in an indirect manner.2, 3 The DWI pulse sequence labels hydrogen nuclei in space, of which most is water molecules at any moment, and determines the length of the path that water molecules travel over a short period of time. DWI estimates the mean distance traveled by all hydrogen nuclei in every voxel of imaged tissue. The greater this mean distance the more
Angiogenesis and Prostate Cancer
For a tumor, one critical factor that affects development, growth, invasiveness, and progression into the metastatic form is the ability of the tumor to generate new blood vessels. Angiogenesis, the sprouting of new capillaries from existing blood vessels, and vasculogenesis, the de novo generation of new blood vessels, are the two primary methods of vascular expansion by which nutrient supply to tumor tissue is adjusted to match physiologic needs.49 Tumor growth beyond 1 to 2 mm in solid
Current research and focuses for the future in diffusion-weighted MR imaging and dynamic contrast-enhanced MR imaging of the prostate
The technical feasibility of DWI and DCE MR imaging techniques for prostate imaging is now well established. Current and future research should focus on the additive values of DWI and DCE MR imaging to conventional and other MR imaging techniques of the prostate.
The performance of prostate DWI and DCE MR imaging is likely to gain from computer-assisted diagnosis.66 The combination of the quantitative functional data makes these techniques very suitable for computer analysis and prospective
Summary
DWI is an advanced MR imaging technique that still needs to be clinically validated in addition to the more commonly used anatomic MR imaging sequences, such as high-resolution T2-weighted imaging. With the increasing availability of 3-T systems, and with the concomitant use of an endorectal coil, the quality of prostate DWI will further improve and this will likely increase its clinical usefulness.
DCE MR imaging of the prostate is increasingly recognized as a potential tool for imaging of
Acknowledgments
The authors thank Christina Hulsbergen–van der Kaa, MD, PhD, for sharing her experience on histopathologic assessment of the prostate.
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