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@ARTICLE{Skwierawska:294782,
author = {D. Skwierawska and S. Bickelhaupt and M. Bachl and R. Janka
and M. Murr and F. Gloger and T. A. Kuder$^*$ and M. Zaiss
and D. Hadler and M. Uder and F. B. Laun},
title = {{R}elevance of {P}rostatic {F}luid on the {A}pparent
{D}iffusion {C}oefficient: {A}n {I}nversion {R}ecovery
{D}iffusion-{W}eighted {I}maging {I}nvestigation.},
journal = {Investigative radiology},
volume = {60},
number = {6},
issn = {0020-9996},
address = {[Erscheinungsort nicht ermittelbar]},
publisher = {Ovid},
reportid = {DKFZ-2024-02497},
pages = {357-368},
year = {2025},
note = {2025 Jun 1;60(6):357-368},
abstract = {Diffusion-weighted imaging (DWI) is pivotal for prostate
magnetic resonance imaging. This is rooted in the generally
reduced apparent diffusion coefficient (ADC) observed in
prostate cancer in comparison to healthy prostate tissue.
This difference originates from microstructural tissue
composition changes, including a potentially decreased
fluid-containing lumen volume. This study explored the
nature of the observed ADC contrast in prostate tissue
through inversion recovery-prepared DWI examinations that
generated varying levels of fluid suppression.This
institutional review board-approved, single-center,
prospective study was conducted from 2023 to 2024; all
participants underwent magnetic resonance imaging including
DWI with b-values of 50 and 800 s/mm2 at 16 inversion times
(TI; 60-4000 milliseconds). The measured ADC was interpreted
with a 2-compartment model (compartments: tissue and fluid).
Descriptive statistics were computed for all analyzed
parameters.Twelve healthy male volunteers (45 ± 17 years)
and 1 patient with prostate adenocarcinoma (66 years) were
evaluated. The ADC map appearance depended heavily on the
TI, and we observed a feature-rich ADC(TI) curve. The ADC in
the transition zone (TZ) of healthy volunteers increased
between TI = 60 milliseconds and approximately 1100
milliseconds, then dropped drastically before increasing
again, stabilizing at a very high TI. This effect was
greatly reduced in the patient's prostate cancer lesion. The
2-compartment model described this behavior well. After the
inversion, tissue magnetization recovers faster, decreasing
its signal contribution in absolute terms and resulting in
an increase in the ADC. At the tipping point, the total
magnetization is zero at b = 0, when the positive tissue
magnetization and still-inverted fluid magnetization cancel
out. A small diffusion encoding leads to a positive signal,
thus generating an infinite ADC. After the tipping point,
the fluid magnetization remains negative and thereby reduces
the ADC.Prostate fluid appears to contribute significantly
to prostate ADCs. Its contribution could be adjusted by
choosing an appropriate inversion recovery preparation,
potentially enhancing contrast for prostate cancer lesions.},
cin = {E020},
ddc = {610},
cid = {I:(DE-He78)E020-20160331},
pnm = {315 - Bildgebung und Radioonkologie (POF4-315)},
pid = {G:(DE-HGF)POF4-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39621870},
doi = {10.1097/RLI.0000000000001139},
url = {https://inrepo02.dkfz.de/record/294782},
}