Comparison of synthesized and acquired high b-value diffusion-weighted MRI for detection of prostate cancer

High b-value diffusion-weighted imaging (DWI) plays an important role for accurate detection of clinically significant prostate cancer (csPCa). Synthesizing high b-value images decreases scan time. We compared (normalized) acquired and synthesized high b-value (2000s/mm2) DWI for detection of csPCa in 151 patients who underwent MRI and biopsy. We also compared these to an advanced DWI biomarker called the Restriction Spectrum Imaging restriction score (RSIrs). Synthesized images yielded similar results to acquired images within the prostate but failed to accurately represent the surrounding pelvic tissue. RSIrs was superior to synthesized and acquired high b-value DWI for detection of csPCa.