To evaluate the efficacy of intravoxel incoherent motion (IVIM) and ultrahigh b-value diffusion kurtosis imaging (DKI) for prostate cancer detection and Gleason score prediction.

From February 2017 to May 2018, totally 45 patients suspected prostate cancer were performed 3T multi-parameters MRI of T2WI, DWI, IVIM and DKI model following pathological confirmed by transrectal ultrasound biopsy. Parameters were postprocessed by IVIM models including quantitation of diffusivity (Dt) and pseudo-diffusivity (Dp) and perfusion fraction (f) using 8 b values (b=0, 50, 100, 150, 200, 400, 800, 1200) and DKI models including the mean diffusivity (D) and kurtosis (K) using 7 b values (b=0, 400, 800, 1200, 2000, 3000, 4000). Correlation between Dt, Dp, f, D, K and Gleason scores were assessed.

The pathologic result showed 26 cases prostate cancer and 19 cases benign prostatic hyperplasia (BPH). Only Dt had significant difference between prostate cancer and BPH in IVIM models [(0.60 ± 0.15) vs (1.19 ± 0.23), P<0.001]. In DKI models, D and K values were apparently different between prostate cancer and BPH [0.78(0.68-0.88) vs 1.68(1.44-1.81), P<0.001]; [0.95(0.89 -1.00) vs 0.57(0.53-0.67), P<0.001]. K value showed relatively higher correlations with Gleason score. The Dt, D and K exhibited higher area under the curve compared with Dp and f.

IVIM and ultrahigh b-value models may help to discriminate prostate from BPH and predict higher Gleason score.