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Background In men suspected of having prostate cancer (PCa), up to 50% of men with positive multiparametric MRI (mpMRI) findings (Prostate Imaging Reporting and Data System [PI-RADS] or Likert score of 3 or higher) have no clinically significant (Gleason score ≤3+3, benign) biopsy findings. Vascular, Extracellular, and Restricted Diffusion for Cytometry in Tumor (VERDICT) MRI analysis could improve the stratification of positive mpMRI findings. Purpose To evaluate VERDICT MRI, mpMRI-derived apparent diffusion coefficient (ADC), and prostate-specific antigen density (PSAD) as determinants of clinically significant PCa (csPCa). Materials and Methods Between April 2016 and December 2019, men suspected of having PCa were prospectively recruited from two centers and underwent VERDICT MRI and mpMRI at one center before undergoing targeted biopsy. Biopsied lesion ADC, lesion-derived fractional intracellular volume (FIC), and PSAD were compared between men with csPCa and those without csPCa, using nonparametric tests subdivided by Likert scores. Area under the receiver operating characteristic curve (AUC) was calculated to test diagnostic performance. Results Among 303 biopsy-naive men, 165 study participants (mean age, 65 years ± 7 [SD]) underwent targeted biopsy; of these, 73 had csPCa. Median lesion FIC was higher in men with csPCa (FIC, 0.53) than in those without csPCa (FIC, 0.18) for Likert 3 (iP/i= .002) and Likert 4 (0.60 vs 0.28,iP/ilt; .001) lesions. Median lesion ADC was lower for Likert 4 lesions with csPCa (0.86 × 10sup-3/supmmsup2/sup/sec) compared with lesions without csPCa (1.12 × 10sup-3/supmmsup2/sup/sec,iP/i= .03), but there was no evidence of a difference for Likert 3 lesions (0.97 × 10sup-3/supmmsup2/sup/sec vs 1.20 × 10sup-3/supmmsup2/sup/sec,iP/i= .09). PSAD also showed no difference for Likert 3 (0.17 ng/mLsup2/supvs 0.12 ng/mLsup2/sup,iP/i= .07) or Likert 4 (0.14 ng/mLsup2/supvs 0.12 ng/mLsup2/sup,iP/i= .47) lesions. The diagnostic performance of FIC (AUC, 0.96; 95% CI: 0.93, 1.00) was higher (iP/i= .02) than that of ADC (AUC, 0.85; 95% CI: 0.79, 0.91) and PSAD (AUC, 0.74; 95% CI: 0.66, 0.82) for the presence of csPCa in biopsied lesions. Conclusion Lesion fractional intracellular volume enabled better classification of clinically significant prostate cancer than did apparent diffusion coefficient and prostate-specific antigen density. Clinical trial registration no. NCT02689271 © RSNA, 2022iOnline supplemental material is available for this article./i

The aim of this work was to extend the VERDICT-MRI framework for modelling brain tumours, enabling comprehensive characterisation of both intra- and peritumoural areas with a particular focus on cellular and vascular features. Diffusion MRI data were acquired with multiple b-values (ranging from 50 to 3500 s/mm2), diffusion times, and echo times in 21 patients with brain tumours of different types and with a wide range of cellular and vascular features. We fitted a selection of diffusion models that resulted from the combination of different types of intracellular, extracellular, and vascular compartments to the signal. We compared the models using criteria for parsimony while aiming at good characterisation of all of the key histological brain tumour components. Finally, we evaluated the parameters of the best-performing model in the differentiation of tumour histotypes, using ADC (Apparent Diffusion Coefficient) as a clinical standard reference, and compared them to histopathology and relevant perfusion MRI metrics. The best-performing model for VERDICT in brain tumours was a three-compartment model accounting for anisotropically hindered and isotropically restricted diffusion and isotropic pseudo-diffusion. VERDICT metrics were compatible with the histological appearance of low-grade gliomas and metastases and reflected differences found by histopathology between multiple biopsy samples within tumours. The comparison between histotypes showed that both the intracellular and vascular fractions tended to be higher in tumours with high cellularity (glioblastoma and metastasis), and quantitative analysis showed a trend toward higher values of the intracellular fraction (fic) within the tumour core with increasing glioma grade. We also observed a trend towards a higher free water fraction in vasogenic oedemas around metastases compared to infiltrative oedemas around glioblastomas and WHO 3 gliomas as well as the periphery of low-grade gliomas. In conclusion, we developed and evaluated a multi-compartment diffusion MRI model for brain tumours based on the VERDICT framework, which showed agreement between non-invasive microstructural estimates and histology and encouraging trends for the differentiation of tumour types and sub-regions.

Objectives: To assess the clinical outcomes of mpMRI before biopsy and evaluate the space remaining for novel biomarkers. Methods: The INNOVATE study was set up to evaluate the validity of novel fluidic biomarkers in men with suspected prostate cancer who undergo pre-biopsy mpMRI. We report the characteristics of this clinical cohort, the distribution of clinical serum biomarkers, PSA and PSA density (PSAD), and compare the mpMRI Likert scoring system to the Prostate Imaging–Reporting and Data System v2.1 (PI-RADS) in men undergoing biopsy. Results: 340 men underwent mpMRI to evaluate suspected prostate cancer. 193/340 (57%) men had subsequent MRI-targeted prostate biopsy. Clinically significant prostate cancer (csigPCa), i.e., overall Gleason ≥ 3 + 4 of any length OR maximum cancer core length (MCCL) ≥4 mm of any grade including any 3 + 3, was found in 96/195 (49%) of biopsied patients. Median PSA (and PSAD) was 4.7 (0.20), 8.0 (0.17), and 9.7 (0.31) ng/mL (ng/mL/mL) in mpMRI scored Likert 3,4,5 respectively for men with csigPCa on biopsy. The space for novel biomarkers was shown to be within the group of men with mpMRI scored Likert3 (178/340) and 4 (70/350), in whom an additional of 40% (70/178) men with mpMRI-scored Likert3, and 37% (26/70) Likert4 could have been spared biopsy. PSAD is already considered clinically in this cohort to risk stratify patients for biopsy, despite this 67% (55/82) of men with mpMRI-scored Likert3, and 55% (36/65) Likert4, who underwent prostate biopsy had a PSAD below a clinical threshold of 0.15 (or 0.12 for men aged &lt, 50 years). Different thresholds of PSA and PSAD were assessed in mpMRI-scored Likert4 to predict csigPCa on biopsy, to achieve false negative levels of ≤5% the proportion of patients whom who test as above the threshold were unsuitably high at 86 and 92% of patients for PSAD and PSA respectively. When PSA was re tested in a sub cohort of men repeated PSAD showed its poor reproducibility with 43% (41/95) of patients being reclassified. After PI-RADS rescoring of the biopsied lesions, 66% (54/82) of the Likert3 lesions received a different PI-RADS score. Conclusions: The addition of simple biochemical and radiological markers (Likert and PSAD) facilitate the streamlining of the mpMRI-diagnostic pathway for suspected prostate cancer but there remains scope for improvement, in the introduction of novel biomarkers for risk assessment in Likert3 and 4 patients, future application of novel biomarkers tested in a Likert cohort would also require re-optimization around Likert3/PI-RADS2, as well as reproducibility testing.

VERDICT maps have shown promising results in clinical settings discriminating normal from malignant tissue and identifying specific Gleason grades non-invasively. However, the quantitative estimation of VERDICT maps requires a specific diffusion-weighed imaging (DWI) acquisition. In this study we investigate the feasibility of synthesizing VERDICT maps from standard DWI data from multi-parametric (mp)- MRI by employing conditional generative adversarial networks (GANs). We use data from 67 patients who underwent both standard DWI-MRI and VERDICT MRI and rely on correlation analysis and mean squared error to quantitatively evaluate the quality of the synthetic VERDICT maps. Quantitative results show that the mean values of tumour areas in the synthetic and the real VERDICT maps were strongly correlated while qualitative results indicate that our method can generate realistic VERDICT maps that could supplement mp-MRI assessment for better diagnosis.

Any novel medical imaging modality that differs from previous protocols e.g. in the number of imaging channels, introduces a new domain that is heterogeneous from previous ones. This common medical imaging scenario is rarely considered in the domain adaptation literature, which handles shifts across domains of the same dimensionality. In our work we rely on stochastic generative modeling to translate across two heterogeneous domains at pixel space and introduce two new loss functions that promote semantic consistency. Firstly, we introduce a semantic cycle-consistency loss in the source domain to ensure that the translation preserves the semantics. Secondly, we introduce a pseudo-labelling loss, where we translate target data to source, label them by a source-domain network, and use the generated pseudo-labels to supervise the target-domain network. Our results show that this allows us to extract systematically better representations for the target domain. In particular, we address the challenge of enhancing performance on VERDICT-MRI, an advanced diffusion-weighted imaging technique, by exploiting labeled mp-MRI data. When compared to several unsupervised domain adaptation approaches, our approach yields substantial improvements, that consistently carry over to the semi-supervised and supervised learning settings.

PurposeWe introduce “Select and retrieve via direct upsampling” network (SARDU-Net), a data-driven framework for model-free quantitative MRI (qMRI) protocol design, and demonstrate it on in vivo brain and prostate diffusion-relaxation imaging (DRI).MethodsSARDU-Net selects subsets of informative measurements within lengthy pilot scans, without the requirement to identify tissue parameters for which to optimise for. The algorithm consists of a selector, identifying measurement subsets, and a predictor, estimating fully-sampled signals from the subsets. We implement both using deep neural networks, which are trained jointly end-to-end. We demonstrate the algorithm on brain (32 diffusion-/T1-weightings) and prostate (16 diffusion-/T2-weightings) DRI scans acquired on 3 healthy volunteers on two separate 3T Philips systems each. We used SARDU-Net to identify sub-protocols of fixed size, assessing the reproducibility of the procedure and testing sub-protocols for their potential to inform multi-contrast analyses via T1-weighted spherical mean diffusion tensor (T1-SMDT, brain) and hybrid multi-dimensional MRI (HM-MRI, prostate) modelling.ResultsIn both brain and prostate, SARDU-Net identifies sub-protocols that maximise information content in a reproducible manner across training instantiations. The sub-protocols enable multi-contrast modelling for which they were not optimised explicitly, providing robust T1-SMDT and HM-MRI maps and goodness-of-fit in the top 5% against extensive sub-protocol comparisons.ConclusionsSARDU-Net gives new opportunities to identify economical but informative qMRI protocols from a subset of the pilot scans that can be used for acquisition-time-sensitive applications. The simple architecture makes the algorithm easy to train when exhaustive searches are intractable, and applicable to a variety of anatomical contexts.

The need for training data can impede the adoption of novel imaging modalities for learning-based medical image analysis. Domain adaptation methods partially mitigate this problem by translating training data from a related source domain to a novel target domain, but typically assume that a one-to-one translation is possible. Our work addresses the challenge of adapting to a more informative target domain where multiple target samples can emerge from a single source sample. In particular we consider translating from mp-MRI to VERDICT, a richer MRI modality involving an optimized acquisition protocol for cancer characterization. We explicitly account for the inherent uncertainty of this mapping and exploit it to generate multiple outputs conditioned on a single input. Our results show that this allows us to extract systematically better image representations for the target domain, when used in tandem with both simple, CycleGAN-based baselines, as well as more powerful approaches that integrate discriminative segmentation losses and/or residual adapters. When compared to its deterministic counterparts, our approach yields substantial improvements across a broad range of dataset sizes, increasingly strong baselines, and evaluation measures.

Background Biologic specificity of diffusion MRI in relation to prostate cancer aggressiveness may improve by examining separate components of the diffusion MRI signal. The Vascular, Extracellular, and Restricted Diffusion for Cytometry in Tumors (VERDICT) model estimates three distinct signal components and associates them to (a) intracellular water, (b) water in the extracellular extravascular space, and (c) water in the microvasculature. Purpose To evaluate the repeatability, image quality, and diagnostic utility of intracellular volume fraction (FIC) maps obtained with VERDICT prostate MRI and to compare those maps with apparent diffusion coefficient (ADC) maps for Gleason grade differentiation. Materials and Methods Seventy men (median age, 62.2 years; range, 49.5-82.0 years) suspected of having prostate cancer or undergoing active surveillance were recruited to a prospective study between April 2016 and October 2017. All men underwent multiparametric prostate and VERDICT MRI. Forty-two of the 70 men (median age, 67.7 years; range, 50.0-82.0 years) underwent two VERDICT MRI acquisitions to assess repeatability of FIC measurements obtained with VERDICT MRI. Repeatability was measured with use of intraclass correlation coefficients (ICCs). The image quality of FIC and ADC maps was independently evaluated by two board-certified radiologists. Forty-two men (median age, 64.8 years; range, 49.5-79.6 years) underwent targeted biopsy, which enabled comparison of FIC and ADC metrics in the differentiation between Gleason grades. Results VERDICT MRI FIC demonstrated ICCs of 0.87-0.95. There was no significant difference between image quality of ADC and FIC maps (score, 3.1 vs 3.3, respectively; P = .90). FIC was higher in lesions with a Gleason grade of at least 3+4 compared with benign and/or Gleason grade 3+3 lesions (mean, 0.49 ± 0.17 vs 0.31 ± 0.12, respectively; P = .002). The difference in ADC between these groups did not reach statistical significance (mean, 1.42 vs 1.16 × 10-3 mm2/sec; P = .26). Conclusion Fractional intracellular volume demonstrates high repeatability and image quality and enables better differentiation of a Gleason 4 component cancer from benign and/or Gleason 3+3 histology than apparent diffusion coefficient. Online supplemental material is available for this article. See also the editorial by Sigmund and Rosenkrantz in this issue.

We develop a framework for calculating clinically-viable diffusion MRI (dMRI) protocols for anisotropic IVIM modelling. The proposed multi-stage framework combines previous approaches to dMRI protocol optimisation: first optimising b-values by minimizing Cramer-Rao lower bounds on parameter variances, and subsequently optimising gradient directions jointly to provide maximum angular coverage across all shells. This removes unnecessary measurements of closely spaced b-values with the same gradient directions, which encode very similar information, and hence reduces the total number of dMRI measurements. We applied the framework to establish an organ-specific, data-driven, set of optimised b-values and gradient directions for dMRI of the placenta. The optimised protocol leads to higher contrast-to-noise ratios in parameter maps compared to a naive protocol of comparable scan time. Applying this framework in other organs has the potential to reduce scanning times required for anisotropic IVIM modelling.

This study compares the theoretical information content of single- and multi-compartment models of diffusion-weighted signal attenuation in prostate tissue. Diffusion-weighted imaging (DWI) was performed at 9.4 T with multiple diffusion times and an extended range of b values in four whole formalin-fixed prostates. Ten models, including different combinations of isotropic, anisotropic and restricted components, were tested. Models were ranked using the Akaike information criterion. In all four prostates, two-component models, comprising an anisotropic Gaussian component and an isotropic restricted component, ranked highest in the majority of voxels. Single-component models, whether isotropic (apparent diffusion coefficient, ADC) or anisotropic (diffusion tensor imaging, DTI), consistently ranked lower than multi-component models. Model ranking trends were independent of voxel size and maximum b value in the range tested (1.6-16 mm(3) and 3000-10,000 s/mm(2)). This study characterizes the two major water components previously identified by biexponential models and shows that models incorporating both anisotropic and restricted components provide more information-rich descriptions of DWI signals in prostate tissue than single- or multi-component anisotropic models and models that do not account for restricted diffusion.

The VERDICT (Vascular, Extracellular and Restricted Diffusion for Cytometry in Tumours) technique estimates non-invasively cancer microstructure features. The clinical application of VERDICT for prostate cancer requires constraining some of the model’s parameter. This work uses the Accelerated Microstructure Imaging via Convex Optimization (AMICO) formulation for VERDICT (VERDICT-AMICO), to investigate parameter estimation for prostate tissue in an attempt to minimize the parameter constraints. We examine various dictionaries for VERDICT-AMICO enabling different levels of flexibility on the choice of parameter values. Depending on the stability of the fitting this procedure leads to the selection of a dictionary (or dictionaries) with the fewest number of model parameter constraints. Results show that with the current VERDICT imaging acquisition, the model can have an extra free parameter to fit, the extracellular diffusivity. In conclusion, the AMICO adaptation for VERDICT allowed testing of different values for the previously fixed model parameters, and helped relax assumptions of fixed extracellular diffusivity that the model currently uses for prostate cancer characterisation.

Currently, non-invasive imaging techniques such as magnetic resonance imaging (MRI) are emerging as powerful diagnostic tools for prostate cancer (PCa) characterization. This paper focuses on automated PCa classification on VERDICT (Vascular, Extracellular and Restricted Diffusion for Cytometry in Tumors) diffusion weighted (DW)-MRI, which is a non-invasive microstructural imaging technique that comprises a rich imaging protocol and a tissue computational model to map in vivo histological indices. The contribution of the paper is two fold. Firstly, we investigate the potential of automated, model-free PCa classification on raw VERDICT DW-MRI. Secondly, we attempt to adapt and evaluate novel fully convolutional neural networks (FCNNs) for PCa characterization. We present two neural network architectures that adapt U-Net and ResNet-18 to the PCa classification problem. We train the networks end-to-end on DW-MRI data and evaluate the diagnostic performance employing a 10-fold cross validation approach using data acquired from 103 patients. ResNet-18 outperforms U-Net with an average AUC of \(86.7\%\). Our results show promise for the utilization of raw VERDICT DW-MRI data and FCNNs for automating the PCa diagnostic pathway.

Purpose To examine the usefulness of rich diffusion protocols with high b-values and varying diffusion time for probing microstructure in bone metastases. Analysis techniques including biophysical and mathematical models were compared with the clinical apparent diffusion coefficient (ADC). Methods Four patients were scanned using 13 b-values up to 3,000 s/mm2 and diffusion times ranging 18–52 ms. Data were fitted to mono-exponential ADC, intravoxel incoherent motion (IVIM), Kurtosis and Vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT) models. Parameters from the models were compared using correlation plots. Results ADC and IVIM did not fit the data well, failing to capture the signal at high b-values. The Kurtosis model best explained the data in many voxels, but in voxels exhibiting a more time-dependent signal, the VERDICT model explained the data best. The ADC correlated significantly (p

There has been slow progress in the development of new therapeutic strategies for treating brain tumours, partly because assessment of treatment response is difficult and largely reliant on simple bi-dimensional measurements of MRI contrast-enhancing regions. Hence, there is a clinical need to develop improved imaging techniques for monitoring treatment response. In this study, we evaluate VERDICT (Vascular, Extracellular and Restricted Diffusion for Cytometry in Tumors) MRI in mouse glioblastomas for the quantification of tumour microstructure and assessment of response to Temozolomide (TMZ) chemotherapy, and, we investigate the feasibility of applying VERDICT MRI in a range of human gliomas. VERDICT MRI detected response to TMZ earlier than structural and apparent diffusion coefficient (ADC) measurements. A significant reduction in the cell radius parameter was detected three days earlier than ADC and six days earlier than structural MRI. Histological analysis showed the same trend as VERDICT of decreased intracellular volume fraction in the TMZ-treated mice. Vascular volume fraction was not altered by TMZ, which was consistent with optical projection tomography measurements. In patients, glioblastoma compartmental volume fractions showed good agreement with mouse glioblastoma parameters. The VERDICT parameters varied across the human gliomas, with raised intracellular volume fraction in the oligodendrogliomas and elevated cell radius in both low-grade tumours subtypes. In conclusion, our results suggest that VERDICT MRI is more sensitive at detecting TMZ response than structural or ADC measurements. In patients, VERDICT is feasible within clinical scan times, and performed best at characterising glioblastoma. Further optimisation should improve assessment of different glioma subtypes.

This article describes apparatus to aid histological validation of magnetic resonance imaging studies of the human prostate. The apparatus includes a 3D-printed patient-specific mold that facilitates aligned in vivo and ex vivo imaging, in situ tissue fixation, and tissue sectioning with minimal organ deformation. The mold and a dedicated container include MRI-visible landmarks to enable consistent tissue positioning and minimize image registration complexity. The inclusion of high spatial resolution ex vivo imaging aids in registration of in vivo MRI and histopathology data.

Purpose To compare the theoretical information content of four popular models of diffusion-weighted signal attenuation. Method Four whole prostates were imaged fresh unfixed and fixed at 9.4T. Biexponential, kurtosis, stretched exponential, and monoexponential models were ranked using Akaike's Information Criterion (AIC) with validation by a leave-one-out test of model prediction error. Results For unfixed tissue measurements (b-value range: 17–2104 s/mm2) the biexponential and kurtosis models had similar information content to each other and this was distinctly higher than for the stretched and monoexponential models. In fixed-tissue measurements (b-value range: 17–8252 s/mm2), the biexponential model had much higher information content than the three other models. Conclusion AIC-based model ranking is consistent with an independent prediction accuracy test. Biexponential and kurtosis models consistently perform better than stretched and monoexponential models. The biexponential model has increasing superiority over all three other models as maximum b-value increases above ∼2000 s/mm2. Magn Reson Med 72:1418–1426, 2014. © 2013 Wiley Periodicals, Inc.

Diffusion-weighted imaging (DWI) is the most effective component of the modern multi-parametric magnetic resonance imaging (mpMRI) scan for prostate pathology. DWI provides the strongest prediction of cancer volume, and the apparent diffusion coefficient (ADC) correlates moderately with Gleason grade. Notwithstanding the demonstrated cancer assessment value of DWI, the standard measurement and signal analysis methods are based on a model of water diffusion dynamics that is well known to be invalid in human tissue. This review describes the biophysical limitations of the DWI component of the current standard mpMRI protocol and the potential for significantly improved cancer assessment performance based on more sophisticated measurement and signal modeling techniques.

This paper aims to identify the minimum requirements for an accurate model of the diffusion MR signal in white matter of the brain. We construct a taxonomy of multi-compartment models of white matter from combinations of simple models for the intra- and the extra-axonal spaces. We devise a new diffusion MRI protocol that provides measurements with a wide range of imaging parameters for diffusion sensitization both parallel and perpendicular to white matter fibres. We use the protocol to acquire data from two fixed rat brains, which allows us to fit, study and compare the different models. The study examines a total of 47 analytic models, including several well-used models from the literature, which we place within the taxonomy. The results show that models that incorporate intra-axonal restriction, such as ball and stick or CHARMED, generally explain the data better than those that do not, such as the DT or the biexponential models. However, three-compartment models which account for restriction parallel to the axons and incorporate pore size explain the measurements most accurately. The best fit comes from combining a full diffusion tensor (DT) model of the extra-axonal space with a cylindrical intra-axonal component of single radius and a third spherical compartment of non-zero radius. We also measure the stability of the non-zero radius intra-axonal models and find that single radius intra-axonal models are more stable than gamma distributed radii models with similar fitting performance.

This study compares the theoretical information content of single- and multi-compartment models of diffusion-weighted signal attenuation in prostate tissue. Diffusion-weighted imaging (DWI) was performed at 9.4 T with multiple diffusion times and an extended range of b values in four whole formalin-fixed prostates. Ten models, including different combinations of isotropic, anisotropic and restricted components, were tested. Models were ranked using the Akaike information criterion. In all four prostates, two-component models, comprising an anisotropic Gaussian component and an isotropic restricted component, ranked highest in the majority of voxels. Single-component models, whether isotropic (apparent diffusion coefficient, ADC) or anisotropic (diffusion tensor imaging, DTI), consistently ranked lower than multi-component models. Model ranking trends were independent of voxel size and maximum b value in the range tested (1.6-16 mm(3) and 3000-10,000 s/mm(2)). This study characterizes the two major water components previously identified by biexponential models and shows that models incorporating both anisotropic and restricted components provide more information-rich descriptions of DWI signals in prostate tissue than single- or multi-component anisotropic models and models that do not account for restricted diffusion.

The purpose of this study was to measure and model the diffusion time dependence of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) derived from conventional prostate diffusion-weighted imaging methods as used in recommended multiparametric MRI protocols. Diffusion tensor imaging (DTI) was performed at 9.4 T with three radical prostatectomy specimens, with diffusion times in the range 10–120 ms and b-values 0–3000 s/mm2. ADC and FA were calculated from DTI measurements at b-values of 800 and 1600 s/mm2. Independently, a two-component model (restricted isotropic plus Gaussian anisotropic) was used to synthesize DTI data, from which ADC and FA were predicted and compared with the measured values. Measured ADC and FA exhibited a diffusion time dependence, which was closely predicted by the two-component model. ADC decreased by about 0.10–0.15 μm2/ms as diffusion time increased from 10 to 120 ms. FA increased with diffusion time at b-values of 800 and 1600 s/mm2 but was predicted to be independent of diffusion time at b = 3000 s/mm2. Both ADC and FA exhibited diffusion time dependence that could be modeled as two unmixed water pools — one having isotropic restricted dynamics, and the other unrestricted anisotropic dynamics. These results highlight the importance of considering and reporting diffusion times in conventional ADC and FA calculations and protocol recommendations, and inform the development of improved diffusion methods for prostate cancer imaging.

Prostate cancer diagnosis involves the highly subjective and time-consuming Gleason grading process. This paper proposes the use of Max-Margin Conditional Random Fields (CRFs) towards the aim of creating an automatic computer-aided diagnosis system. Unlike previous methods, this approach enables us to fuse information from multiple classifiers while leveraging CRFs to model spatial dependencies. We perform grading on superpixels which reduce redundancy and the size of data. Probabilistic outputs from independent classifiers are passed as input to a Max-Margin CRF, which then performs structured prediction on the biopsy core, segmenting the image into regions of benign tissue, Gleason grade 3 adenocarcinoma and Gleason grade 4 adenocarcinoma. The system achieves an accuracy of 83.0% with accuracies of 83.6%, 86.9% and 77.1% reported for benign, grade 3 and grade 4 classes respectively.

To compare the theoretical information content of four popular models of diffusion-weighted signal attenuation.Four whole prostates were imaged fresh unfixed and fixed at 9.4T. Biexponential, kurtosis, stretched exponential, and monoexponential models were ranked using Akaike's Information Criterion (AIC) with validation by a leave-one-out test of model prediction error.For unfixed tissue measurements (b-value range: 17-2104 s/mm(2)) the biexponential and kurtosis models had similar information content to each other and this was distinctly higher than for the stretched and monoexponential models. In fixed-tissue measurements (b-value range: 17-8252 s/mm(2)), the biexponential model had much higher information content than the three other models.AIC-based model ranking is consistent with an independent prediction accuracy test. Biexponential and kurtosis models consistently perform better than stretched and monoexponential models. The biexponential model has increasing superiority over all three other models as maximum b-value increases above ∼2000 s/mm(2).

Fixed samples have been used extensively in diffusion MRI (dMRI) studies. However, fixation causes significant structural changes in tissue. The purpose of this study was to evaluate fixed white matter as a surrogate for viable white matter during development and validation of dMRI methods.dMRI data was acquired from fixed and viable rat optic nerves maintained in identical conditions in a viable isolated tissue (VIT) chamber. The chamber preserves tissue integrity for 10 h at 37°C. Diffusion tensors (DT) and multi-compartment white matter signal models were fitted to the data.When comparing VIT and fixed tissue, DT parameters demonstrated that fixation causes significant reductions in axial diffusivity and increases in radial diffusivity. However, both tissues exhibited similar responses to changes in diffusion times and gradient strengths. Multicompartment models demonstrated differences in parameter estimates (e.g., directional diffusivities) that were analogous to differences in DT parameters. Similarities in multi-compartment model rankings suggested that tissue water populations were broadly maintained postfixation.The data demonstrate that fixed tissue, while maintaining the broad water environment of viable tissue, differs significantly in diffusion parameters. Results from dMRI experiments on fixed tissue may correlate with-but will not directly translate into-results from viable tissue.