A single-shot T2 mapping protocol based on echo-split gradient-spin-echo acquisition and parametric multiplexed sensitivity encoding based on projection onto convex sets reconstruction.

PURPOSE: To develop a high-speed T2 mapping protocol that is capable of accurately measuring T2 relaxation time constants from a single-shot acquisition. THEORY: A new echo-split single-shot gradient-spin-echo (GRASE) pulse sequence is developed to acquire multicontrast data while suppressing signals from most nonprimary echo pathways in Carr-Purcell-Meiboom-Gill (CPMG) echoes. Residual nonprimary pathway signals are taken into consideration when performing T2 mapping using a parametric multiplexed sensitivity encoding based on projection onto convex sets (parametric-POCSMUSE) reconstruction method that incorporates extended phase graph modeling of GRASE signals. METHODS: The single-shot echo-split GRASE-based T2 mapping procedure was evaluated in human studies at 3 Tesla. The acquired data were compared with reference data obtained with a more time-consuming interleaved spin-echo echo planar imaging protocol. T2 maps derived from conventional single-shot GRASE scans, in which nonprimary echo pathways were not appropriately addressed, were also evaluated. RESULTS: Using the developed single-shot T2 mapping protocol, quantitatively accurate T2 maps can be obtained with a short scan time (<0.2 seconds per slice). CONCLUSION: Accurate T2 mapping with minimal signal contamination from CPMG high-order echo pathways can be achieved by the developed method that integrates single-shot echo-split GRASE acquisition and parametric-POCSMUSE reconstruction. Magn Reson Med 79:383-393, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Diffusion-weighted imaging of prostate cancer using a statistical model based on the gamma distribution.

PURPOSE: To assess the adequacy of a statistical model based on the gamma distribution for diffusion signal decays of prostate cancer (PCa) using b-values ranging up to 2000 sec/mm(2) , and to evaluate the differences in gamma model parameters for PCa, benign prostatic hyperplasia (BPH), and peripheral zone (PZ). MATERIALS AND METHODS: Twenty-six patients with histologically proven PCa underwent diffusion-weighted magnetic resonance imaging using five b-values (0, 500, 1000, 1500, 2000 sec/mm(2) ). The acquired signal decay curves were fit with both gamma and truncated Gaussian models and a statistical comparison between the two fits was performed. The acquired parameters using the gamma model (mean, standard deviation, the area fraction for D < 1.0 mm(2) /s [Frac<1.0], the area fraction of D > 3.0 mm(2) /s [Frac>3.0]) were compared between PCa, BPH, and PZ. RESULTS: The gamma model provided a statistically improved fit over the truncated Gaussian model in PCa. The mean and the standard deviation were significantly lower in PCa than in BPH and PZ (P < 0.01). Frac<1.0 was significantly higher in PCa than in BPH and PZ, and Frac>3.0 was significantly lower in PCa than in BPH and PZ (P < 0.01). CONCLUSION: A statistical model based on the gamma distribution proved suitable for describing diffusion signal decay curves of PCa. This approach may provide better correlation between diffusion signal decay and histological information in the prostate gland.

Visualization of Cerebrospinal Fluid Outflow and Egress along the Nerve Roots of the Lumbar Spine.

Intrinsic cerebrospinal fluid (CSF) dynamics in the brain have been extensively studied, particularly the egress sites of tagged intrinsic CSF in the meninges. Although spinal CSF recirculates within the central nervous system (CNS), we hypothesized that CSF outflows from the lumbar spinal canal. We aimed to visualize and semi-quantify the outflow using non-contrast MRI techniques. We utilized a 3 Tesla clinical MRI with a 16-channel spine coil, employing time-spatial labeling inversion (Time-SLIP) with tag-on and tag-off acquisitions, T2-weighted coronal 2D fluid-attenuated inversion recovery (FLAIR) and T2-weighted coronal 3D centric ky-kz single-shot FSE (cSSFSE). Images were acquired using time-spatial labeling inversion pulse (Time-SLIP) with tag-on and tag-off acquisitions with varying TI periods. Ten healthy volunteers with no known spinal diseases participated. Variations in tagged CSF outflow were observed across different thoracolumbar nerve root segments in all participants. We quantified CSF outflow at all lumbar levels and the psoas region. There was no significant difference among the ROIs for signal intensity. The tagged CSF outflow from the spinal canal is small but demonstrates egress to surrounding tissues. This finding may pave the way for exploring intrathecal drug delivery, understanding of CSF-related pathologies and its potential as a biomarker for peripheral neuropathy and radiculopathy.

Characterizing Protein Concentration in Cerebrospinal Fluid with T2 Component Analysis.

PURPOSE: T2 values are hypothesized to be reduced where protein accumulates in the cerebrospinal fluid (CSF). We aimed to verify the accuracy of Carr-Purcell-Meiboom-Gil (CPMG) pulses and non-negative least squares (NNLS) analysis in visualizing protein concentrations by mapping the T2 values. METHODS: We first dissolved 1.2g of bovine serum albumin powder in 4 mL of artificial CSF to purify an albumin solution with a concentration of 4.5 mM. Artificial CSF was added thereto, and eight types of albumin solutions, with concentrations of 0.002-4.5 mM, were purified. We acquired this albumin solution with CPMG pulses and NNLS, decomposed the T2 values per pixel, and derived 25 T2 component values of 60-2000 ms. We assessed the change of T2 values by the difference in albumin concentration of a single voxel. Finally, we used the method to assess T2 values from two patients, one with a subdural hematoma and one with a suprasellar cystic tumor. T2 component values were plotted graphically, presented individually, and created in color maps. RESULTS: T2 component values for albumin concentrations ranging from 0.056 to 4.55 mM showed different T2 peaks, whereas, for concentrations 0.002 to 0.019 mM, the peaks were similar heights and overlapped. Peak width was similar for all concentrations. The color maps successfully reflected the changes in T2 values across both RGB color patterns. T2 components for albumin samples with 2.5 mM and 6.1 mM concentrations within a single voxel were represented separately and reflected the ratio of the two samples in nine different regions of interest within one slice. In the clinical cases, the T2 component map imaged differences in albumin concentrations, similar to those observed in the albumin samples. CONCLUSION: The present method with CPMG sequences and NNLS provide adequate images to differentiate accumulating protein concentrations in the CSF, even at the level of a single pixel.

What Is the "Glymphatic System"?

Although the glymphatic system hypothesis is highly popular, it also lacks certain details. In this paper, an attempt was made to present a more clearly defined hypothesis, which is consistent with the past experiment results. The new hypothesis consists of (1) water flux in the brain parenchyma, (2) water and solutes pathway of the perivascular space, and (3) maintenance of this pathway by the network of astrocytes.

Ultrafast 1D MR thermometry using phase or frequency mapping.

OBJECT: To develop an ultrafast MRI-based temperature monitoring method for application during rapid ultrasound exposures in moving organs. MATERIALS AND METHODS: A slice selective 90° - 180° pair of RF pulses was used to solicit an echo from a column, which was then sampled with a train of gradient echoes. In a gel phantom, phase changes of each echo were compared to standard gradient-echo thermometry, and temperature monitoring was tested during focused ultrasound sonications. Signal-to-noise ratio (SNR) performance was evaluated in vivo in a rabbit brain, and feasibility was tested in a human heart. RESULTS: The correlation between each echo in the acquisition and MRI-based temperature measurements was good (R = 0.98 ± 0.03). A temperature sampling rate of 19 Hz was achieved at 3T in the gel phantom. It was possible to acquire the water frequency in the beating heart muscle with 5-Hz sampling rate during a breath hold. CONCLUSION: Ultrafast thermometry via phase or frequency monitoring along single columns was demonstrated. With a temporal resolution around 50 ms, it may be possible to monitor focal heating produced by short ultrasound pulses.

The Spatial Distribution of Water Components with Similar T2 May Provide Insight into Pathways for Large Molecule Transportation in the Brain.

PURPOSE: Although there is no lymphatic system in the central nervous system (CNS), there seems to be a mechanism to remove macro molecules from the brain. Cerebrospinal fluid (CSF) and interstitial fluid (ISF) are thought to be parts of this pathway, but the details are not known. In this study, MR signal of the extracellular water was decomposed into components with distinct T2's, to obtain some information about distribution of waste material in the brain. METHODS: Images were acquired using a Curr, Purcell, Meiboom, Gill (CPMG) imaging sequence. In order to reduce T1 contamination and the signal oscillation, hard pulses were used as refocusing pulses. The signal was then decomposed into many T2 components using non-negative least squares (NNLS) in pixel-by-pixel basis. Finally, a color map was generated by assigning different color for each T2 component, then adding them together. RESULTS: From the multi-echo images, it was possible to decompose the decaying signal into separate T2 components. By adjusting the color table to create the color map, it is possible to visualize the extracellular water distribution, as well as their T2 values. Several observation points include: (1) CSF inside ventricles has very long T2 (~2 s), and seems to be relatively homogeneous, (2) subarachnoid CSF also have long T2, but there are short T2 component at the brain surface, at the surface of dura, at the blood vessels in the subarachnoid space, etc., (3) in the brain parenchyma, short T2 components (longer than intracellular component but shorter than CSF) exists along the white matter, in the choroid plexus, etc. These can be considered as distribution of macromolecules (waste materials) in the brain. CONCLUSION: From T2 component analysis it is possible to obtain some insight into pathways for the transport of large molecules in the CNS, where no lymphatic system is present.

Peripheral nerve injury: diagnosis with MR imaging of denervated skeletal muscle--experimental study in rats.

PURPOSE: To prospectively evaluate signal intensity change on T2-weighted magnetic resonance (MR) images and the time course of T2 values and T2 ratios after reinnervation in various nerve injury models in rats. MATERIALS AND METHODS: Institutional animal use and care committee approval was obtained. Thirty male rats made up four groups of rats with an injured left posterior tibial nerve (irreversible neurotmesis, reversible neurotmesis, severe axonotmesis, or moderate axonotmesis) and one control group. There were six rats in each group. Signal intensity changes were seen in the gastrocnemius muscle on the T2-weighted MR images. T2 values were also measured in vivo with the Carr-Purcell-Meiboom-Gill method. Gait function was assessed by calculating the print length factor (PLF). T2 ratios and PLFs on the injured side were compared with those on the unaffected side. Ratios of specific acquisition points within groups were compared by using repeated-measures analysis of variance. Comparisons across the five groups at each acquisition point were performed by using one-way analysis of variance with Scheffe post hoc testing. P < .05 indicated a significant difference. RESULTS: The more severe the nerve damage, the higher the signal intensity on T2-weighted MR images. There were significant differences in T2 ratios between the nerve injury groups and the control group (P < .05). Changes in T2 values and ratios depended on the degree of nerve injury. In the reversible neurotmesis group, T2 values and ratios began to decrease 28 days after surgery. In the severe and moderate axonotmesis groups, T2 values and ratios began to decrease 14 days after surgery. The starting point of functional recovery also depended on the degree of nerve injury. CONCLUSION: The degree and prognosis of nerve injury can be evaluated by observing changes in signal intensity on T2-weighted images and the time course of T2 values and ratios.

Semiquantitative assessment of MR imaging in prediction of efficacy of gonadotropin-releasing hormone agonist for volume reduction of uterine leiomyoma: initial experience.

PURPOSE: To prospectively determine if semiquantitative assessment of R2* images and T1-weighted magnetic resonance (MR) images of leiomyomas correlates with the efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment for volume reduction. MATERIALS AND METHODS: Internal review board approval and informed consent were obtained for this study. Twenty women (mean age, 36.3 years) with intramyometrial leiomyomas were enrolled in this study. Single-section double-echo dynamic MR imaging was performed before GnRH agonist administration. T2-weighted images were obtained before and after two or three GnRH agonist injections (1.88 mg leuprorelin acetate). The steepest signal intensity (SI) upslope on T1-weighted images and the area under the curve (AUC) on R2* images were determined by using a 16 x 16-voxel matrix that was placed in the center of a leiomyoma. Pearson correlation analysis was performed to compare the percentage of volume reduction with SI upslope and AUC. Unpaired t test was performed to evaluate the difference between leiomyomas with AUC and SI upslope values that were less than or greater than the mean. RESULTS: Percentage of volume reduction ranged from 6.2% to 51.1%. The mean AUC and mean SI upslope were 39.2 and 9.83% per second, respectively. There was a significant correlation between the AUC and the percentage of volume reduction (r = 0.81, P < .001), although no significant correlation was observed between the SI upslope and the percentage of volume reduction. A significant difference in percentage of volume reduction was observed in leiomyomas by using mean AUC as a cutoff value (P = .003). CONCLUSION: AUC on R2* images correlates with the efficacy of GnRH agonist before initiation of treatment for volume reduction of leiomyoma.

Quantification of edematous changes by diffusion magnetic resonance imaging in gastrocnemius muscles after spinal nerve ligation.

Patients with complex regional pain syndrome (CRPS) exhibit diverse symptoms, such as neuropathic pain, allodynia, local edema and skin color changes in the affected lesion. Although nerve injury may cause CRPS, pathophysiological mechanisms underlying the syndrome are unclear, and local edema, a characteristic of CRPS, has not been evaluated quantitatively for technical reasons. Here, using a rat spinal nerve ligation-induced CRPS model, we show that edematous changes in gastrocnemius muscle can be detected quantitatively by diffusion magnetic resonance imaging (MRI). Using the line-scan diffusion spectrum on a 1.5 T clinical MR imager, we demonstrate significant elevation of the apparent diffusion coefficient (ADC) ratios in gastrocnemius muscle on the ligated versus the sham-operated rats by one day after surgery, those ratios gradually decreased over time. Meanwhile, T2 ratios in gastrocnemius muscle on the ligated rats increased gradually and significantly, peaking two weeks after surgery, and those ratios remained high and were consistent with edema. Expression of vascular endothelial growth factor (VEGF), a key regulator of blood vessel formation and function, was significantly lower in gastrocnemius muscle on the ligated versus non-ligated side, suggesting that nerve ligation promotes edematous changes and perturbs VEGF expression in target muscle.

Removing Ambiguity Caused by T2 Shine-through using Weighted Diffusion Subtraction (WDS).

We propose a novel image processing technique that combines images routinely acquired with low and high b values to create a single image that contains clinically useful information without the ambiguity of T2 shine-through. The contrast of resulting images is similar to that of a T2 image, but the signals of pixels with low apparent diffusion coefficient (ADC) values are inverted. The proposed technique takes the threshold ADC value as the one adjustable parameter.

Diffusion-weighted MR Imaging for the Assessment of Renal Function: Analysis Using Statistical Models Based on Truncated Gaussian and Gamma Distributions.

PURPOSE: To determine the appropriateness of statistical models using the truncated Gaussian distribution and gamma distribution for diffusion signal decay, and to assess the correlation between the parameters obtained from the statistical models and estimated glomerular filtration rate (eGFR). METHODS: Twenty-nine patients with chronic kidney disease and 21 healthy volunteers were included and classified in four groups according to eGFR (ml/min/1.73 m(2)): group 1 (90 ≤ eGFR, n = 10), group 2 (eGFR 60-90, n = 15), group 3 (eGFR 30-60, n = 17), and group 4 (eGFR < 30, n = 8). Diffusion-weighted imaging using five b-values (0, 500, 1000, 1500, and 2000 s/mm(2)) was performed. Truncated Gaussian and gamma models were compared for goodness of fit. Area fractions for the diffusion coefficient D < 1.0 × 10(-3) mm(2)/s (Frac < 1.0) and D > 3.0 × 10(-3) mm(2)/s (Frac > 3.0) obtained from the statistical model were compared among four groups. Correlation between proposed parameters and conventional apparent diffusion coefficient (ADC) with eGFR was calculated. RESULTS: There was no significant difference in goodness of fit between the truncated Gaussian and gamma models. Frac < 1.0 and Frac > 3.0 showed good correlation with eGFR, as did ADC. Comparison between groups 1 and 2 showed that only Frac < 1.0 in both distribution models had significant differences. CONCLUSION: Statistical models yield robust interpretation of diffusion magnetic resonance (MR) signals with relevance to histological changes in the kidney. The parameters of the statistical models, particularly Frac < 1.0, strongly correlated with eGFR.

Spatially selective T2 and T2 * measurement with line-scan echo-planar spectroscopic imaging.

Line-scan echo planar spectroscopic imaging (LSEPSI) is applied to quickly measure the T2 and T2* relaxation time constants in pre-selected 2D or 3D regions. Results from brain imaging studies at 3T suggest that the proposed method may prove valuable for both basic research (e.g., quantifying the changes of T2/T2* values in functional MRI with blood oxygenation level-dependent contrast) and clinical studies (e.g., measuring the T2' shortening due to iron deposition). The proposed spatially selective T2 and T2* mapping technique is especially well suited for studies, where T2/T2* quantification needs to be performed dynamically in a pre-selected 2D or 3D region.

Fast spectroscopic imaging strategies for potential applications in fMRI.

Technical aspects of two general fast spectroscopic imaging (SI) strategies, one based on gradient echo trains and the other on spin echo trains, are reviewed within the context of potential applications in the field of functional magnetic resonance imaging (fMRI). Fast spectroscopic imaging of water may prove useful for identifying mechanisms underlying the blood oxygenation level dependence (BOLD) of the water signal during brain activation studies. Reasonably rapid mapping of changes in proton signals from brain metabolites, like lactate, creatine or even neurotransmitter associated metabolites like GABA, is substantially more challenging but technically feasible particularly as higher field strengths become available. Fast spectroscopic methods directed towards the 31P signals from phosphocreatine (PCr) and adenosine tri-phosphates (ATP) are also technically feasible and may prove useful for studying cerebral energetics within fMRI contexts.

Accuracy of MR temperature measurement based on chemical shift change for radiofrequency ablation using hook-shaped electrodes.

The purpose of the current study is to evaluate the accuracy of MR thermometry for radiofrequency ablation (RFA) with hook-shaped electrodes. The objects were eight extracted bovine livers. The chemical shift change was calculated from MR images acquired with a spoiled gradient echo sequence and compared with the temperature directly measured with a thermocouple. Linear regression was established between them with a coefficient of -0.0110+/-0.0007 ppm/ degrees C and errors were calculated as -0.50+/-7.50 degrees C. MR thermometry is capable of monitoring temperature for RFA.

Feasibility of internally referenced brain temperature imaging with a metabolite signal.

The feasibility of using a metabolite signal as an internal reference for self-referenced temperature distribution measurement was examined. Line scan echo-planar spectroscopic imaging (LSEPSI) was applied to obtain quick multi-voxel spectroscopic measurements and to avoid possible spectral degradation from motion. Temperature distribution in a rabbit brain in vivo was successfully visualized by means of the chemical shift of water, which was measured by using naturally abundant (up to 10 mM) N-acetyl-aspartate (NAA) as the reference signal. Unlike the phase-mapping approach, this technique does not require a pixel-by-pixel subtraction. Therefore, in theory, it is more resistant to inter-scan motion or changes in susceptibility. The spatial and temporal resolutions of this technique are 1.5 cm3 and 4.5 min. A higher signal-to-noise ratio and optimization of the water and outer-volume suppression capabilities will be required to further enhance the temperature-mapping capabilities.

Interpretation of diffusion MR imaging data using a gamma distribution model.

PURPOSE: Although many models have been proposed to interpret non-Gaussian diffusion MRI data in biological tissues, it is often difficult to see the correlation between the MRI data and the histological changes in the tissue. Among these models, so called statistical models, which assume the diffusion coefficient D is distributed continuously within a voxel, are more suitable for interpreting the data in a histological context than others. In this work, we examined a statistical model based on the gamma distribution. METHODS: First, the proposed gamma model, the bi-exponential model, and the truncated Gaussian model were compared for goodness of fit. To evaluate diagnostic capability, area fractions of certain D ranges were evaluated. The area fraction for D < 1.0 mm2/s (frac < 1) was attributed to small cancer cells with restricted diffusion, and the area fraction for D > 3.0 mm2/s (frac > 3) was considered to reflect perfusion component. A clinical data set of histologically proven prostate cancer cases from previous study was used. RESULTS: For the cancer tissue, the gamma model was better fit than the truncated Gaussian model, and there was no significant difference between the gamma model and the bi-exponential model. For the normal peripheral zone tissue, there was no significant differences among all models. In the 2D scatter plot of frac < 1 vs. frac > 3, Cancer and non-cancer tissues were clearly separated. CONCLUSION: Using the proposed model, the diffusion MR data was well fit, and histological interpretation of the data appears possible.

Lung Parenchymal Signal Intensity in MRI: A Technical Review with Educational Aspirations Regarding Reversible Versus Irreversible Transverse Relaxation Effects in Common Pulse Sequences.

Lung parenchyma is challenging to image with proton MRI. The large air space results in ~l/5th as many signal-generating protons compared to other organs. Air/tissue magnetic susceptibility differences lead to strong magnetic field gradients throughout the lungs and to broad frequency distributions, much broader than within other organs. Such distributions have been the subject of experimental and theoretical analyses which may reveal aspects of lung microarchitecture useful for diagnosis. Their most immediate relevance to current imaging practice is to cause rapid signal decays, commonly discussed in terms of short T2* values of 1 ms or lower at typical imaging field strengths. Herein we provide a brief review of previous studies describing and interpreting proton lung spectra. We then link these broad frequency distributions to rapid signal decays, though not necessarily the exponential decays generally used to define T2* values. We examine how these decays influence observed signal intensities and spatial mapping features associated with the most prominent torso imaging sequences, including spoiled gradient and spin echo sequences. Effects of imperfect refocusing pulses on the multiple echo signal decays in single shot fast spin echo (SSFSE) sequences and effects of broad frequency distributions on balanced steady state free precession (bSSFP) sequence signal intensities are also provided. The theoretical analyses are based on the concept of explicitly separating the effects of reversible and irreversible transverse relaxation processes, thus providing a somewhat novel and more general framework from which to estimate lung signal intensity behavior in modern imaging practice.

Reduction in the vascular bed volume of uterine fibroids after hormonal treatment: evaluation with dynamic double-echo R2* imaging.

PURPOSE: To demonstrate the reduction in vascular bed volume (VBV) of uterine fibroids after administration of gonadotropin-releasing hormone analogue (GnRHa) using magnetic resonance (MR) imaging including dynamic double-echo R2* imaging (DDE-R2*I) and to assess the value of DDE-R2*I as a predictor of such reduction. METHODS: Twenty-one women with uterine intramural fibroids underwent MR imaging including DDE-R2*I before GnRHa treatment. DDE-R2*I was acquired using a single-section, double-echo, fast spoiled gradient recalled acquisition in the steady state (SPGR) sequence. We calculated the area under the curve (AUC) of the signal intensity on R2*I within a 3×3-cm²region of interest that served to represent the VBV. We repeated MR imaging after 2 administrations of GnRHa and repeated image analyses. We statistically analyzed correlations between (A) pre-treatment AUC (AUC(pre)) and AUC reduction and (B) AUC(pre) and volume reduction. RESULTS: The interval between the 2 MR studies ranged from 56 to 119 days (mean: 80.4 days). The average volume of the fibroids before GnRHa treatment was 647.8 mL compared with 463.4 mL after the therapy (decreased by an average of 28.5%; P<0.0001). Meanwhile, measured AUC was reduced by 55.3% (483.4 vs. 206.5; P<0.0001). AUC(pre) correlated with volume reduction (r=0.68), but not AUC reduction. CONCLUSIONS: We confirmed reduction in the VBV of fibroids using DDE-R2*I. The measurement of AUC(pre) on DDE-R2*I aids prediction of fibroid volume reduction but correlates poorly with the percentage of AUC reduction.

Biexponential apparent diffusion coefficients in prostate cancer.

PURPOSE: The purpose of this study was to investigate the need for biexponential signal decay modeling for prostate cancer diffusion signal decays with b-factor over an extended b-factor range. MATERIALS AND METHODS: Ten healthy volunteers and 12 patients with a bulky prostate cancer underwent line scan diffusion-weighted MR imaging in which b-factors from 0 to 3000 s/mm(2) in 16 steps were sampled. The acquired signal decay curves were fit with both monoexponential and biexponential signal decay functions and a statistical comparison between the two fits was performed. RESULTS: The biexponential model provided a statistically better fit over the monoexponential model on the peripheral zone (PZ), transitional zone (TZ) and prostate cancer. The fast and slow apparent diffusion coefficients (ADCs) in the PZ, TZ and cancer were 2.9+/-0.2, 0.7+/-0.2 x 10(-3) mm(2)/ms (PZ); 2.9+/-0.4, 0.7+/-0.2 x 10(-3) mm(2)/ms (TZ); and 1.7+/-0.4, 0.3+/-0.1 x 10(-3) mm(2)/ms (cancer), respectively. The apparent fractions of the fast diffusion component in the PZ, TZ and cancer were 70+/-10%, 60+/-10% and 50+/-10%, respectively. The fast and slow ADCs of cancer were significantly lower than those of TZ and PZ, and the apparent fraction of the fast diffusion component was significantly smaller in cancer than in PZ. CONCLUSIONS: Biexponential diffusion decay functions are required for prostate cancer diffusion signal decay curves when sampled over an extended b-factor range, providing additional, unique tissue characterization parameters for prostate cancer.