This study presents the utility and two-reader reliability of a quantitative protocol comprising of MRF-relaxometry and diffusion-based ADC mapping in differentiating transition zone (TZ) prostate cancers from non- cancers. Two-reader agreement was good to excellent for T1, T2 and ADC. T1, T2 and ADC values were significantly lower in targeted biopsy-proven cancers versus non-cancers. T1+ADC combination could differentiate all cancers from non-cancers with an AUC of 0.95. For indeterminate PIRADS category 3 TZ lesions, non-cancers had significantly higher T1 and ADC than cancers and T1 may be the best property for further characterization of indeterminate TZ lesions (AUCT: 0.87 versus AUCADC: 0.84).
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