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Objective  The objective of our study was to investigate tumor conspicuity and the discrimination potential for tumor aggressiveness on diffusion-weighted magnetic resonance imaging (DW-MRI) with high b value at 3-T.    Materials and Methods  The institutional review board approved this study and waived the requirement for informed consent. A total of 50 patients with prostate cancer (69 cancer foci; 48 in the PZ, 20 in the TZ, and one in whole prostate) who underwent multiparametric prostate MRI including DW-MRI (b values: 0, 1000 s/mm 2  and 0, 2000 s/mm 2 ) on a 3-T system were included. Lesion conspicuity score (LCS) using visual assessment (1 = invisible for surrounding normal site; 2 = slightly high intensity; 3 = moderately high; and 4 = very high) and tumor-normal signal intensity ratio (TNR) were assessed, and apparent diffusion coefficient (ADC, ×10 −3  mm 2 /s) of the tumor regions and normal regions were measured.    Results  Mean LCS and TNR at 0, 2000 s/mm 2  was significantly higher than those at 0, 1000 s/mm 2  ( p <0.001 for both). In addition, ADC at both 0, 1000 and 0, 2000 s/mm 2  was found to distinguish intermediate or high risk cancer with Gleason score ≥7 from low risk cancer with Gleason score ≤6 ( p <0.001 for both). Furthermore, ADC of tumor regions correlated with Gleason score at both 0, 1000 s/mm 2  (ρ = −0.602;  p <0.001) and 0, 2000 s/mm 2  (ρ = −0.645;  p <0.001).    Conclusions  For tumor conspicuity and characterization of prostate cancer on DW-MRI of 3-T MRI, b = 0, 2000 s/mm 2  is more useful than b = 0, 1000 s/mm 2 .

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High b Value (2,000 s/mm2) Diffusion-Weighted Magnetic Resonance Imaging in Prostate Cancer at 3 Tesla: Comparison with 1,000 s/mm2 for Tumor Conspicuity and Discrimination of Aggressiveness