Prostate cancer detection among readers with different degree of experience using ultra-high b-value diffusion-weighted Imaging: Is a non-contrast protocol sufficient to detect significant cancer? 
To evaluate the accuracy of a T2-weighted (T2w) - and a parallel transmit zoomed b = 2000 s/mm2 (b2000) - diffusion-weighted imaging sequence among three readers with different degrees of experience for prostate cancer (Pca) detection.  Ninety-three patients with suspected Pca were enrolled.  For b2000 a two-dimensional spatially-selective RF pulse using an echo-planar transmit trajectory was applied, and the field of view (FOV) was reduced to one-third.  All three readers (Reader A: 7, B 4 and C <1 years of experience in prostate MRI) independently evaluated b2000 with regard to the presence of suspicious lesions that displayed increased signal.  The results were compared to histopathology obtained by real-time MR/ultrasound fusion and systematic biopsy.  In 62 patients Pca was confirmed.  One significant Pca (Gleason score (GS) 7b) was missed by Reader C. Overall, sensitivity/specificity/positive predictive value/negative predictive value were 90/71/86/79% for Reader A, 87/84/92/76% for Reader B and 85/74/87/72% for Reader C, respectively.  Detection rates for significant Pca (GS >7a) were 100/100/94% for Readers A/B/C, respectively.  Inter-reader agreement was generally good (Kappa A/B: 0.8; A/C: 0.82; B/C: 0.74).  B2000 in combination with a T2w could be useful to detect clinically significant Pca. •  Significant prostate cancer using zoomed ultra-high b-value DWI was detected. •  Diagnostic performance among readers with different degrees of experience was good. •  mp- MRI of the prostate using a comprehensive non-contrast protocol is clinically feasible.