Improved differentiation of prostate cancer using advanced diffusion models: a comparative study of mono-exponential, fractional-order-calculus, and multi-compartment models

Advanced diffusion models, particularly the MC model, demonstrated a significant improvement over ADC in differentiating prostate lesions, especially between low and intermediate-risk PCa, between intermediate and high-risk PCa, and between clinically significant and insignificant PCa. Comparable performance was observed in distinguishing BPH from PCa among three models. Moreover, the combination of MC and FROC models further enhanced differentiation accuracy, particularly in the more challenging classifications between intermediate and high-risk PCa, where ADC alone proved inadequate. These results highlight the potential clinical value of MC model and combining MC and FROC models for more precise PCa risk stratification.