Therefore, when using ultra-high b values, it is necessary to use some practices that reduce the associated image artifacts, such as evacuation of the rectum before the examination. This can be challenging since increasing b values over 1000 s/mm 2 favors image artifacts, leading to a lower-quality image. However, in MRI of the prostate, ultra-high b values of 1400 are used to provide suppression of benign prostate and focal prostatitis in the peripheral area and to improve prostate cancer (PCa) detection.

In an area with more cells (such as in cancer), the restricted diffusion of water molecules will demonstrate high signal intensity on DWIs with a high b value (800 or higher), thus increasing the visibility of tumor foci since higher b values offer a better contrast between the tumor and healthy tissue compared to b values lower than 800, which provide limited utility in this case. In simple fluids, the movement of water is free, but in tissues, it is restricted, especially by cell membranes, which, due to their hydrophobic character, act as a barrier that reduces the movement of intracellular and extracellular water. A DWI can analyze the property of water molecules in the body to be in Brownian motion.

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