Purpose: To evaluate the effectiveness of whole-body diffusion-weighted MRI (WB-DWI) in early detection of bone metastases in high-risk prostate cancer patients.

Methods: Forty patients with elevated PSA and high-risk prostate cancer underwent WB-DWI and standard bone scintigraphy. Lesion detection rates, sensitivity, and specificity were compared.

Results: WB-DWI detected 95% of metastatic lesions, compared with 78% for bone scintigraphy. Sensitivity and specificity for WB-DWI were 0.95 and 0.92, respectively. Additional lesions in the axial skeleton were detected in 15% of cases.

Conclusion: WB-DWI provides superior sensitivity compared with conventional bone scintigraphy for early detection of bone metastases, supporting its use in high-risk prostate cancer surveillance.

Keywords: Diffusion-weighted MRI, prostate cancer, bone metastases, whole-body imaging, oncologic imaging