Diagnostic performance of diffusion-weighted magnetic resonance imaging in bladder cancer: potential utility of apparent diffusion coefficient values as a biomarker to predict clinical aggressiveness

Kobayashi, Shuichiro; Koga, Fumitaka; Yoshida, Soichiro; Masuda, Hitoshi; Ishii, Chikako; Tanaka, Hiroshi; Komai, Yoshinobu; Yokoyama, Minato; Saito, Kazutaka; Fujii, Yasuhisa; Kawakami, Satoru; Kihara, Kazunori

doi:10.1007/s00330-011-2174-7

Cited by 163 publications

(143 citation statements)

References 31 publications

(48 reference statements)

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“…In the various studies, different approaches were used; most of them used both T2W and DWI [8] [10] [15], but some evaluated the sequences separately in identifying the tumor [7] [15]. The sensitivities and specificities in the present study are lower than those studies.…”

Section: Discussionmentioning

confidence: 75%

MRI of the Bladder in Patients Suspected of Bladder Tumors

Gandrup¹,

Nordling²,

Thomsen³

2014

OJRad

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Objective: To prospectively evaluate the use of MRI for the detecting of bladder tumors and the Tstage using T2W, T1W and diffusion-weighted images (DWI). Material and methods: Twenty-eight consecutive patients (21 men, 7 women; age range, 20 -82 years; mean age, 62.8 years) suspected of bladder tumors underwent MRI, flexible cystoscopy and transurethral resection (TURB). The presence of bladder tumor was confirmed by histopathology in 21 patients; 18 patients had pTa, one pT1 and two pT2. The images were reviewed by two uroradiologists. They assigned the presence of a bladder tumor and whether the tumor was non-muscle invasive (Ta and T1) or muscleinvasive (T2, T3 or T4). Results: Compared to the histopathological results, the accuracy for identifying a bladder tumor was 60.7% and 53.7% for reviewer A and B, respectively. The sensitivity and specificity were 66.7%/61.9% and 57.1%/42.9%. Positive predictive values were 82.6%/ 76.5%. The overall staging was correct in 47.6%/52.5%, but improved on stage-by-stage up to 50%/66.7%. The agreement between the reviewers was moderate in the detecting, staging and location of the tumor (Kappa = 0.47 -0.57). Conclusion: A simple MRI using no contrast media, but DWI, cannot replace flexible cystoscopy in the detection of new or recurrent bladder tumors.

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Section: Discussionmentioning

confidence: 75%

MRI of the Bladder in Patients Suspected of Bladder Tumors

Gandrup¹,

Nordling²,

Thomsen³

2014

OJRad

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“…The inconsistency may due to the fact that there is substantial interviewer variation of the ADC value for any particular region of interest in a relatively thin bladder wall [39]; moreover, the ADC value may be difficult to reproduce since it can alter between systems depending on many variables including the coil system, the vendor, the imaging protocol and others. It may be affected by many factors associated with variability in the subject's tissue itself, and this would include such variables as body temperature, tissue pressure, perfusion rate or the magnetic environment of each individual, and so on [40,41].…”

Section: Initial Results For Bladder Tumor Stagingmentioning

confidence: 99%

Urinary Bladder Cancer: The Current and Potential Role of MR Imaging in Non-Distant Metastatic Lesions

Wang¹,

Guo²,

Zhou³

et al. 2013

JCT

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Urinary bladder cancer is the second most common genitourinary malignancy in Westernized countries. A number of emerging imaging techniques have recently been reported in the literature for use in imaging bladder cancer. While the explicit application of MR imaging in bladder cancer especially in non-distant bladder cancer or bladder cancer localized in pelvic remains uncertain and awaits a thorough evaluation. Therefore, this article aims to make a systematic review of previous literature and provide a complete assessment of the value of MR as an evolving imaging tool in localized urinary bladder cancer application. Studies were conducted by searching the MEDLINE and PubMed databases up to 2012 using both medical subject heading (Mesh) and a free text method like "urinary bladder cancer", "magnetic resonance imaging" or "MRI", "diffusion weighted imaging" or "DWI". About 53 articles were selected and analyzed which were considered to be associated with the objective of this systematic review ( Table 1). Results showed that MRI especially the newer functional imaging technique like DWI may has a great potential role in localized bladder cancer like early detection, staging, evaluation of tumor aggressiveness and therapeutic responsiveness of patients in the assessment of urinary bladder cancer and so forth. Newer MRI has already proceeded promising results in bladder cancer application; and the explicit role of newer MRI in bladder cancer patients still needs further research and awaits to be thoroughly evaluated.

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“…In fact, Kobayashi's group reported the histopathological diagnosis of 6 tumors with the "inchworm sign" on DWI as muscle-invasive bladder cancer. 7 Although bladder tumors with stalks on MR imaging tend to be of low stages, thickness of the bladder wall at the base of the stalk should be evaluated carefully.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have suggested that MR imaging at 1.5T facilitates the detection of stalks and staging of bladder tumors. 5,7,10 However, we believe no study has compared MR imaging sequences with regard to the efficacy of stalk detection.…”

Section: Introductionmentioning

confidence: 99%

Preoperative T Staging of Urinary Bladder Cancer: Efficacy of Stalk Detection and Diagnostic Performance of Diffusion-weighted Imaging at 3T

Ohgiya

Suyama

et al. 2014

MRMS

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Purpose: We evaluated the ability of diffusion-weighted imaging (DWI) at 3 tesla for diagnosing T stage and detecting stalks in bladder cancer.Methods: In total, 39 consecutive patients with bladder tumors underwent magnetic resonance (MR) imaging that included T 2 -weighted imaging (T 2 WI) and DWI using a 3T MR scanner. Two radiologists interpreted T 2 WI plus DWI and T 2 WI for diagnosis of T stage and for detection of stalks. We used McNemar's test to examine differences in diagnostic performance and Fisher's exact test to evaluate differences in stalk detection frequency.Results: Specificity and accuracy in differentiating T1 tumors from T2 to T4 tumors were significantly better with T 2 WI plus DWI (83% [20/24] Conclusion: DWI at 3T was superior to T 2 WI for evaluating the T stage of bladder cancer, particularly in differentiating T1 tumors from those T2 or higher, and in detecting stalks of papillary bladder tumors.

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Diagnostic performance of diffusion-weighted magnetic resonance imaging in bladder cancer: potential utility of apparent diffusion coefficient values as a biomarker to predict clinical aggressiveness

Abstract: DW-MRI exhibits high diagnostic performance in bladder cancer with excellent objectivity. The ADC value could potentially serve as a biomarker to predict clinical aggressiveness in bladder cancer.

Cited by 163 publications

References 31 publications

MRI of the Bladder in Patients Suspected of Bladder Tumors

MRI of the Bladder in Patients Suspected of Bladder Tumors

Urinary Bladder Cancer: The Current and Potential Role of MR Imaging in Non-Distant Metastatic Lesions

Preoperative T Staging of Urinary Bladder Cancer: Efficacy of Stalk Detection and Diagnostic Performance of Diffusion-weighted Imaging at 3T

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