Diffusion weighted magnetic resonance imaging in bladder cancer, is it time to replace biopsy?

Rs, Al Johi; Seifeldein, Gehan S.; Am, Moeen; Na, Aboulhagag; Em, Moussa; Da, Hameed; Hm, Imam

doi:10.5173/ceju.2017.1427

Cited by 9 publications

(7 citation statements)

References 29 publications

(61 reference statements)

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“…In our study, the accuracy of T2 plus DWI in differentiating organ confined from non-organ confined tumors is 84.6%. Similar results are reported by Al-Johi et al, [14] who reported an accuracy of 83% which is better than T2 alone (75.9%) and DWI alone (77.4%).…”

Section: Discussionsupporting

confidence: 90%

“…Also, in our current work, we studied the advantage of T2WI plus DWI, and the overall sensitivity, specificity and accuracy were 87.8, 95.5 and 91.6%, respectively. Al-Johi et al, [14] study reported sensitivity and accuracy of T2 plus DWI being 100 and 68.5% respectively with an accuracy more than T2 (63%) but less than DWI (100%) may be due to usage of higher b values. In our study, the accuracy of T2 plus DWI in differentiating organ confined from non-organ confined tumors is 84.6%.…”

Section: Discussionmentioning

confidence: 95%

“…Our analysis of DWI alone revealed an overall sensitivity, specificity and accuracy of 87.8, 87.8 and 88%, respectively. Al-Johi et al, [14] study reported that the overall sensitivity and accuracy of DWI alone was 100%. In our study, the accuracy of differentiating organ confined from non-organ confined is 84.6% by using DWI alone may be due to usage of lower b values.…”

Section: Discussionmentioning

confidence: 98%

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Diffusion-Weighted Image in Correlation with T2 Sequence as an Imaging Biomarker for Urinary Bladder Cancer

Hussein¹,

Al-Gaafary²

2019

The Medical Journal of Cairo University

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Background: Recent functional diagnostic imaging techniques have emphasized the role and importance of MRI in pelvic organs imaging. Functional imaging by means of Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) and ADC value are now considered an essential part of the standard imaging protocols for evaluation of the pelvic organs. DWI depends on the fact that water molecules can diffuse freely in low cellular tissues, while increased cellularity restricts its diffusion, a phenomenon called 'Brownian motion'. Therefore, in cases of malignant lesions which have high cellularity, water diffusion is restricted and appear as bight lesions, in contrary to most benign tumors which have low cellularity. Aim of Study: To assess the diagnostic value of DWI in correlation with T2WI for preoperative urinary bladder tumor T-staging. Patients and Methods: This is a prospective study that included twenty-six patients with hematuria and suspicious urinary bladder mass lesion on ultrasonography, age ranged from 54 to 70 years old, 22 patients were male while 4 were female. The patients were referred from the Urology Clinics, Ain Shams University, before cystoscopy and initial biopsy confirmation. MRI examination with DWI and T2WI was performed at the Radiology Department of Ain Shams University Hospital in a period of 6 months from January to June 2018. Results: In this study, 24 patients were confirmed to have urinary bladder cancer while one patient had nonspecific inflammatory reaction and another patient had infiltrating prostatic cancer. Regarding the detection of urinary bladder carcinoma the overall sensitivity, specificity, and accuracy using T2 images alone were 71.8, 73.2 and 72.4%, respectively, using DWI alone were 87.8, 87.8 and 88%, respectively and by using T2 plus DWI images were 87.8, 95.5 and 91.6%, respectively. The ADC value of 0.8 X 10-3 mm 2 /sec was found to be a cut off value for differentiating low grade tumors (grade I-II) from high grade tumors (grade III) with sensitivity, specificity and accuracy of 71, 55.5 and 65% respectively.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

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Diffusion-Weighted Image in Correlation with T2 Sequence as an Imaging Biomarker for Urinary Bladder Cancer

Hussein¹,

Al-Gaafary²

2019

The Medical Journal of Cairo University

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“…Biopsy of the lesions through the urethra was performed and specimen were fixed at room temperature in 10% formalin for 12–24 h, embedded in paraffin at 62°C for 3 h, cut into 4-µm-thick sections and stained with a hematoxylin (Shanghai Regal Biology Technology Co., Ltd., Shanghai, China) and eosin (Sinopharm Chemical Reagent Co., Ltd., Shanghai, China) according to the manufacturer's protocol. Specimens were examined histopathologically using a light microscope (magnification, ×400; DM 2000 LED; Leica Microsystems, Inc., Buffalo Grove, IL, USA) to assess the types of lesions ( 15 ). Lesions revealed congestion and edema of the bladder mucosa ( Fig.…”

Section: Case Reportmentioning

confidence: 99%

Eosinophilic cystitis in children: A case report

Ning

et al. 2018

Exp Ther Med

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The aim of the present case report was to investigate the clinical features, pathological examination and treatment of eosinophilic cystitis (EC) in children. Two cases of EC were reported and reviewed from January 2016 to March 2017. Case 1 (male; 6 years old) had intermittent hematuria, frequent urination, urgent urination, difficulty in urination and abdominal pain. Case 2 (male; 7 years old) had frequent urination, urgent urination, urinary pain, dysuria and suprapubic pain with no hematuria. One patient had a history of allergies and both patients underwent a cystoscope biopsy. Blood eosinophils were clearly increased and a bone marrow biopsy examination revealed that marrow eosinophils were also increased in both cases. The urine culture results were negative. Ultrasonography and computed tomography revealed uneven thickening of the bladder wall and diffusive mucosal lesions. Cystoscopy revealed that the bladder volume became smaller and the mucosa at the bladder floor and neck was red. Lesions were biopsied through the urethra and the following characteristics were observed: Congestion and edema of the bladder mucosa, infiltration of the blood vessels and eosinophils in the muscular layer, accompanied by focal muscle necrosis. Patient 1 was administered anti-inflammatory and cetirizine hydrochloride treatments, followed by 6 weeks of prednisone dose-reduction therapy. Patient 2 was administered antibiotics and cetirizine hydrochloride. Following 6-month follow-ups, abnormal voiding symptoms had disappeared in each case. Ultrasonography and computed tomography revealed no bladder wall thickening or space-occupying lesions. EC in children is rare and easily misdiagnosed as nonspecific bladder inflammation or bladder occupying lesions. Cystoscopy and biopsy are necessary to diagnose EC and conservative treatments with anti-inflammatory, anti-allergic and cortical hormone nonspecific treatments are suggested.

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“…Similar to bladder cancer, BPGs show marked hyperintensity on DWI and hypointensity on ADC maps due to restricted diffusion of water molecules. 14 The tumours presented slight hyperintensity on T1WI and "fast in and slow out" enhanced pattern on contrast-enhanced images, which may be distinctive MRI features of BPGs. 10,15 The potential pathological bases for the above imaging findings are that the tumour cells are large with abundant cytoplasm and the intercellular stromata are rich in blood vessels showing fissure or haemangiomalike dilatation.…”

Section: Discussionmentioning

confidence: 92%

Bladder paraganglioma: CT and MR imaging characteristics in 16 patients

Zhang

Bai

Yuan

et al. 2021

Radiology and Oncology

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Background Bladder paraganglioma (BPG) is a rare extra-adrenal pheochromocytoma with variable symptoms and easy to be misdiagnosed and mishandled. The aim of the study was to document the imaging features of BPG using computed tomography (CT) and magnetic resonance imaging (MRI). Patients and methods We retrospectively enrolled consecutive patients with pathology-proven BPG, who underwent CT or MRI examinations before surgery between October 2009 and October 2017. The clinical characteristics, CT, and MRI features of the patients were described and analysed. Results A total of 16 patients with 16 bladder tumours (median age 51 years, 9 females) were included. Among them, 13 patients underwent CT examinations and eight patients underwent MRI examinations preoperatively. Tumour diameters ranged from 1.6−5.4 cm. Most of the tumours grew into the bladder cavity (n = 11) with oval shapes (n = 10) and well-defined margins (n = 14). Intratumour cystic degeneration or necrosis (n = 2) was observed. Two lesions showed peripheral tissue invasion, suggesting malignant BPGs. All 13 lesions imaged with CT exhibited slight hypoattenuation and moderate to marked enhancement. Compared to the gluteus maximus, all lesions showed slight h yperintensity in T2-weighted images, hyperintensity on diffusion-weighted images (DWI), hypointensity on apparent diffusion coefficient maps, hyperintensity on T1-weighted images and a “fast in and slow out” enhanced pattern on contrast-enhanced MRI images. Conclusions BPGs are mostly oval-shaped, broadly-based and hypervascular bladder tumours with hypoattenuation on non-contrast CT, T2 hyperintensity, slight T1 hyperintensity compared to the muscle, marked restricted diffusion on DWI. Peripheral tissue invasion can suggest malignancy of the BPGs. All of these features contribute to preoperative decision-making.

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Diffusion weighted magnetic resonance imaging in bladder cancer, is it time to replace biopsy?

Cited by 9 publications

References 29 publications

Diffusion-Weighted Image in Correlation with T2 Sequence as an Imaging Biomarker for Urinary Bladder Cancer

Diffusion-Weighted Image in Correlation with T2 Sequence as an Imaging Biomarker for Urinary Bladder Cancer

Eosinophilic cystitis in children: A case report

Bladder paraganglioma: CT and MR imaging characteristics in 16 patients

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