Gadolinium-Enhanced Magnetic Resonance Imaging in the Staging of Urinary Bladder Neoplasms

Abstract

Magnetic resonance imaging (MRI) proved to be an important diagnostic tool in the correct staging of bladder neoplasms. The advantage of multiplane imaging and high soft-tissue contrast may be extended by the use of MRI contrast media such as the gadoliniumdiethylene-triaminepentaacetic acid complex. In 60 patients with suspected or proved bladder tumors, the results of preoperative gadolinium-enhanced MRI were correlated with the histopathologic findings. The staging accuracy of infiltrating tumors was 83% and sensitivity and specificity 86% and 83%, respectively. Three tumors could only be localized after administration of gadolinium. All active tumors demonstrated significant contrast enhancement after intravenously injected gadolinium. Small papillary tumors or carcinoma in situ remain problematic to preoperative staging procedures. The advantages of gadolinium-enhanced MRI will best be employed in the exact pretherapeutic staging of infiltrative bladder neoplasms or in restaging procedures after chemotherapy and radiotherapy.

Fast dynamic gadolinium-enhanced MR imaging of urinary bladder and prostate cancer

“…As clinical staging is not reliable for deeply infiltrative tumors, more accurate methods are needed. Recently, several investigators have described the use of Gdenhanced MR imaging for staging urinary bladder cancer (16,(23)(24)(25)(26). With the use of IV Gd-contrast, visualization of small tumors improved (16,(24)(25)(26), and furthermore, an increase in accuracy of local staging was reported (23,26).…”

Staging urinary bladder cancer after transurethral biopsy: value of fast dynamic contrast-enhanced MR imaging.

“…Although MR imaging is better than CT for staging urinary bladder cancer, CT is more commonly used in most centers be cause of its greater availability and of the greater familiarity with this tech nique. Recently, several authors have described the use of gadolinium-en hanced MR imaging for staging uri nary bladder cancer (10,(11)(12)(13)(14). With intravenously administered gadopentetate dimeglumine, visualization of small tumors improved (10,(12)(13)(14) and increased accuracy of local staging was reported (11,14).…”

“…Recently, several authors have described the use of gadolinium-en hanced MR imaging for staging uri nary bladder cancer (10,(11)(12)(13)(14). With intravenously administered gadopentetate dimeglumine, visualization of small tumors improved (10,(12)(13)(14) and increased accuracy of local staging was reported (11,14). The best stag ing results w ith contrast materialenhanced MR were obtained with fast Tl-w eighted imaging (9).…”

“…Even w hen gadolinium enhancem ent is used, however, dif ferentiation betw een residual tumor and edema, scar, or granulation tissue remains problematic in patients after TUR (12,(14)(15)(16)(17).…”

Imaging for staging bladder cancer: a clinical study of intravenous 111indium‐labelled anti‐MUC1 mucin monoclonal antibody C595

“…CT may only detect nodes of >1 cm and liver metastases of > 1.5 cm in diameter, and enlargement of the lymph nodes may not necessarily indicate metastatic disease [5]. Early studies showed that CT failed to detect nodal metastases in up to 40% of patients [6] and more recent imaging with MRI, including gadolinium‐DTPA‐enhanced images, produced similar results [7]. Even with the latest three‐dimensional MRI techniques the sensitivity of the detection of metastatic lymph nodes is still only 75% [8].…”