Mp01-11 Detection of Malignancy by Hematuria Screening in Patients on Anticoagulation

Abstract

treatment including total cystectomy, radiation and chemotherapy, whereas T1G3 NMIBC has less invasive treatment options including re-TURBT or BCG instillation as bladder preservation therapy. Between these two tumor's groups the treatment selection is drastically changed, however, the relationship between these groups and ADC value has not yet been clearly identified.We investigated the difference between T1G3 NMIBC and MIBC by evaluating ADC value measured from DWI.METHODS: Diffusion-weighted MRI (DW-MRI) at 1.5 Tesla using b-values of 0, 1000 s/mm2 was taken before transurethral resection or total cystectomy by 156 bladder urothelial tumor patients in our hospital. ADC value was measured and its relationship with clinicopathological factors were analyzed. Fisher's exact test, receiver operating characteristic (ROC) curve analysis and logistic regression analysis were performed for data analysis.RESULTS: Among 156 cases of bladder urothelial tumor, 34 and 42 cases were diagnosed as T1G3 NMIBC and MIBC, respectively. Area under the ROC curve for differentiating between T1G3 NMIBC and MIBC by using ADC value was 0.701, with optimal thereshold of 0.91x10-3mm/s2, which was associated with a sensitivity of 50.0%, specificity of 88.1%.Multivariate analysis showed that ADC value less than 0.91x10-3mm/s2(OR: 0.148, p¼0.035) and lymphatic invasion (ly) (OR: 10.540, p¼0.006) were significant predictive factors for distinguishing between T1G3 NMIBC and MIBC.CONCLUSIONS: This is the first report which indicated that ADC value was significant predictive biomarker differentiating between T1G3 NMIBC and MIBC, which would be useful prior to treatment for patient counseling and treatment selection, especially about bladder preservation. Consequently it may provide more accurate diagnosis between these two groups, which leads to avoid unnecessary invasive treatment.