Role of Diffusion MRI and Apparent Diffusion Coefficient Measurement in the Diagnosis, Staging and Pathological Classification of Bladder Tumors

Abstract

Objectives: Our aim was to investigate the role of simultaneous apparent diffusion coefficient (ADC) measurement and diffusion-weighted MRI (DWMRI) in the diagnosis and differentiation of bladder masses. Methods: Weexamined 45 patients presenting with hematuria by dynamic and diffusion MRI (at b100, b600, b1000 gradients) and cystoscopy. Thirty healthy volunteers without hematuria were also included in the study. Results from imaging techniques were compared to cystoscopic and histopathologic findings. The ADC values of benign and malignant bladder masses, and bladder tissue in healthy subjects were measured and compared with each other. Results: The mean ADC values of benign (n = 10) and malignant lesions (n = 35) were significantly lower than the mean ADC values of adjacent bladder walls and bladder walls of healthy subjects at all 3 gradients (p < 0.05). However, no significant difference was detected between benign and malignant lesions (p > 0.05). Mean ADC values of invasive tumors were significantly lower than superficial malignancies at b600 and b1000 gradients. The mean ADC values of transitional cell tumors were significantly higher than squamous cell tumors at b100 and b600 gradients. Conclusion: Simultaneous measurement ofADC and DWMRI provided useful information in the diagnosis, staging and histopathological classification of bladder tumors.

Non-invasive quantification of tumour heterogeneity in water diffusivity to differentiate malignant from benign tissues of urinary bladder: a phase I study

“…These assessments neglect the heterogeneous distribution of ADC among voxels of the whole tumour. The study by Daggulli [21] assessed the difference in mean ADC between benign and malignant lesions in 45 bladder patients and did not find statistical significance in mean ADC in this patient population, which is in agreement with the findings in our study. A recent study by Suo [28] applied histogram analysis to differentiate bladder cancer from benign lesions and assess tumour stage and found significant differences in skewness and kurtosis.…”

“…A number of studies have applied quantitative measurement of ADC in the diagnosis of bladder cancer [21–27]. These studies showed that there was correlation of tumour ADC with the histological grade [27], stage [25], and invasive and proliferative potential [24] of the bladder tumour.…”

Intravoxel incoherent motion diffusion‐weighted imaging in assessing bladder cancer invasiveness and cell proliferation

“…Previous studies have shown that ADCs can be used to stage bladder cancer. ADCs are lower in higher T‐stage bladder cancer.…”

Potential Utility of Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Residual Bladder Cancer before Second Transurethral Resection

“…Bladder cancers generally show a hyperintense signal because of their higher cellularity and tissue disorganization [8,9] . Since the first report showing the usefulness of DW-MRI in the detection of bladder cancer in 2007, DW-MRI has been increasingly applied in the management of bladder cancer [10][11][12][13][14] . Abou-El-Ghar et al [15] reported that it had a sensitivity of 98.1% and a specificity of 92.3% in detecting bladder cancers in a prospective study.…”