Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer

Shalaby, Essam A.; Mohamed, Ahmed R.; Elkammash, Tarek H.; Abouelkheir, Rasha T.; Housseini, Ahmed M.

doi:10.1097/cu9.0000000000000128

Cited by 3 publications

(3 citation statements)

References 27 publications

(49 reference statements)

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“…Similar outcomes were discovered in previous studies. 14,15 In our study, we discovered that higher grades were frequently linked with invasive tumours (p 0.001) because bladder carcinoma tumour grades had a significant impact on treatment options. The mp-MRI is a predictor of both cancer invasiveness and tumour grade, as we have already observed in our work.…”

Section: Discussionmentioning

confidence: 74%

Role of multiparametric MRI in predicting muscle invasiveness in urinary bladder neoplasms with pathological correlations

Tandon,

Chakraborty,

Barkondaj

et al. 2023

Urologia

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Urinary bladder cancer (BC) is one of the most frequent malignancies and the ninth most common malignancy worldwide. The objective of this study is to assess the role of multiparametric magnetic resonance imaging (mp-MRI) in predicting the invasiveness of urinary bladder space occupying lesions. Thirty-five patients diagnosed with bladder masses underwent an mp-MRI study. The results of three image sets were analysed and compared with the histopathological results as a reference standard: T2-weighted image (T2WI) plus dynamic contrast-enhanced (DCE), T2WI plus diffusion-weighted images (DWI), and mp-MRI, including T2WI plus DWI and DCE. The diagnostic accuracy of mp-MRI was evaluated using receiver operating characteristic curve analysis. We discovered a highly significant correlation between muscle invasiveness as staged by HPE (Histopathological examination) and mp-MRI utilising a VI-RADS score >3 ( p 0.001) with a sensitivity of 100% and a specificity of 85.7%. With a diagnostic accuracy of 77.14%, a sensitivity of 92.31%, a specificity of 72.72%, a positive predictive value of 66.67%, and a negative predictive value of 94.11%, In terms of muscle invasiveness, there is good concordance between HPE staging and mp-MRI utilising the VI-RADS score. The mean apparent diffusion coefficient (ADC) values were higher in low grades than in high grades. The ROC curve study revealed a very strong correlation between HPE grade and ADC ( p = 0.045). In 77.14% of patients, Mp-MRI correctly identified the local T stage. Mp-MRI is imaging biomarker for invasiveness and grade of tumour. The tumours with high grade are more invasive. However, the diagnostic accuracy of mp-MRI in determining muscle invasiveness is not very high and it overstages the disease in some cases (33.3%). Its clinical usefulness in determining muscle invasiveness before TURBT and histopathological examination can be questioned.

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Section: Discussionmentioning

confidence: 74%

Role of multiparametric MRI in predicting muscle invasiveness in urinary bladder neoplasms with pathological correlations

Tandon,

Chakraborty,

Barkondaj

et al. 2023

Urologia

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“…In concert with our research, the evolving landscape of diagnostic technologies is evident in recent publications that explore novel approaches to improve the accuracy of microhematuria assessment. Notable studies have investigated the role of advanced imaging modalities, such as contrast-enhanced ultrasound and multiparametric magnetic resonance imaging, in enhancing the sensitivity and specificity of diagnostic evaluations [18].…”

Section: Discussionmentioning

confidence: 99%

Microscopic Hematuria: A Classical Definition in a Modern Lab Era

Köseoğlu,

Eroğlu

2023

Grn Int J Apl Med Sci

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Purpose: This study endeavors to elucidate the diagnostic intricacies surrounding microhematuria, a prevalent indication for urological consultation. Specifically, the research seeks to assess the diagnostic value of urinalysis and cystoscopy procedures in minimizing the need for invasive cystoscopies, given the evolving landscape of technology-driven urinalysis. The primary objective is to provide nuanced insights for clinicians to optimize diagnostic pathways in cases of microhematuria. Method: In this retrospective case-control study, conducted at our university-based hospital, patient records spanning January 2017 to January 2022 were scrutinized following approval from the local ethics committee. The study focused on individuals diagnosed with microhematuria and subsequently subjected to cystoscopy and urine cytology. Exclusion criteria encompassed urinary tract infection, positive or suspicious urine cultures, urolithiasis, bladder pain syndrome/interstitial cystitis, pregnancy, and pre-existing bladder cancer. Urine analyses were carried out using the FUS-200 automatic urinalysis system. Results: Cystoscopy identified lesions in 17% of cases, leading to biopsy/endoscopic resection. Dipstick analysis revealed mean RBC/hpf values of 8.93±3.78 (24.61) for RBC+, 22.08±12.30 (52.77) for RBC++, and 763.56±1993.63 (78.08) for RBC+++. Among cytologies, 1% exhibited atypia with normal follow-up. Patients with detected lesions displayed varying pathology, with 23% benign cases and 77% urothelial carcinoma. Levels of measured RBC/hpf across tumor stages and histological grades were statistically insignificant, yet the median levels significantly differed between cases with and without lesions. The study outcomes indicate a significant difference in median RBC/hpf levels between cases with lesions present (77.38) and absent (45.66) (p=0.001). ROC analysis yielded an AUC of 0.814 (p=0.001, 95% CI 0.677-0.952). However, diagnostic value was suboptimal at lower cut-offs and appeared to be optimum within the range of 35-40 RBC/hpf. Conclusion: This study provides nuanced insights into the specificity of urinalysis in cases of microhematuria by correlating modern urinalysis results with cystoscopic outcomes, the research contributes to a refined decision-making framework for clinicians. It emphasizes the need for evidence-based guidelines in assessing microhematuria comprehensively, considering the evolving landscape of diagnostic technologies.

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“…The precise evaluation of muscular invasion is crucial for determining the appropriate treatment, as patients with non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) necessitate different therapeutic approaches. In this scenario, computed tomography (CT) and multiparametric magnetic resonance imaging (mpMRI) are non-invasive diagnostic techniques, each exhibiting variable degrees of accuracy in staging BC [4,5]. More specifically, a standardized methodology for imaging and reporting mpMRI in BC patients was developed by Panebianco et al in 2018 with the Vesical Imaging-Reporting and Data System (VI-RADS) score [6].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Contrast-Enhanced Ultrasound (CEUS) in the Detection of Muscle-Invasive Bladder Cancer: A Systematic Review and Diagnostic Meta-Analysis

Tufano,

Rosati,

Moriconi

et al. 2024

Current Oncology

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Background: Contrast-enhanced ultrasound (CEUS) is a diagnostic tool that is gaining popularity for its ability to improve overall diagnostic accuracy in bladder cancer (BC) staging. Our aim is to determine the cumulative diagnostic performance of CEUS in predicting preoperative muscle invasiveness using a comprehensive systematic review and pooled meta-analysis. Methods: A systematic review until October 2023 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Patients with BC suspicion were offered CEUS before the transurethral resection of the bladder tumor (TURBT). The diagnostic performance of CEUS was evaluated based on non-muscle-invasive bladder cancer (NMIBC) vs. muscle-invasive bladder cancer (MIBC) confirmed at the final histopathological examination after TURBT. The outcomes were determined through pooled sensitivity, specificity, pooled positive likelihood ratio (PLR+), negative likelihood ratio (PLR−), and area under the summary receiver operating characteristic (SROC) along with their respective 95% confidence intervals (CI). Results: Overall, five studies were included. In these studies, a total of 362 patients underwent CEUS prior to TURBT. The pooled sensitivity and specificity were 0.88 (95% CI: 0.81–0.93) and 0.88 (95% CI: 0.82–0.92), respectively. SROC curve depicted a diagnostic accuracy of 0.94 (95% CI: 0.81–0.98). The pooled PLR+ and PLR− were 7.3 (95% CI: 4.8–11.2) and 0.14 (95% CI: 0.08–0.23), respectively. Conclusions: Our meta-analysis indicates that CEUS is highly accurate in the diagnosis and staging for BC. Beyond its accuracy, CEUS offers the advantage of being a cost-effective, safe, and versatile imaging tool.

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Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer

Cited by 3 publications

References 27 publications

Role of multiparametric MRI in predicting muscle invasiveness in urinary bladder neoplasms with pathological correlations

Role of multiparametric MRI in predicting muscle invasiveness in urinary bladder neoplasms with pathological correlations

Microscopic Hematuria: A Classical Definition in a Modern Lab Era

Diagnostic Accuracy of Contrast-Enhanced Ultrasound (CEUS) in the Detection of Muscle-Invasive Bladder Cancer: A Systematic Review and Diagnostic Meta-Analysis

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