Usefulness of Diffusion-Weighted MRI in Diagnosis of Upper Urinary Tract Cancer

Yoshida, Soichiro; Masuda, Hitoshi; Ishii, Chikako; Tanaka, Hiroshi; Fujii, Yasuhisa; Kawakami, Satoru; Kihara, Kazunori

doi:10.2214/ajr.10.4632

Cited by 42 publications

(21 citation statements)

References 23 publications

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“…Diffusion-weighted MRI, which quantifies the diffusion of water molecules in a non-invasive manner, is useful for not only diagnosing the presence of urothelial cancer, but also predicting pathological information, including histological grade and T stage. [40][41][42] Intriguingly, the degree of diffusion is closely associated with CRT sensitivity in MIBC, and is useful for predicting CRT response. 43 Diffusion-weighted Selective bladder preservation for MIBC MRI is also useful for monitoring CRT response 44 and potentially for monitoring recurrence of bladder cancer in bladder-preserved patients.…”

Section: Candidate Selection For Bladder Preservationmentioning

confidence: 99%

Selective bladder preservation with curative intent for muscle‐invasive bladder cancer: A contemporary review

Koga

Kihara

2012

Int J of Urology

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Abbreviations & Acronyms BIS = bladder-intact survival CIS = carcinoma in situ CR = complete response CRT = chemoradiotherapy CSS = cancer-specific survival FU = fluorouracil GasLESS = gasless laparoendoscopic single-port surgery GC = gemcitabine, cisplatin HD = hemodialysis IAC = intra-arterial chemotherapy IMRT = intensity-modulated radiation therapy LCRT = low-dose chemoradiotherapy MCV = methotrexate, cisplatin and vinblastine MIBC = muscle-invasive bladder cancer MRI = magnetic resonance imaging MVAC = methotrexate, vinblastine, adriamycin and cisplatin NA = not available NFkB = nuclear factor kB NMIBC = non-muscle-invasive bladder cancer OS = overall survival PC = partial cystectomy PLND = pelvic lymph node dissection QoL = quality of life RC = radical cystectomy RTOC = Radiation Therapy Oncology Group SPARE = Selective bladder Preservation Against Radical Excision TMDU = Tokyo Medical and Dental University TURBT = transurethral resection of bladder tumors Abstract: Radical cystectomy plus urinary diversion, the reference standard treatment for muscle-invasive bladder cancer, associates with high complication rates and compromises quality of life as a result of long-term effects on urinary, gastrointestinal and sexual function, and changes in body image. As a society ages, the number of elderly patients unfit for radical cystectomy as a result of comorbidity will increase, and thus the demand for bladder-sparing approaches for muscle-invasive bladder cancer will also inevitably increase. Trimodality bladder-sparing approaches consisting of transurethral resection, chemotherapy and radiotherapy (S55-65 Gy) yield overall survival rates comparable with those of radical cystectomy series (50-70% at 5 years), while preserving the native bladder in 40-60% of muscle-invasive bladder cancer patients, contributing to an improvement in quality of life for such patients. Limitations of the trimodality therapy include (i) muscle-invasive bladder cancer recurrence in the preserved bladder, which most often arises in the original muscle-invasive bladder cancer site; (ii) potential lack of curative intervention for regional lymph nodes; and (iii) increased morbidity in the event of salvage radical cystectomy for remaining or recurrent disease as a result of high-dose pelvic irradiation. Consolidative partial cystectomy with pelvic lymph node dissection followed by induction chemoradiotherapy at lower dose (e.g. 40 Gy) is a rational strategy for overcoming such limitations by strengthening locoregional control and reducing radiation dosage. Molecular profiling of the tumor and functional imaging might play important roles in optimal patient selection for bladder preservation. Refinement of radiation techniques, intensified concurrent or adjuvant chemotherapy, and novel sensitizers, including molecular targeting agent, are also expected to improve outcomes and consequently provide more muscle-invasive bladder cancer patients with favorable quality of life.

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Section: Candidate Selection For Bladder Preservationmentioning

confidence: 99%

Selective bladder preservation with curative intent for muscle‐invasive bladder cancer: A contemporary review

Koga

Kihara

2012

Int J of Urology

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“…Malignant tumours are characterized by active proliferation, enlarged nuclei, increased nuclear/cytoplasmic ratio, with ambiguous contour profiles in which many cells are tightly packed together with little extracellular space [31]. Consequently, malignant tumours exhibit high signal intensity by DW-MRI, attributed to their higher cellularity, increased extracellular tortuosity and tissue disorganization resulting in restricted water diffusion [35]. Yamada et al r e p o r t e d t h a t t h e a d d i t i o n diffusion-weighting to conventional MRI may not only improve the accuracy of detection BC, but also may aid in the prognosis of BC [36].…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and Specificity of Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Bladder Cancers

Zhai¹,

Wang²,

Zhu³

et al. 2015

CIM

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Purpose: Our study is designed to examine the diagnostic performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for bladder cancers (BC), and to determine whether DW-MRI can differentiate muscle invasive bladder cancer (MIBC) from non-MIBC (NMIBC).Methods: A meta-analysis was performed of published studies that investigated the performance of DW-MRI for BC. These studies were retrieved from scientific literature databases using sensitive electronic search strategies. The STATA 12.0 and Meta-disc software were employed for statistical analyses of data extracted from selected studies.Results: Our search initially returned 230 articles, of which 11 met the inclusion criteria and were enrolled into the final meta-analysis. Five of the included studies reported the diagnostic performance of DW-MRI for BC with a cumulative total of 243 BC patients and 82 healthy subjects. Eight studies investigated the diagnostic performance of DW-MRI for differentiating MIBC from NMIBC, involving 259 MIBC lesions and 515 NMIBC lesions. Meta-analysis results were as follows: the diagnostic performance of DW-MRI for Conclusion: DW-MRI has an outstanding diagnostic performance, with advanced sensitivity and specificity, for imaging of bladder cancers and for differentiating MIBC from NMIBC.

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“…The use of diffusion-weighted imaging (DWI) sequences associated with conventional T1-and T2-weighted sequences increases the accuracy and sensitivity of Uro-MRI. 10,11 conclusion Although rare, spontaneous rupture of renal pelvis secondary to ureteral obstruction caused by urothelial tumor may be suspected clinically, and the detailed radiological analysis of tomographic images and MRI-guided sequences, including Uro-MRI, is of great importance for both diagnosis and follow-up of these patients.…”

Section: Case Reportmentioning

confidence: 99%

Spontaneous rupture of renal pelvis secondary to ureteral obstruction by urothelial tumor

Fernandes

Palma

Kido

et al. 2014

Rev. Assoc. Med. Bras.

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Usefulness of Diffusion-Weighted MRI in Diagnosis of Upper Urinary Tract Cancer

Cited by 42 publications

References 23 publications

Selective bladder preservation with curative intent for muscle‐invasive bladder cancer: A contemporary review

Selective bladder preservation with curative intent for muscle‐invasive bladder cancer: A contemporary review

Sensitivity and Specificity of Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Bladder Cancers

Spontaneous rupture of renal pelvis secondary to ureteral obstruction by urothelial tumor

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