Huanjun Wang MD, Presenter: Nothing to Disclose

Yan Guo MD, Abstract Co-Author: Nothing to Disclose

Shurong Li, Abstract Co-Author: Nothing to Disclose

Jian Guan MD, Abstract Co-Author: Nothing to Disclose

Xiaoling Zhang, Abstract Co-Author: Nothing to Disclose

Mingjuan Liu MMEd, Abstract Co-Author: Nothing to Disclose

To determine an optimal multi-parametric MRI protocol for preoperative staging of bladder urothelial carcinoma.

The study was approved by the institutional ethics committee and informed consent was obtained from all patients. Enrollment requirement: patients with suspected or confirmed urothelial bladder cancer and no renal function impairment. Exclusion criteria: patients without histopathologic confirmation and tumors smaller than 1cm. Thirty-nine patients underwent conventional, diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI within one week before surgery. Three image sets of T2WI & DW-MRI, T2WI & DCE-MRI, and T2WI & DCE-MRI & DW-MRI were independently interpreted by two readers at 2-week intervals. Diagnostic efficacy of detrusor muscle invasion by cancer was compared among the three image sets. The apparent diffused coefficient (ADC) values were correlated with histopathologic grading. 

54 urothelial carcinomas (36 T1, 13 T2, 1 T3 and 4 T4 stages) in 33 patients were analyzed. Receiver operating characteristic (ROC) curves were plotted for both readers to compare the diagnostic efficacy of the three image sets for detrusor muscle invasion and the area under the ROC curve were compared using Bonferroni test. The ADC values of 11 high-grade carcinomas were significantly lower than those of 20 low-grade carcinomas. Using the cutoff ADC value of 0.899 x10-3 mm2/s, the sensitivity and specificity for differentiating high- and low-grade bladder urothelial carcinoma were 100% and 95%, respectively. 

Multi-parametric MRI with T2WI, DW-MRI and DCE-MRI is the optimal imaging protocol for preoperative staging of bladder urothelial carcinoma. The ADC of low-grade tumor is significantly higher than that of high-grade bladder malignancy with 100% sensitivity and 95% specificity at cutoff ADC value of 0.899 mm2/s.

Mlti-parametric MRI with T2WI, DW-MRI and DCE-MRI is the optimal imaging protocol for preoperative staging of urothelial bladder cancer. The ADC of low-grade tumor is significantly higher than that of high-grade bladder malignancy.

Wang, H, Guo, Y, Li, S, Guan, J, Zhang, X, Liu, M, Multi-parametric MRI Staging of Bladder Urothelial Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009181.html