The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions

Objectives: To investigate the role of diffusion-weighted MRI (DWI) in the diagnosis of urinary bladder (UB) tumours by means of measuring apparent diffusion coefficient (ADC) values. Methods: A total of 83 people aged between 18 and 86 years were included in the study: 63 patients with UB pathology (46 malignant, 17 benign) constituted the case group; 20 individuals without any UB pathology constituted the control group. DWI was applied to all individuals. The ADC values were measured based on the tissue of the UB mass entities and normal UB wall in the control group. Results: The mean ADC value in the UB carcinoma group was significantly lower than that in the control group: 1.0684 +/- 0.26 x 10(-3) mm(2) s(-1) and 2.010 +/- 0.11 x 10(-3) mm(2) s(-1), respectively (p < 0.01). There was a significant difference among the mean ADC values of different grades of malignant tumours, corresponding to 0.9185 +/- 0.20 mm(2) s(-1) and 1.281 +/- 0.18 mm(2) s(-1) in high-grade and low-grade malignant UB carcinomas, respectively (p < 0.01). The ADC value in the carcinoma group was significantly lower than that in the benign lesion group: 1.0684 +/- 0.26 x 10(-3) mm(2) s(-1) and 1.803 +/- 0.19 x 10(-3) mm(2) s(-1), respectively (p < 0.01). All 46 malignant lesions displayed a restriction in diffusion; 4 of the 17 benign lesions displayed a mild restriction in diffusion. The sensitivity, specificity and accuracy of DWI in the diagnosis of malignant UB lesions was 100%, 76.5% and 93.65%, respectively. Conclusion: DWI can be beneficial in the differentiation of benign and malignant UB lesions, as well as of high-grade and low-grade UB carcinomas, using quantitative ADC measurements.