Preoperative T Staging of Urinary Bladder Cancer: Does Diffusion-Weighted MRI Have Supplementary Value?

被引:82
作者
Watanabe, Haruo [1 ]
Kanematsu, Masayuki [1 ,2 ,3 ]
Kondo, Hiroshi [1 ]
Goshima, Satoshi [1 ]
Tsuge, Yusuke [1 ]
Onozuka, Minoru [4 ]
Moriyama, Noriyuki [5 ]
机构
[1] Gifu Univ Hosp, Dept Radiol, Gifu 5011194, Japan
[2] Gifu Univ Hosp, High Level Imaging Diag Ctr, Gifu 5011194, Japan
[3] Kanagawa Dent Coll, Res Ctr Brain & Oral Sci, Yokosuka, Kanagawa 238, Japan
[4] Kanagawa Dent Coll, Dept Physiol & Neurosci, Yokosuka, Kanagawa 238, Japan
[5] Natl Canc Ctr Hosp, Res Ctr Canc Prevent & Screening, Tsukiji, Japan
关键词
diffusion-weighted imaging; MRI; urinary bladder cancer; CARCINOMA; TUMOR; DIFFERENTIATION; NEOPLASMS; LESIONS; ECHO;
D O I
10.2214/AJR.08.1430
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The objective of our study was to evaluate whether diffusion-weighted MRI has supplementary value in the preoperative T staging of urinary bladder cancer. MATERIALS AND METHODS. Nineteen consecutive patients (18 men and one woman; age range, 55-83 years; mean, 71 years) known to have or suspected of having urinary bladder cancer underwent MRI at our institution. Urinary bladder cancer was pathologically proven in 18 patients. The pathologic stages were T1 in 14 patients, T2 in two, T3 in one, and T4 in one. Three separate MR image sets were retrospectively reviewed by two independent radiologists: unenhanced T1-weighted images (TR/TE, 607/10) and T2-weighted images (TR eff/TE eff, 4,415/100); unenhanced T1-weighted, T2-weighted, and gadolinium-enhanced images (TR/TE, 10/4.2); and unenhanced T1-weighted, T2-weighted, and diffusion-weighted images (TR (eff)/TEeff, 2,191/69; b factor, 1,000 s/mm(2)). The radiologists, who were blinded to the pathology findings, assigned T stages and confidence levels for tumors of stage T2 or greater. We used pathologic stages documented in the official pathologic reports as the standard of reference. Observer performance was tested using Spearman's rank correlation, the McNemar test, and receiver operating characteristic (ROC) curve analysis. RESULTS. The correlation between the radiologic and pathologic stages was greater with the diffusion sequence (rho = 0.66) than with the unenhanced (0.62) or gadolinium-enhanced (0.62) sequence (p = 0.34). The sensitivity, specificity, accuracy, and area under the ROC curve for tumors of stage T2 or greater were 80%, 79%, 79%, and 0.71 for the unenhanced sequence; 80%, 79%, 79%, and 0.77 for the gadolinium sequence; and 40%, 93%, 79%, and 0.56 for the diffusion-weighted sequence, respectively (p > 0.05). CONCLUSION. Our results suggest that diffusion-weighted MRI might have high specificity for the detection of invasive urinary bladder tumors. Patients with suspected urinary bladder carcinomas may well be evaluated by MRI including diffusion-weighted imaging for better preoperative T staging.
引用
收藏
页码:1361 / 1366
页数:6
相关论文
共 24 条
  • [1] THE ROLE OF MR IMAGING IN CARCINOMA OF THE URINARY-BLADDER
    BARENTSZ, JO
    RUIJS, SHJ
    STRIJK, SP
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 1993, 160 (05) : 937 - 947
  • [2] Staging urinary bladder cancer after transurethral biopsy: Value of fast dynamic contrast-enhanced MR imaging
    Barentsz, JO
    Jager, GJ
    vanVierzen, PBJ
    Witjes, JA
    Strijk, SP
    Peters, H
    Karssemeijer, N
    Ruijs, SHJ
    [J]. RADIOLOGY, 1996, 201 (01) : 185 - 193
  • [3] STAGING URINARY-BLADDER CANCER - VALUE OF T1-WEIGHTED 3-DIMENSIONAL MAGNETIZATION PREPARED-RAPID GRADIENT-ECHO AND 2-DIMENSIONAL SPIN-ECHO SEQUENCES
    BARENTSZ, JO
    JAGER, G
    MUGLER, JP
    OOSTERHOF, G
    PETERS, H
    VANERNING, LTJO
    RUIJS, SHJ
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 1995, 164 (01) : 109 - 115
  • [4] MR STAGING OF BLADDER-CARCINOMA - CORRELATION WITH PATHOLOGIC FINDINGS
    BUY, JN
    MOSS, AA
    GUINET, C
    GHOSSAIN, MA
    MALBEC, L
    ARRIVE, L
    VADROT, D
    [J]. RADIOLOGY, 1988, 169 (03) : 695 - 700
  • [5] Diffusion-weighted MR imaging in diagnosis of superficial and invasive urinary bladder carcinoma: A preliminary prospective study
    El-Assmy, Ahmed
    Abou-El-Ghar, Mohamed E.
    Refaie, Huda F.
    El-Diasty, Tarek
    [J]. THESCIENTIFICWORLDJOURNAL, 2008, 8 : 364 - 370
  • [6] Diffusion-weighted MR imaging with a single-shot echoplanar sequence: Detection and characterization of focal hepatic lesions
    Ichikawa, T
    Haradome, H
    Hachiya, J
    Nitatori, T
    Araki, T
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 1998, 170 (02) : 397 - 402
  • [7] BLADDER-TUMOR STAGING - COMPARISON OF CONTRAST-ENHANCED CT, T1-WEIGHTED AND T2-WEIGHTED MR-IMAGING, DYNAMIC GADOLINIUM-ENHANCED IMAGING, AND LATE GADOLINIUM-ENHANCED IMAGING
    KIM, BH
    SEMELKA, RC
    ASCHER, SM
    CHALPIN, DB
    CARROLL, PR
    HRICAK, H
    [J]. RADIOLOGY, 1994, 193 (01) : 239 - 245
  • [8] Diffusion-weighted single-shot echoplanar MR imaging for liver disease
    Kim, T
    Murakami, T
    Takahashi, S
    Hori, M
    Tsuda, K
    Nakamura, H
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 1999, 173 (02) : 393 - 398
  • [9] Imaging in oncology from the University of Texas M. D. Anderson Cancer Center - Imaging in the diagnosis, staging, and follow-up of cancer of the urinary bladder
    Kundra, V
    Silverman, PM
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 2003, 180 (04) : 1045 - 1054
  • [10] Diffusion-weighted MR imaging for urinary bladder carcinoma: initial results
    Matsuki, Mitsuru
    Inada, Yuki
    Tatsugami, Fuminari
    Tanikake, Masato
    Narabayashi, Isamu
    Katsuoka, Yoji
    [J]. EUROPEAN RADIOLOGY, 2007, 17 (01) : 201 - 204