scholarly journals Diagnostic performance of 3-tesla multiparametric MRI for assessment of the bladder cancer T stage and histologic grade

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Badawy ◽  
Hashim Farg ◽  
Basma Gadelhak ◽  
Mohamed Abou ElGhar ◽  
Ahmed Galal Sadeq ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Diagnostic Accuracy ◽  
Preoperative Staging ◽  
Multiparametric Mri ◽  
Histologic Grade ◽  
Mri Findings ◽  
Dce Mri ◽  
Tnm System ◽  
T Stage

Abstract Background Preoperative staging of urinary bladder carcinomas using TNM system is crucial in the management of bladder cancer which is determined mainly by stage and grade of tumor at diagnosis. We aim to evaluate the diagnostic accuracy of multiparametric MRI (mp-MRI) for assessment of the bladder cancer T stage and histologic grade. Results The overall T2-WI diagnostic accuracy for the T stage was 72.3%, increased to be 87.1% for contrast-enhanced images, and 92.6% for DWI, reaching the maximum accuracy 94.5% using the combined multi-parametric MRI technique. Diagnostic accuracies of mp-MRI in differentiating superficial from muscle-invasive (91%) and organ-confined from non-organ confined tumors (92%) were superior to DW-MRI (89% and 87%), DCE-MRI (84% and 83%), and T2W-MRI (74% and 71%), respectively. The agreement between MRI findings and histopathological staging was greater in mp-MRI (k = 0.91; excellent agreement) than in DW-MRI (k = 0.77; moderate agreement), DCE-MRI (k = 0.76; substantial agreement), and T2W-MRI (k = 0.53; fair agreement). Conclusion Mp-MRI provides useful information for evaluating the local T stages of bladder cancer and can predict the histological grades of urinary bladder cancers with high diagnostic accuracy.

Urinary Bladder Cancer: Diffusion-weighted MR Imaging—Accuracy for Diagnosing T Stage and Estimating Histologic Grade

Radiology ◽  
2009 ◽  
Vol 251 (1) ◽  
pp. 112-121 ◽  
Author(s):  
Mitsuru Takeuchi ◽  
Shigeru Sasaki ◽  
Masato Ito ◽  
Shinsuke Okada ◽  
Satoru Takahashi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Mr Imaging ◽  
Urinary Bladder Cancer ◽  
Histologic Grade ◽  
T Stage ◽  
Diffusion Weighted

scholarly journals Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Daly Avendano ◽  
Maria Adele Marino ◽  
Doris Leithner ◽  
Sunitha Thakur ◽  
Blanca Bernard-Davila ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curves ◽  
Breast Cancer Diagnosis ◽  
Breast Lesions ◽  
Mri Findings ◽  
Adc Value ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Mass Enhancement

Abstract Background Available data proving the value of DWI for breast cancer diagnosis is mainly for enhancing masses; DWI may be less sensitive and specific in non-mass enhancement (NME) lesions. The objective of this study was to assess the diagnostic accuracy of DWI using different ROI measurement approaches and ADC metrics in breast lesions presenting as NME lesions on dynamic contrast-enhanced (DCE) MRI. Methods In this retrospective study, 95 patients who underwent multiparametric MRI with DCE and DWI from September 2007 to July 2013 and who were diagnosed with a suspicious NME (BI-RADS 4/5) were included. Twenty-nine patients were excluded for lesion non-visibility on DWI (n = 24: 12 benign and 12 malignant) and poor DWI quality (n = 5: 1 benign and 4 malignant). Two readers independently assessed DWI and DCE-MRI findings in two separate randomized readings using different ADC metrics and ROI approaches. NME lesions were classified as either benign (> 1.3 × 10−3 mm2/s) or malignant (≤ 1.3 × 10−3 mm2/s). Histopathology was the standard of reference. ROC curves were plotted, and AUCs were determined. Concordance correlation coefficient (CCC) was measured. Results There were 39 malignant (59%) and 27 benign (41%) lesions in 66 (65 women, 1 man) patients (mean age, 51.8 years). The mean ADC value of the darkest part of the tumor (Dptu) achieved the highest diagnostic accuracy, with AUCs of up to 0.71. Inter-reader agreement was highest with Dptu ADC max (CCC 0.42) and lowest with the point tumor (Ptu) ADC min (CCC = − 0.01). Intra-reader agreement was highest with Wtu ADC mean (CCC = 0.44 for reader 1, 0.41 for reader 2), but this was not associated with the highest diagnostic accuracy. Conclusions Diagnostic accuracy of DWI with ADC mapping is limited in NME lesions. Thirty-one percent of lesions presenting as NME on DCE-MRI could not be evaluated with DWI, and therefore, DCE-MRI remains indispensable. Best results were achieved using Dptu 2D ROI measurement and ADC mean.

scholarly journals Assessment of DCE Utility for PCa Diagnosis Using PI-RADS v2.1: Effects on Diagnostic Accuracy and Reproducibility

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 164 ◽  
Author(s):  
Valentina Brancato ◽  
Giuseppe Di Costanzo ◽  
Luca Basso ◽  
Liberatore Tramontano ◽  
Marta Puglia ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Multiparametric Mri ◽  
Added Value ◽  
Operating Characteristics ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Controversial Topic ◽  
Clinically Significant ◽  
Method Agreement

The role of dynamic contrast-enhanced-MRI (DCE-MRI) for Prostate Imaging-Reporting and Data System (PI-RADS) scoring is a controversial topic. In this retrospective study, we aimed to measure the added value of DCE-MRI in combination with T2-weighted (T2W) and diffusion-weighted imaging (DWI) using PI-RADS v2.1, in terms of reproducibility and diagnostic accuracy, for detection of prostate cancer (PCa) and clinically significant PCa (CS-PCa, for Gleason Score ≥ 7). 117 lesions in 111 patients were identified as suspicion by multiparametric MRI (mpMRI) and addressed for biopsy. Three experienced readers independently assessed PI-RADS score, first using biparametric MRI (bpMRI, including DWI and T2W), and then multiparametric MRI (also including DCE). The inter-rater and inter-method agreement (bpMRI- vs. mpMRI-based scores) were assessed by Cohen’s kappa (κ). Receiver operating characteristics (ROC) analysis was performed to evaluate the diagnostic accuracy for PCa and CS-PCa detection among the two scores. Inter-rater agreement was excellent for the three pairs of readers (κ ≥ 0.83), while the inter-method agreement was good (κ ≥ 0.73). Areas under the ROC curve (AUC) showed similar high-values (0.8 ≤ AUC ≤ 0.85). The reproducibility of PI-RADS v2.1 scoring was comparable and high among readers, without relevant differences, depending on the MRI protocol used. The inclusion of DCE did not influence the diagnostic accuracy.

Utility of first order MRI-Texture analysis parameters in the prediction of histologic grade and muscle invasion in urinary bladder cancer: a preliminary study

2021 ◽  
pp. 20201114
Author(s):  
Abdul Razik ◽  
Chandan J Das ◽  
Raju Sharma ◽  
Sundeep Malla ◽  
Sanjay Sharma ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Texture Analysis ◽  
Urinary Bladder Cancer ◽  
Histologic Grade ◽  
Low Grade ◽  
High Grade ◽  
First Order ◽  
Muscle Invasive ◽  
Muscle Invasion

Objective: To explore the utility of first-order MRI-texture analysis (TA) parameters in predicting histologic grade and muscle invasion in urinary bladder cancer (UBC). Methods: After ethical clearance, 40 patients with UBC, who were imaged on a 3.0-Tesla scanner, were retrospectively included. Using the TexRADTM platform, two readers placed freehand ROI on the sections demonstrating the largest dimension of the tumor, evaluating only one tumor per patient. Interobserver reproducibility was assessed using the intraclass correlation coefficient (ICC). Mann–Whitney U test and ROC curve analysis were used to identify statistical significance and select parameters with high class separation capacity (AUC >0.8), respectively. Pearson’s test was used to identify redundancy in the results. Results: All texture parameters showed excellent ICC. The best parameters in differentiating high and low-grade tumors were mean/ mean of positive pixels (MPP) at SSF 0 (AUC: 0.897) and kurtosis at SSF 5 (AUC: 0.828) on the ADC images. In differentiating muscle invasive from non-muscle invasive tumors, mean/ MPP at SSF 0 on the ADC images showed AUC >0.8; however, this finding resulted from the confounding effect of high-grade histology on the ADC values of muscle invasive tumors. Conclusion: MRI-TA generated few parameters which were reproducible and useful in predicting histologic grade. No independent parameters predicted muscle invasion. Advances in knowledge: There is lacuna in the literature concerning the role of MRI-TA in the prediction of histologic grade and muscle invasion in UBC. Our study generated a few first-order parameters which were useful in predicting high-grade histology.

Role of diffusion weighted magnetic resonance imaging in assessment of urinary bladder cancer

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Mohamed S Al Thqaby ◽  
Sherif H Abu-Gamrah ◽  
Ayman M Ibrahem ◽  
Ahmed M Hussein ◽  
Mohamed Elazab
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Pathological Examination ◽  
Low Grade ◽  
Bladder Tumors ◽  
T Stage ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
The Mean

Abstract Purpose The aim of this work is to ellucidate the role of diffusion-weighted imaging in T-stage of bladder cancer, to find correlation between the apparent diffusion coefficient (ADC) and histologic grade and to detect early tumor recurrence. Materials and Methods In this retrospective study, 34 patients were gathered, 28 men and 6 women, with ages ranging from 46 to 90 years, presented with gross hematuria or suspected of urinary bladder tumors detected on U/S and/or CT examinations. The patients were referred to Radiology department at national cancer institute for MRI examination after fulfilling inclusion and exclusion criteria. The urinary bladder tumors were classified in accordance with TNM classification from the American Joint Committee on Cancer into: T1 or lower, T2 (T2a or T2b), T3 (T3a or T3b), and T4.The mean ADC value of patients with low grade tumor (G1) and patients with high grade tumor (G2 or G3) was done The results were compared with histo-pathological examination obtained by transurethral resection (TUR) or after radical cystectomy. Results The overall accuracy of T stage diagnosis was 74.29% for T2-weighted images, 88.57 % for DW images, 80 % for contrast-enhanced images, and about 88.57 % for T2 plus DWIs. The mean ADC of G3 tumors was significantly lower than that of G1 and G2 tumors. Conclusion Our results suggest that adding DWIs to T2WIs lead to marked improvement regarding the accuracy for differentiating T2 or lower tumors from T3 and higher tumors, helping to limit the usage of contrast enhanced MRI imaging as a noninvasive diagnostic tool.

Update on multiparametric MRI of urinary bladder cancer

2018 ◽  
Vol 48 (4) ◽  
pp. 882-896 ◽  
Author(s):  
Christian B. van der Pol ◽  
Andrew Chung ◽  
Christopher Lim ◽  
Niket Gandhi ◽  
Wendy Tu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Bladder ◽  
Urinary Bladder Cancer ◽  
Multiparametric Mri
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