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Non-contrast magnetic resonance imaging for bladder cancer: fused high b value diffusion-weighted imaging and T2-weighted imaging helps evaluate depth of invasion

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Abstract

Objects

To investigate the utility of fused high b value diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) for evaluating depth of invasion in bladder cancer.

Methods

We included 62 patients with magnetic resonance imaging (MRI) and surgically confirmed urothelial carcinoma in the urinary bladder. An experienced genitourinary radiologist analysed the depth of invasion (T stage <2 or ≥2) using T2WI, DWI, T2WI plus DWI, and fused DWI and T2WI (fusion MRI). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were investigated. Area under the curve (AUC) was analysed to identify T stage ≥2.

Results

The rate of patients with surgically confirmed T stage ≥2 was 41.9% (26/62). Sensitivity, specificity, PPV, NPV and accuracy were 50.0%, 55.6%, 44.8%, 60.6% and 53.2%, respectively, with T2WI; 57.7%, 77.8%, 65.2%, 71.8% and 69.4%, respectively, with DWI; 65.4%, 80.6%, 70.8%, 76.3% and 74.2%, respectively, with T2WI plus DWI and 80.8%, 77.8%, 72.4%, 84.9% and 79.0%, respectively, with fusion MRI. AUC was 0.528 with T2WI, 0.677 with DWI, 0.730 with T2WI plus DWI and 0.793 with fusion MRI for T stage ≥2.

Conclusion

Fused high b value DWI and T2WI may be a promising non-contrast MRI technique for assessing depth of invasion in bladder cancer.

Key Points

• Accuracy of fusion MRI was 79.0% for T stage ≥2 in bladder cancer.

• AUC of fusion MRI was 0.793 for T stage ≥2 in bladder cancer.

• Diagnostic performance of fusion MRI was comparable with T2WI plus DWI.

• As a non-contrast MRI technique, fusion MRI is useful for bladder cancer.

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Abbreviations

AUC:

area under the curve

CI:

confidence interval

DCE:

dynamic contrast-enhanced

DWI:

diffusion-weighted imaging

MRI:

magnetic resonance imaging

NPV:

negative predictive value

PPV:

positive predictive value

ROC:

receiver operating-characteristic

TE:

echo time

TR:

repetition time

TURB:

transurethral resection of the bladder

T2WI:

T2-weighted imaging

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Authors and Affiliations

  1. Department of Radiology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Minsu Lee, Young Taik Oh, Dae Chul Jung & Sung Yoon Park

  2. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

    Su-Jin Shin & Nam Hoon Cho

  3. Department of Urology, Yonsei University College of Medicine, Seoul, Korea

    Young Deuk Choi

  4. Department of Pathology, Hanyang University College of Medicine, Seoul, Korea

    Su-Jin Shin

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  1. Minsu Lee
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  2. Su-Jin Shin
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Correspondence to Sung Yoon Park.

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The scientific guarantor of this publication is Sung Yoon Park.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Institutional review board approval was obtained.

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Written informed consent was waived by the institutional review board.

Methodology

• retrospective

• cross sectional study

• performed at one institution

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Lee, M., Shin, SJ., Oh, Y.T. et al. Non-contrast magnetic resonance imaging for bladder cancer: fused high b value diffusion-weighted imaging and T2-weighted imaging helps evaluate depth of invasion. Eur Radiol 27, 3752–3758 (2017). https://doi.org/10.1007/s00330-017-4759-2

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  • DOI: https://doi.org/10.1007/s00330-017-4759-2

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