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Muscle-invasive bladder cancer: pretreatment prediction of response to neoadjuvant chemotherapy with diffusion-weighted MR imaging

  • Special Section: Male pelvis
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Abstract

Purpose

To investigate the usefulness of diffusion-weighted MR imaging with ADC value and histogram analysis of ADC in the prediction of response to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC).

Methods

Fifty-eight consecutive patients with clinical T2-4aN0M0 MIBC who underwent MRI before and after NAC were enrolled in the prospective study. The evaluation of response to NAC was based on the pathologic T (pT) stage after surgery. Patients with non-muscle-invasive residual cancer (pTa, pTis, pT1) were defined as responders, while those with muscle-invasive residual cancer (≥ pT2) were defined as non-responders. The ADC value measured from a single-section region of interest and ADC histogram parameters derived from whole-tumor volume of interest in responder and non-responder were compared using the Mann–Whitney U test or independent samples t test. ROC curve analysis was used to evaluate the diagnostic performance of ADC value and ADC histogram parameters in predicting the response to NAC.

Results

The pretreatment ADC value of responders ([1.33 (± 0.21)] × 10−3mm2/s) was significantly higher than that of non-responders ([1.09 (± 0.08)] × 10−3mm2/s) (P < .001). Most of the pretreatment ADC histogram parameters (Mean, 10th, 25th, 50th, 75th, and 90th percentiles) of responders were significantly higher than that of non-responders (P < .001). The AUC was highest for the pretreatment ADC value (0.88; 95% confidence interval: 0.77, 0.95; P < .001).

Conclusion

Diffusion-weighted MR imaging with ADC value and histogram analysis of ADC are useful to predict NAC response in patients with MIBC.

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Funding

This work was supported by the Special Scientific Research Projects of Beijing Science and Technology Project (Grant Number Z181100001718089). The funding source is not involved in study design, data collection, analysis and interpretation, report writing, or the decision to submit articles for publication.

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 7 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China

    Xinxin Zhang, Yichen Wang, Jin Zhang, Xiaojuan Xu, Lianyu Zhang & Yan Chen

  2. Division of Life Sciences and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, People’s Republic of China

    Miaomiao Zhang

  3. GE Healthcare, MR Research China, Beijing, 100176, China

    Lizhi Xie

  4. Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Jianzhong Shou

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  1. Xinxin Zhang
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  2. Yichen Wang
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  3. Jin Zhang
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  9. Yan Chen
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Correspondence to Yan Chen.

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Conflict of interest

One of the authors of this manuscript (Li-zhi Xie) is an employee of GE Healthcare. The remaining authors 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 approval was granted by the Ethics Committee of Cancer Hospital, Chinese Academy of Medical Sciences. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Zhang, X., Wang, Y., Zhang, J. et al. Muscle-invasive bladder cancer: pretreatment prediction of response to neoadjuvant chemotherapy with diffusion-weighted MR imaging. Abdom Radiol 47, 2148–2157 (2022). https://doi.org/10.1007/s00261-022-03455-y

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  • DOI: https://doi.org/10.1007/s00261-022-03455-y

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