Diffusion-weighted MRI in bladder carcinoma: the differentiation between tumor recurrence and benign changes after resection

Wang, Huan-jun; Pui, Margaret H.; Guo, Yan; Yang, Dong; Pan, Bi-tao; Zhou, Xuhui

doi:10.1007/s00261-013-0038-0

Cited by 76 publications

(81 citation statements)

References 19 publications

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“…This is because several studies in different cancers suggest that DWI may, contrary to standard morphologic MRI, be potentially able to distinguish between residual tumor tissue and non-neoplastic residual changes (e.g., fibrosis) after therapy (8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2015

Clinical Cancer Research

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Purpose: To determine the value of diffusion-weighted MRI (DWI-MRI) for treatment response assessment in 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-avid lymphoma.Experimental Design: Patients with FDG-avid Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at pretherapeutic 18F-FDG-PET/CT, who had also undergone pretherapeutic whole-body DWI-MRI, were included in this prospective study. Depending on the histologic lymphoma subtype, patients received different systemic treatment regimens, and follow-up DWI-MRI and 18F-FDG-PET/CT were performed at one or more time points, depending on the clinical course. For each follow-up DWI-MRI, regionbased rates of agreement, and rates of agreement in terms of treatment response (complete remission, partial remission, stable disease, or progressive disease), relative to the corresponding 18F-FDG-PET/CT, were calculated.Results: Sixty-four patients were included: 10 with HL, 22 with aggressive NHL, and 32 with indolent NHL. The overall region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.4%. For the 51 interim examinations (performed after 1-3 therapy cycles), region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.2%, and for the 48 end-oftreatment examinations, agreement was 99.8%. No significant differences, in terms of region-based agreement between DWI-MRI and 18F-FDG-PET/CT, were observed between the three lymphoma groups (HL, aggressive NHL, indolent NHL; P ¼ 0.25), or between interim and end-of-treatment examinations (P ¼ 0.21). With regard to treatment response assessment, DWI-MRI agreed with 18F-FDG-PET/CT in 99 of 102 follow-up examinations (97.1%), with a k value of 0.94 (P < 0.0001).Conclusions: In patients with FDG-avid lymphoma, DWI-MRI may be a feasible alternative to 18F-FDG-PET/CT for follow-up and treatment response assessment. Clin Cancer Res; 21(11); 2506-13.Ó2015 AACR.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2015

Clinical Cancer Research

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“…Notably, several recent, smaller-sized studies suggest that DWI-MRI may-similar to 18F-FDG-PET/CT, and unlike standard morphologic MRI or CE-CT-possibly be able to distinguish between vital tumor tissue and residual changes (e.g., fibrosis) after therapy (13)(14)(15)(16)(17). The data that support the notion that DWI-MRI is comparable with 18F-FDG-PET/CT for lymphoma staging are, however, mainly based on patients with diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma, and/or a limited sample size (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2014

Clinical Cancer Research

102

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Purpose: To determine the value of diffusion-weighted MRI (DWI-MRI) for pretherapeutic imaging of fluorodeoxyglucose (FDG)-avid lymphoma and lymphoma with variable FDG avidity.Experimental Design: Treatment-na€ ve patients with lymphoma who were referred for whole-body staging were included in this prospective study. Group A included patients with FDG-avid lymphoma (e.g., Hodgkin, diffuse large B-cell, and follicular lymphoma), whereas Group B included patients with lymphoma of variable FDG avidity [e.g., extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)]. All patients underwent DWI-MRI and 18F-FDG-positron emission tomography/ computed tomography (PET/CT). Region-based sensitivity and agreement with Ann Arbor staging, relative to the reference standard, were calculated for DWI-MRI, and, in Group B, also 18F-FDG-PET/CT and contrast-enhanced (CE-) CT.Results: In Group A (100 patients), DWI-MRI had a region-based sensitivity of 97%, and with regard to staging, agreed with the reference standard in 94 of 100 patients (k, 0.92). In Group B (40 patients; 38 MALT lymphomas and 2 small lymphocytic lymphomas/chronic lymphocytic leukemias), DWI-MRI, 18F-FDG-PET/CT, and CE-CT had region-based sensitivities of 94.4%, 60.9%, and 70.7%, respectively. With regard to staging in Group B, DWI-MRI, 18F-FDG-PET/CT, and CE-CT agreed with the reference standard in 37 of 40, 26 of 40, and 24 of 40 patients, with k values of 0.89, 0.52, and 0.43, respectively.Conclusions: In patients with FDG-avid lymphoma, DWI-MRI seems to be only slightly inferior to 18F-FDG-PET/CT with regard to pretherapeutic regional assessment and staging. In patients with lymphoma subtypes that show a variable FDG avidity (e.g., MALT lymphoma), DWI-MRI seems to be superior to both 18F-FDG-PET/CT and CE-CT. Clin Cancer Res; 20(11); 2984-93. Ó2014 AACR.

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“…The successfully clinical application of DW-MRI is based on the principle that, through random and diffusion-driven displacement by water molecules, live tissue structures can be probed at a microscopic scale, which is beyond the imaging resolution of other methods [11]. In multiple previous studies, DW-MRI showed excellent performance in accurate characterization of lesions, and the results correlated with histological grading, clinical and pathological staging, differentiating tumour recurrence and guiding correct treatment decision in BC, and the staging accuracy was 96%, with a high diagnosis accuracy of 93.65% [9,[12][13][14][15]. Nevertheless, other studies showed that there is not enough evidence to suggest a high diagnostic performance of DW-MRI, especially in early and accurate detection of BC [16].…”

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confidence: 97%

Sensitivity and Specificity of Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Bladder Cancers

Zhai¹,

Wang²,

Zhu³

et al. 2015

CIM

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Purpose: Our study is designed to examine the diagnostic performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for bladder cancers (BC), and to determine whether DW-MRI can differentiate muscle invasive bladder cancer (MIBC) from non-MIBC (NMIBC).Methods: A meta-analysis was performed of published studies that investigated the performance of DW-MRI for BC. These studies were retrieved from scientific literature databases using sensitive electronic search strategies. The STATA 12.0 and Meta-disc software were employed for statistical analyses of data extracted from selected studies.Results: Our search initially returned 230 articles, of which 11 met the inclusion criteria and were enrolled into the final meta-analysis. Five of the included studies reported the diagnostic performance of DW-MRI for BC with a cumulative total of 243 BC patients and 82 healthy subjects. Eight studies investigated the diagnostic performance of DW-MRI for differentiating MIBC from NMIBC, involving 259 MIBC lesions and 515 NMIBC lesions. Meta-analysis results were as follows: the diagnostic performance of DW-MRI for Conclusion: DW-MRI has an outstanding diagnostic performance, with advanced sensitivity and specificity, for imaging of bladder cancers and for differentiating MIBC from NMIBC.

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Diffusion-weighted MRI in bladder carcinoma: the differentiation between tumor recurrence and benign changes after resection

Abstract: DWI is superior to DCE MRI for differentiating recurrent bladder tumors from postoperative inflammation or fibrosis. DWI can be included in the follow-up MRI protocol after bladder cancer surgery.

Cited by 76 publications

References 19 publications

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

Sensitivity and Specificity of Diffusion-Weighted Magnetic Resonance Imaging in Diagnosis of Bladder Cancers

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