Dynamic MRI of Bladder Cancer: Evaluation of Staging Accuracy

Tekes, Aylin; Kamel, Ihab R.; Imam, Khursheed; Szarf, Gilberto; Schoenberg, Mark; Nasir, Khurram; Thompson, Richard E.; Bluemke, David A.

doi:10.2214/ajr.184.1.01840121

Cited by 240 publications

(154 citation statements)

References 28 publications

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“…38 According to Tekes et al, gadolinium-enhanced MRI has an accuracy of 85% in differentiating noninvasive versus invasive disease and was 82% accurate in differentiating organ-confined from nonorgan-confined disease. 39 Overstaging can be a problem with MRI, however, because of acute edema and hyperemia after recent biopsy or resection, as both may give the appearance of tumor spread. 38 Continued advances in MRI may help to further improve staging in the future.…”

Section: Cystoscopymentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

300

275

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Bladder cancer is the fourth most common cancer and ranks eighth as a cause of death from cancer among men in the United States. Although guidelines assist in treatment, the art of managing bladder cancer, such as the decision to use neoadjuvant chemotherapy and the timing of cystectomy, is still variable. Bladder cancer has a propensity to recur, and with recurrence, a significant number of cases progress, which makes the early detection of high-risk patients imperative. Advances in detection, surveillance, and treatment of bladder cancer are reviewed in this article.

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Section: Cystoscopymentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

300

275

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“…DCE-MRI has been shown to significantly improve tissue characterization, and both the dynamic parameters of the contrast enhancement (e.g., onset time, rate of enhancement, etc.) and the pharmacokinetic modeling parameters have been used to differentiate between cancer and normal tissue in the breast (5), bladder (6), and bone (7). DCE-MRI has been quite successful in diagnosing and staging prostate cancer in the peripheral zone (PZ) (8 -12); however, there appears to be some overlap in the enhancement patterns between the tumor and the transitional zone (10).…”

mentioning

confidence: 99%

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Kozłowski

Chang

Jones

et al. 2006

Magnetic Resonance Imaging

245

192

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Purpose:To determine whether the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI provides higher diagnostic sensitivity for prostate cancer than each technique alone. Materials and Methods:Fourteen patients with a clinical suspicion of prostate cancer underwent endorectal MRI on a 1.5T scanner prior to transrectal ultrasound (TRUS)-guided biopsies. The average values of the apparent diffusion coefficient (ADC, calculated from b-values of 0 and 600), K trans , v e , maximum gadolinium (Gd) concentration, onset time, mean gradient, and maximum enhancement were determined. Correlation with histology was based on biopsy (six patients) and prostatectomy specimen (eight patients) results. The Tukey-Kramer test was used for statistical analysis. Results:The average values of all MRI parameters, except v e and maximum Gd concentration, showed significant differences between tumor and normal prostate. The sensitivity and specificity values were respectively 54% (35-72%) and 100% (95-100%) for the ADC data, and 59% (39 -77%) and 74% (63-83%) for the DCE data. When both ADC and DCE results were combined, the sensitivity increased to 87% (68 -95%) and specificity decreased to 74% (62-83%). Conclusion:All but two DW-and DCE-MRI parameters showed significant differences between tumor and normal prostate. Combining both techniques provides better sensitivity, with a small decrease in specificity.

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“…It improved up to 66% when differentiating between NMIBT and MIBT ( Table 2). Tekes et al [13] reported overstaging as the most common error in 32% with an overall accuracy at 62%. Their results also improved, up to 85%, when differentiating between NMIBT and MIBT.…”

Section: Discussionmentioning

confidence: 99%

“…In a study by Tekes et al [13] evaluating the ability of MRI in staging bladder tumors without DWI, but with enhanced and unenhanced sequences, the agreement among reviewers was good (kappa = 0.80) and accuracy in differentiating between invasive and non-invasive was 82% -85%. Takeuchi et al [14] used dynamic contrast sequences along with T2W and DWI, and reported an accuracy of 88% for T2W plus DWI.…”

Section: Discussionmentioning

confidence: 99%

“…has radiation injuries, infection or in other ways is not able to undergo cystoscopy. Several studies [6]- [12] have shown that diffusion-weighted images (DWI) may be used to detect bladder tumors, and studies regarding staging [13] [14] show promising results. Most of these studies are retrospective, use supplementary dynamic contrast series or have a population of patients with high-stage tumors [6] [8] [15].…”

Section: Introductionmentioning

confidence: 99%

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MRI of the Bladder in Patients Suspected of Bladder Tumors

Gandrup¹,

Nordling²,

Thomsen³

2014

OJRad

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Objective: To prospectively evaluate the use of MRI for the detecting of bladder tumors and the Tstage using T2W, T1W and diffusion-weighted images (DWI). Material and methods: Twenty-eight consecutive patients (21 men, 7 women; age range, 20 -82 years; mean age, 62.8 years) suspected of bladder tumors underwent MRI, flexible cystoscopy and transurethral resection (TURB). The presence of bladder tumor was confirmed by histopathology in 21 patients; 18 patients had pTa, one pT1 and two pT2. The images were reviewed by two uroradiologists. They assigned the presence of a bladder tumor and whether the tumor was non-muscle invasive (Ta and T1) or muscleinvasive (T2, T3 or T4). Results: Compared to the histopathological results, the accuracy for identifying a bladder tumor was 60.7% and 53.7% for reviewer A and B, respectively. The sensitivity and specificity were 66.7%/61.9% and 57.1%/42.9%. Positive predictive values were 82.6%/ 76.5%. The overall staging was correct in 47.6%/52.5%, but improved on stage-by-stage up to 50%/66.7%. The agreement between the reviewers was moderate in the detecting, staging and location of the tumor (Kappa = 0.47 -0.57). Conclusion: A simple MRI using no contrast media, but DWI, cannot replace flexible cystoscopy in the detection of new or recurrent bladder tumors.

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Dynamic MRI of Bladder Cancer: Evaluation of Staging Accuracy

Abstract: MRI shows good reproducibility between reviewers for staging bladder cancer. Although overall staging accuracy was only moderate, the accuracy for differentiating superficial versus invasive disease and organ-confined versus non-organ-confined disease was high.

Cited by 240 publications

References 28 publications

Bladder Cancer in 2010: How Far have We Come?

Bladder Cancer in 2010: How Far have We Come?

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

MRI of the Bladder in Patients Suspected of Bladder Tumors

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