Preoperative T Staging of Urinary Bladder Cancer: Efficacy of Stalk Detection and Diagnostic Performance of Diffusion-weighted Imaging at 3T

Ohgiya, Yoshimitsu; Suyama, Jumpei; S, Sai; Kawahara, Mutsuto; Takeyama, Nobuyuki; Ohike, Nobuyuki; Sasamori, Hiroto; Munechika, Jiro; Saiki, Makoto; Onoda, Yui; Hirose, Masahiro; Gokan, Takehiko

doi:10.2463/mrms.2013-0104

Cited by 32 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, functional imaging has been introduced into the diagnosis of bladder cancer, including DWI MR imaging. Several studies (6,10,11,(17)(18)(19)21) have had a wide range of partially conflicting results for DWI MR imaging in differentiating T1 or lower tumors from T2 or higher tumors. This motivated researchers to perform a recently published meta-analysis (33), which included eight studies published before September 2014 in English or Chinese.…”

Section: Evidence-based Practice: Diagnostic Value Of Mr Imaging In Dmentioning

confidence: 99%

See 1 more Smart Citation

The Diagnostic Value of MR Imaging in Differentiating T Staging of Bladder Cancer: A Meta-Analysis

et al. 2018

View full text Add to dashboard Cite

Purpose To assess the diagnostic accuracy of magnetic resonance (MR) imaging for differentiating stage T1 or lower tumors from stage T2 or higher tumors and to analyze the influence of different imaging protocols in patients with bladder cancer. Materials and Methods A systematic literature search for original diagnostic studies was performed in PubMed, Medline, the Cochrane Library, and Web of Science. The methodologic quality of each study was evaluated by two independent reviewers who used the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data necessary to complete 2 × 2 tables were obtained, and patient, study, and imaging characteristics were extracted. Statistical analysis included data pooling, heterogeneity testing, sensitivity analyses, and forest plot construction. Results Seventeen studies (1449 patients with bladder cancer) could be analyzed. The pooled sensitivity and specificity of MR imaging were 0.90 (95% confidence interval [CI]: 0.83, 0.94) and 0.88 (95% CI: 0.77, 0.94), respectively, for differentiating tumors staged T1 or lower from those staged T2 or higher. Diffusion-weighted imaging and use of higher field strengths (3 T) improved sensitivity (0.92; 95% CI: 0.86, 0.96) and specificity (0.96; 95% CI: 0.93, 0.98). Conclusion This meta-analysis demonstrated high diagnostic performance of MR imaging for differentiating T1 or lower tumors from T2 or higher tumors in patients with bladder cancer. Higher field strength (3 T) and the use of diffusion-weighted imaging can slightly help improve sensitivity and specificity. RSNA, 2017.

show abstract

Section: Evidence-based Practice: Diagnostic Value Of Mr Imaging In Dmentioning

confidence: 99%

“…It can also help improve the determination of tumor extent. Authors of many studies have investigated the accuracy of MR imaging in local staging (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). These studies differ in their use of magnetic field strengths, combinations of anatomic and functional MR imaging techniques, and number of patients.…”

mentioning

confidence: 99%

The Diagnostic Value of MR Imaging in Differentiating T Staging of Bladder Cancer: A Meta-Analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Finally, DWI was performed in only 29 patients in our study. Numerous studies have demonstrated the value of DWI for the improved characterization of detected renal neoplasms [ 15 , 16 , 57 , 70 – 74 ]. One such study [ 15 ] showed that the addition of ADC information to CE-MRI findings led to the reclassification of 3 of 6 oncocytomas and 2 of 2 multilocular cystic nephromas that had originally been misdiagnosed as malignant on CE-MRI alone, thereby increasing specificity from 89 to 96 %.…”

Section: Discussionmentioning

confidence: 99%

Low-dose gadobenate dimeglumine-enhanced MRI of the kidney for the differential diagnosis of localized renal lesions

et al. 2015

View full text Add to dashboard Cite

ObjectiveTo evaluate low-dose gadobenate dimeglumine-enhanced MRI for the differential diagnosis of malignant renal tumors.MethodsSixty-two consecutive patients with unclear diagnosis at MDCT/ultrasound underwent dynamic CE-MRI of the kidneys with 0.05 mmol/kg gadobenate dimeglumine. Retrospective image evaluation was performed by two blinded readers. Lesion diagnosis at CE-MRI was correlated with findings from histology following tumor resection or from imaging follow-up after at least 1 year. Assessments were performed of diagnostic quality and level of diagnostic information.ResultsThirty-nine (63 %) patients were correctly diagnosed with malignant lesions (36 with RCC, 2 with renal metastases, 1 with lymphoma) while 14 (22.6 %) patients were correctly diagnosed with benign (n = 12) or no (n = 2) lesions. Eight patients were considered false positive (5 with oncocytoma, 3 with atypical AML) and 1 patient false negative (atypical RCC). The sensitivity, specificity, accuracy, PPV, and NPV for the diagnosis of malignant renal lesions were 97.5 % (39/40), 63.6 % (14/22), 85.5 % (53/62), 83.0 % (39/47), and 93.3 % (14/15), respectively. Images were excellent in 60 and good in 2 patients. Minimal artifacts that did not compromise diagnosis were noted in 4/62 patients.ConclusionLow-dose gadobenate dimeglumine-enhanced MRI is effective for the differential diagnosis of malignant renal tumors.

show abstract

“…Staging of bladder cancer by DWI alone is in general unsatisfactory [46] , although a study revealed high accuracy of staging bladder cancer with the combination of DWI and T2WI [8] . Staging a tumor with a stalk showing imaging of “inchworm sign” not only is seen in stage Ta or stage T1 tumors but also can be seen in stage T2 tumors [46,57,58] . It is occasionally unable to determinate if the tumor margin is smooth on DWI, which makes the correct categorization of the tumor as stage T2 or stage T3 difficult [8] .…”

Section: Pitfalls and Limitations In Staging Of Bladder Cancermentioning

confidence: 99%

Pitfalls and Limitations of Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Urinary Bladder Cancer

Lin

Chen

2015

Translational Oncology

View full text Add to dashboard Cite

Adequately selecting a therapeutic approach for bladder cancer depends on accurate grading and staging. Substantial inaccuracy of clinical staging with bimanual examination, cystoscopy, and transurethral resection of bladder tumor has facilitated the increasing utility of magnetic resonance imaging to evaluate bladder cancer. Diffusion-weighted imaging (DWI) is a noninvasive functional magnetic resonance imaging technique. The high tissue contrast between cancers and surrounding tissues on DWI is derived from the difference of water molecules motion. DWI is potentially a useful tool for the detection, characterization, and staging of bladder cancers; it can also monitor posttreatment response and provide information on predicting tumor biophysical behaviors. Despite advancements in DWI techniques and the use of quantitative analysis to evaluate the apparent diffusion coefficient values, there are some inherent limitations in DWI interpretation related to relatively poor spatial resolution, lack of cancer specificity, and lack of standardized image acquisition protocols and data analysis procedures that restrict the application of DWI and reproducibility of apparent diffusion coefficient values. In addition, inadequate bladder distension, artifacts, thinness of bladder wall, cancerous mimickers of normal bladder wall and benign lesions, and variations in the manifestation of bladder cancer may interfere with diagnosis and monitoring of treatment. Recognition of these pitfalls and limitations can minimize their impact on image interpretation, and carefully applying the analyzed results and combining with pathologic grading and staging to clinical practice can contribute to the selection of an adequate treatment method to improve patient care.

show abstract

Preoperative T Staging of Urinary Bladder Cancer: Efficacy of Stalk Detection and Diagnostic Performance of Diffusion-weighted Imaging at 3T

Cited by 32 publications

References 17 publications

The Diagnostic Value of MR Imaging in Differentiating T Staging of Bladder Cancer: A Meta-Analysis

The Diagnostic Value of MR Imaging in Differentiating T Staging of Bladder Cancer: A Meta-Analysis

Low-dose gadobenate dimeglumine-enhanced MRI of the kidney for the differential diagnosis of localized renal lesions

Pitfalls and Limitations of Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Urinary Bladder Cancer

Contact Info

Product

Resources

About