The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions

Avcu, Serhat; Köseoğlu, Mehmet; Ceylan, Kadir; Dbulutand, M; Ünal, Özlem

doi:10.1259/bjr/30591350

Cited by 78 publications

(59 citation statements)

References 20 publications

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“…Because of this limitation, DW-MRI was previously only used for brain imaging until the development of fast MRI techniques. The development of echo planar imaging (EPI), one of the fast MRI techniques, eliminated the long imaging time of conventional sequences and the associated artifacts, thus making DW-MRI usable for abdominal examinations (8)(9)(10)(11).…”

Section: Discussionmentioning

confidence: 99%

The value of diffusion weighted MR imaging and apparent diffusion coefficient quantification in the diagnosis of perforated and non-perforated appendicitis

Avcu

Çetin²,

Arslan³

et al. 2012

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) values in the diagnosis of acute appendicitis and differentiation of perforated and nonperforated appendicitis cases, with histopathologic correlation. MATERIALS AND METHODSSixty consecutive patients (34 males, 26 females; mean age, 35.6±15.5 years; range, 17-83 years) with a presumptive diagnosis of acute appendicitis were included in this prospective study. With a 1.5 Tesla MRI unit, DW-MRI examinations were performed with b values of 50, 400, and 800 s/mm 2 . The mean ADC values of case and control groups, as well as in perforated and nonperforated groups were compared. RESULTSOf the 60 cases, 44 had a radiological diagnosis of acute appendicitis, and 16 were regarded as normal. Of the 40 patients who underwent surgical operation, 12 had a histopathological diagnosis of perforated appendicitis, and 28 had nonperforated appendicitis. Mean ADC value in patients with acute appendicitis (1.01±0.26×10 -3 mm 2 /s) was lower than the control group (1.85±0.13×10 -3 mm 2 /s) (P < 0.001). Mean ADC value of the perforated group (0.79±0.19×10 -3 mm 2 /s) was lower than the nonperforated group (1.11±0.22×10 -3 mm 2 /s) (P < 0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of DW-MRI in the diagnosis of acute appendicitis were 97.5%, 100%, 97.5%, 100%, and 98.1%, respectively. CONCLUSION DW-MRI and ADC quantification are effective in the diagnosis of acute appendicitis, both in perforated and nonperforated cases. Magnetic resonance imaging (MRI) is the radiological imaging technique offering the highest soft tissue contrast resolution. Currently, in addition to conventional MRI, other MRI techniques are commonly and routinely used, including diffusion-weighted MRI (DW-MRI). DW-MRI is a functional imaging technique that relies on the measurement of the accelerated or slowed microscopic diffusion movements of protons of water molecules. The images are obtained in short interval times and without the requirement for any contrast medium (1).Recently, studies have reported the use of DW-MRI to show active inflammatory lesions in the bowel. In these reports, the mean apparent diffusion coefficient (ADC) of the inflamed bowel segments were compared with the ADC of normal segments, and statistically significant difference was demonstrated (1, 2). Only one study has been investigated the use of DW-MRI for the diagnosis of patients with acute appendicitis (3). However, this study did not focus on the differential diagnosis of perforated and nonperforated appendicitis cases.The aim of this study was to evaluate the effectiveness of DW-MRI and quantitative measurement of ADC values in the diagnosis of acute appendicitis, and in the differentiation between perforated and nonperforated appendicitis cases, with histopathologic correlation. Materials and methods Patient selectionThis prospective study was performed betw...

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Section: Discussionmentioning

confidence: 99%

The value of diffusion weighted MR imaging and apparent diffusion coefficient quantification in the diagnosis of perforated and non-perforated appendicitis

Avcu

Çetin²,

Arslan³

et al. 2012

Diagn Interv Radiol

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“…In the various studies, different approaches were used; most of them used both T2W and DWI [8] [10] [15], but some evaluated the sequences separately in identifying the tumor [7] [15]. The sensitivities and specificities in the present study are lower than those studies.…”

Section: Discussionmentioning

confidence: 73%

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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“…Of these, 27 studies were excluded after scanning their title and abstract and a further 192 studies were excluded for failing to meet our inclusion criteria after examining their full-text. Finally, 11 studies, with diagnostic trials published between 1998 and 2014, were enrolled into the final analysis [9,[22][23][24][25][26][27][28][29][30][31]. Among these 11 studies, five studies reported the diagnostic performance of DW-MRI in BC, including 243 BC patients with bladder lesions and 82 subjects with healthy bladder tissues,Eight studies investigated the diagnostic performance of DW-MRI in 747 MIBC patients with 259 MIBC lesions and 515 NMIBC lesions.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…In recent years, several MRI methods, in conjunction with conventional methods including computed tomography (CT), ultrasound and positron emission tomography (PET), are being used for routine radiodiagnostic applications [9]. Diffusion-weighted magnetic resonance imaging (DW-MRI) is a recent advancement in microstructural imaging modality, and is characterized within the context of functional MRI.…”

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confidence: 99%

“…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: 99%

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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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The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions

Cited by 78 publications

References 20 publications

The value of diffusion weighted MR imaging and apparent diffusion coefficient quantification in the diagnosis of perforated and non-perforated appendicitis

The value of diffusion weighted MR imaging and apparent diffusion coefficient quantification in the diagnosis of perforated and non-perforated appendicitis

MRI of the Bladder in Patients Suspected of Bladder Tumors

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

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