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Background <p>The preoperative evaluation of bladder cancer (BC) pathological grade and muscle invasion is crucial for effective management outcomes. MRI is noninvasive and has no radiation exposure. MRI sequences enable anatomical and functional assessment with the capability of using functional quantitative parameters as biomarkers to analyze tissue characteristics. This study aimed to investigate the utility of apparent diffusion coefficient (ADC) and apparent transverse relaxation rate (R2*) in predicting preoperative histopathological grade and detrusor muscle invasion in bladder cancer (BC).</p> Results <p>This ethically approved prospective clinical study included 53 patients with suspected bladder tumors (mean age 62.85&#xa0;years ± 10.02 [SD]; 49 males). Two independent readers had strong concordance in measuring ADC and R2* values (ICC &gt; 0.9), with significantly negative correlation observed between R2* and ADC (<i>p</i> &lt; 0.001). ADC cutoff value of (0.79 × 10<sup>–3&#xa0;</sup>mm<sup>2</sup>/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (90.57%) and (84.9%); respectively. R2* cutoff values of (17.8/s) and (18.1/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (88.68%) and (83.02%); respectively. The conjugate R2* and ADC exhibited high diagnostic accuracies that were more impressive for predicting the histologic grade (94.2%) than for muscle invasiveness (82.7%).</p> Conclusions <p>ADC and R2* deployment for preoperative bladder cancer evaluation has excellent potential to predict tumor grades and detrusor muscle invasion, aiding in management planning.</p>

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BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月19日

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  • Omnia Ezz Eldin,
  • Mohamed Ragab Nouh,
  • Khaled Refaai,
  • Marwa Shawky Abdou,
  • Heba Refaat Gouda,
  • Dina Altarawy,
  • Ahmed Samir

摘要

Background

The preoperative evaluation of bladder cancer (BC) pathological grade and muscle invasion is crucial for effective management outcomes. MRI is noninvasive and has no radiation exposure. MRI sequences enable anatomical and functional assessment with the capability of using functional quantitative parameters as biomarkers to analyze tissue characteristics. This study aimed to investigate the utility of apparent diffusion coefficient (ADC) and apparent transverse relaxation rate (R2*) in predicting preoperative histopathological grade and detrusor muscle invasion in bladder cancer (BC).

Results

This ethically approved prospective clinical study included 53 patients with suspected bladder tumors (mean age 62.85 years ± 10.02 [SD]; 49 males). Two independent readers had strong concordance in measuring ADC and R2* values (ICC > 0.9), with significantly negative correlation observed between R2* and ADC (p < 0.001). ADC cutoff value of (0.79 × 10–3 mm2/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (90.57%) and (84.9%); respectively. R2* cutoff values of (17.8/s) and (18.1/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (88.68%) and (83.02%); respectively. The conjugate R2* and ADC exhibited high diagnostic accuracies that were more impressive for predicting the histologic grade (94.2%) than for muscle invasiveness (82.7%).

Conclusions

ADC and R2* deployment for preoperative bladder cancer evaluation has excellent potential to predict tumor grades and detrusor muscle invasion, aiding in management planning.