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

2014; Japan Society of Magnetic Resonance in Medicine; Volume: 13; Issue: 3 Linguagem: Inglês

10.2463/mrms.2013-0104

1880-2206

Yoshimitsu Ohgiya, Jumpei Suyama, Sai Shoei, Masaaki Kawahara, Nobuyuki Takeyama, Nobuyuki Ohike, Hiroto Sasamori, Jiro Munechika, Makoto Saiki, Yui Onoda, Masanori Hirose, Takehiko Gokan,

MRI in cancer diagnosis

Purpose: We evaluated the ability of diffusion-weighted imaging (DWI) at 3 tesla for diagnosing T stage and detecting stalks in bladder cancer.Methods: In total, 39 consecutive patients with bladder tumors underwent magnetic resonance (MR) imaging that included T2-weighted imaging (T2WI) and DWI using a 3T MR scanner. Two radiologists interpreted T2WI plus DWI and T2WI for diagnosis of T stage and for detection of stalks. We used McNemar's test to examine differences in diagnostic performance and Fisher's exact test to evaluate differences in stalk detection frequency.Results: Specificity and accuracy in differentiating T1 tumors from T2 to T4 tumors were significantly better with T2WI plus DWI (83% [20/24] and 85% [33/39]) than T2WI (50% [12/24] and 67% [26/39]; P = 0.02), and accuracy for diagnosing tumor stage was significantly better with T2WI plus DWI (82% [32/39]) than T2WI alone (59% [23/39]; P = 0.03). The observers identified stalks in 11 tumors by T2WI (48% [11/23]) and 17 by DWI (74% [17/23]) (P < 0.03).Conclusion: DWI at 3T was superior to T2WI for evaluating the T stage of bladder cancer, particularly in differentiating T1 tumors from those T2 or higher, and in detecting stalks of papillary bladder tumors.