OBJECTIVES: To investigate the role of apparent diffusion coefficient (ADC) as a biomarker reflecting the aggressiveness of upper urinary tract urothelial cell carcinoma (UUT-UCC). METHODS: Thirty-four consecutive patients treated with nephroureterectomy for non-metastatic disease were prospectively enrolled in this study. ADC was compared with clinicopathological variables including Ki-67 labelling index (LI) and cancer-specific survival (CSS). RESULTS: The overall 3-year CSS rate was 82 % (median follow-up, 36 months). ADC was significantly lower in grade 3 disease than in grades 1-2 disease (P = 0.011) and significantly and inversely correlated with Ki-67 LI (ρ = -0.59, P = 0.0002). Low ADCs (<1.10 × 10(-3) mm(2)/s) were significantly associated with shorter CSS (P = 0.039). Multivariate analysis of preoperative variables identified ADC and MRI-based clinical T stage as independent indicators of shorter CSS; the patients were stratified into high-risk (8 patients with low ADC and at least clinical T3) and low-risk (26 patients with high ADC or not more than clinical T2) groups with 3-year CSS rates of 43 % and 93 % (P = 0.0003). CONCLUSIONS: Our preliminary data suggest the potential role of ADC as a quantitative biomarker reflecting the aggressiveness of UUT-UCC. ADC might be useful for preoperative risk stratification of UUT-UCC patients. KEY POINTS: • Diffusion-weighted MRI offers new information about the aggressiveness of urinary tract cancers. • The apparent diffusion coefficient acts as a quantitative biomarker for upper urinary tract cancers. • ADC inversely correlates with immunohistochemical and histological grading of UUT-UCC. • ADC offers a prognosis for UUT-UCC patients treated with nephroureterectomy.
OBJECTIVES: To investigate the role of apparent diffusion coefficient (ADC) as a biomarker reflecting the aggressiveness of upper urinary tract urothelial cell carcinoma (UUT-UCC). METHODS: Thirty-four consecutive patients treated with nephroureterectomy for non-metastatic disease were prospectively enrolled in this study. ADC was compared with clinicopathological variables including Ki-67 labelling index (LI) and cancer-specific survival (CSS). RESULTS: The overall 3-year CSS rate was 82 % (median follow-up, 36 months). ADC was significantly lower in grade 3 disease than in grades 1-2 disease (P = 0.011) and significantly and inversely correlated with Ki-67 LI (ρ = -0.59, P = 0.0002). Low ADCs (<1.10 × 10(-3) mm(2)/s) were significantly associated with shorter CSS (P = 0.039). Multivariate analysis of preoperative variables identified ADC and MRI-based clinical T stage as independent indicators of shorter CSS; the patients were stratified into high-risk (8 patients with low ADC and at least clinical T3) and low-risk (26 patients with high ADC or not more than clinical T2) groups with 3-year CSS rates of 43 % and 93 % (P = 0.0003). CONCLUSIONS: Our preliminary data suggest the potential role of ADC as a quantitative biomarker reflecting the aggressiveness of UUT-UCC. ADC might be useful for preoperative risk stratification of UUT-UCC patients. KEY POINTS: • Diffusion-weighted MRI offers new information about the aggressiveness of urinary tract cancers. • The apparent diffusion coefficient acts as a quantitative biomarker for upper urinary tract cancers. • ADC inversely correlates with immunohistochemical and histological grading of UUT-UCC. • ADC offers a prognosis for UUT-UCC patients treated with nephroureterectomy.
Authors: Ricardo L Favaretto; Shahrokh F Shariat; Caroline Savage; Guilherme Godoy; Daher C Chade; Matthew Kaag; Bernard H Bochner; Jonathan Coleman; Guido Dalbagni Journal: BJU Int Date: 2011-06-01 Impact factor: 5.588
Authors: Matthew J Wieduwilt; Francisco Valles; Samar Issa; Caroline M Behler; James Hwang; Michael McDermott; Patrick Treseler; Joan O'Brien; Marc A Shuman; Soonmee Cha; Lloyd E Damon; James L Rubenstein Journal: Clin Cancer Res Date: 2012-01-06 Impact factor: 12.531
Authors: W B Pope; A Lai; R Mehta; H J Kim; J Qiao; J R Young; X Xue; J Goldin; M S Brown; P L Nghiemphu; A Tran; T F Cloughesy Journal: AJNR Am J Neuroradiol Date: 2011-02-17 Impact factor: 3.825
Authors: Y Uchida; S Yoshida; S Kobayashi; F Koga; J Ishioka; S Satoh; C Ishii; H Tanaka; Y Matsuoka; N Numao; K Saito; H Masuda; Y Fujii; K Kihara Journal: Br J Radiol Date: 2014-07-30 Impact factor: 3.039