Huan-Jun Wang1, Margaret H Pui2, Jian Guan1, Shu-Rong Li1, Jin-Hua Lin1, Bitao Pan1, Yan Guo1. 1. 1 Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Rd 2, Guangzhou, Guangdong 510080, China. 2. 2 Department of Radiology, Conde de S. Januario Central Hospital, Macau, China.
Abstract
OBJECTIVE: The purpose of this study was to compare the efficacy of submucosal enhancement on dynamic contrast-enhanced MRI (DCE-MRI) and detection of a stalk on DWI for differentiating stage T1 from stage T2 bladder urothelial carcinoma. SUBJECTS AND METHODS: Our prospective study was approved by the institutional medical ethics committee and informed consent was obtained from all patients. Fifty-nine patients (92 tumors in total) with urothelial bladder cancer underwent MRI within 2 weeks before surgery. Two image sets of T2-weighted MRI with DWI and T2-weighted with DCE-MRI were interpreted independently at 2-week intervals by two uroradiologists without any knowledge of the surgical or histologic findings. The tumor was categorized as stage T1 or lower when a stalk was evident at the tumor base on DWI or when continuous linear submucosal enhancement was detected in the early phase of DCE-MRI. Tumors without stalks or with discontinuous linear submucosal enhancement were categorized as stage T2. RESULTS: Of the 42 tumors with stalks on DWI, 41 showed continuous and one had discontinuous submucosal enhancement on DCE-MRI. In 50 carcinomas without stalks on DWI, submucosal enhancement was absent in 34, continuous in 12, and discontinuous in four. The staging accuracy of DWI (91.3%, 84/92) and DCE-MRI (91.3%, 84/92) was improved to 94.6% (87/92) by combining the interpretations of both DWI and DCE-MRI. CONCLUSION: Submucosal linear enhancement under the tumor base on DCE-MRI complements tumor stalk detection on DWI for differentiating stage T1 from stage T2 bladder urothelial carcinoma.
OBJECTIVE: The purpose of this study was to compare the efficacy of submucosal enhancement on dynamic contrast-enhanced MRI (DCE-MRI) and detection of a stalk on DWI for differentiating stage T1 from stage T2 bladder urothelial carcinoma. SUBJECTS AND METHODS: Our prospective study was approved by the institutional medical ethics committee and informed consent was obtained from all patients. Fifty-nine patients (92 tumors in total) with urothelial bladder cancer underwent MRI within 2 weeks before surgery. Two image sets of T2-weighted MRI with DWI and T2-weighted with DCE-MRI were interpreted independently at 2-week intervals by two uroradiologists without any knowledge of the surgical or histologic findings. The tumor was categorized as stage T1 or lower when a stalk was evident at the tumor base on DWI or when continuous linear submucosal enhancement was detected in the early phase of DCE-MRI. Tumors without stalks or with discontinuous linear submucosal enhancement were categorized as stage T2. RESULTS: Of the 42 tumors with stalks on DWI, 41 showed continuous and one had discontinuous submucosal enhancement on DCE-MRI. In 50 carcinomas without stalks on DWI, submucosal enhancement was absent in 34, continuous in 12, and discontinuous in four. The staging accuracy of DWI (91.3%, 84/92) and DCE-MRI (91.3%, 84/92) was improved to 94.6% (87/92) by combining the interpretations of both DWI and DCE-MRI. CONCLUSION: Submucosal linear enhancement under the tumor base on DCE-MRI complements tumor stalk detection on DWI for differentiating stage T1 from stage T2 bladder urothelial carcinoma.
Authors: Giovanni Barchetti; Giuseppe Simone; Isabella Ceravolo; Vincenzo Salvo; Riccardo Campa; Francesco Del Giudice; Ettore De Berardinis; Dorelsa Buccilli; Carlo Catalano; Michele Gallucci; James W F Catto; Valeria Panebianco Journal: Eur Radiol Date: 2019-03-18 Impact factor: 5.315
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