Christian B van der Pol1, Atul B Shinagare2, Sree Harsha Tirumani1, Mark A Preston3, Mark G Vangel4, Stuart G Silverman1. 1. Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. 2. Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02215, USA. ashinagare@partners.org. 3. Division of Urology, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, ASBII-3, Boston, MA, 02115, USA. 4. Massachusetts General Hospital, Harvard Medical School, Radiology/CNY149-Rm 2301, 149 13th St, Charlestown, MA, 02129, USA.
Abstract
PURPOSE: To evaluate the performance of multiparametric MRI (mpMRI) for the local staging of bladder cancer following transurethral resection of bladder tumor. METHODS: This Institutional Review Board-approved, retrospective study identified 45 patients with pathology-proven bladder cancer who underwent transurethral resection followed by mpMRI between August 2011 and October 2016. Two radiologists reviewed each MRI independently and assigned T and N stage. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the presence of muscle invasion (T2 or higher), peri-vesical invasion (T3 or higher), and regional nodal disease compared to findings at cystectomy as the reference standard. Inter-observer agreement was measured using Cohen's κ coefficient. RESULTS: Of 45 patients, 13% were stage T2, 27% T3, 16% T4; of 40 patients, 28% had regional nodal disease. Sensitivity, specificity, PPV, NPV, and accuracy of mpMRI for readers 1 and 2, respectively, were muscle invasion, 92% and 88%, 74% and 84%, 81% and 88%, 88% and 84%, 84% and 86%; peri-vesical invasion, 72% and 67%, 92% and 92%, 87% and 86%, 81% and 79%, 83% and 81%; regional nodal disease, 45% and 45%, 93% and 90%, 71% and 63%, 82% and 81%, 80% and 78%. Inter-observer agreement was good using all sequences. CONCLUSIONS: mpMRI was both sensitive and specific in the detection of muscle invasive bladder cancer, and was specific but not sensitive for both peri-vesical invasion and nodal involvement. mpMRI may have a role at locally staging bladder cancer following transurethral resection.
PURPOSE: To evaluate the performance of multiparametric MRI (mpMRI) for the local staging of bladder cancer following transurethral resection of bladder tumor. METHODS: This Institutional Review Board-approved, retrospective study identified 45 patients with pathology-proven bladder cancer who underwent transurethral resection followed by mpMRI between August 2011 and October 2016. Two radiologists reviewed each MRI independently and assigned T and N stage. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the presence of muscle invasion (T2 or higher), peri-vesical invasion (T3 or higher), and regional nodal disease compared to findings at cystectomy as the reference standard. Inter-observer agreement was measured using Cohen's κ coefficient. RESULTS: Of 45 patients, 13% were stage T2, 27% T3, 16% T4; of 40 patients, 28% had regional nodal disease. Sensitivity, specificity, PPV, NPV, and accuracy of mpMRI for readers 1 and 2, respectively, were muscle invasion, 92% and 88%, 74% and 84%, 81% and 88%, 88% and 84%, 84% and 86%; peri-vesical invasion, 72% and 67%, 92% and 92%, 87% and 86%, 81% and 79%, 83% and 81%; regional nodal disease, 45% and 45%, 93% and 90%, 71% and 63%, 82% and 81%, 80% and 78%. Inter-observer agreement was good using all sequences. CONCLUSIONS: mpMRI was both sensitive and specific in the detection of muscle invasive bladder cancer, and was specific but not sensitive for both peri-vesical invasion and nodal involvement. mpMRI may have a role at locally staging bladder cancer following transurethral resection.
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
Authors: Luís Vale; José Sousa; Pedro Abreu-Mendes; Pedro Vale; Nuno Dias; Paulo Dinis; Tiago Antunes-Lopes; João Silva Journal: Porto Biomed J Date: 2022-09-09