Xinxin Zhang1, Yichen Wang1, Jin Zhang1, Xiaojuan Xu1, Lianyu Zhang1, Miaomiao Zhang2, Lizhi Xie3, Jianzhong Shou4, Yan Chen5. 1. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 7 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China. 2. Division of Life Sciences and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, People's Republic of China. 3. GE Healthcare, MR Research China, Beijing, 100176, China. 4. Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. 5. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 7 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China. doctorchenyan626@sina.com.
Abstract
PURPOSE: To investigate the usefulness of diffusion-weighted MR imaging with ADC value and histogram analysis of ADC in the prediction of response to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC). METHODS: Fifty-eight consecutive patients with clinical T2-4aN0M0 MIBC who underwent MRI before and after NAC were enrolled in the prospective study. The evaluation of response to NAC was based on the pathologic T (pT) stage after surgery. Patients with non-muscle-invasive residual cancer (pTa, pTis, pT1) were defined as responders, while those with muscle-invasive residual cancer (≥ pT2) were defined as non-responders. The ADC value measured from a single-section region of interest and ADC histogram parameters derived from whole-tumor volume of interest in responder and non-responder were compared using the Mann-Whitney U test or independent samples t test. ROC curve analysis was used to evaluate the diagnostic performance of ADC value and ADC histogram parameters in predicting the response to NAC. RESULTS: The pretreatment ADC value of responders ([1.33 (± 0.21)] × 10-3mm2/s) was significantly higher than that of non-responders ([1.09 (± 0.08)] × 10-3mm2/s) (P < .001). Most of the pretreatment ADC histogram parameters (Mean, 10th, 25th, 50th, 75th, and 90th percentiles) of responders were significantly higher than that of non-responders (P < .001). The AUC was highest for the pretreatment ADC value (0.88; 95% confidence interval: 0.77, 0.95; P < .001). CONCLUSION: Diffusion-weighted MR imaging with ADC value and histogram analysis of ADC are useful to predict NAC response in patients with MIBC.
PURPOSE: To investigate the usefulness of diffusion-weighted MR imaging with ADC value and histogram analysis of ADC in the prediction of response to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC). METHODS: Fifty-eight consecutive patients with clinical T2-4aN0M0 MIBC who underwent MRI before and after NAC were enrolled in the prospective study. The evaluation of response to NAC was based on the pathologic T (pT) stage after surgery. Patients with non-muscle-invasive residual cancer (pTa, pTis, pT1) were defined as responders, while those with muscle-invasive residual cancer (≥ pT2) were defined as non-responders. The ADC value measured from a single-section region of interest and ADC histogram parameters derived from whole-tumor volume of interest in responder and non-responder were compared using the Mann-Whitney U test or independent samples t test. ROC curve analysis was used to evaluate the diagnostic performance of ADC value and ADC histogram parameters in predicting the response to NAC. RESULTS: The pretreatment ADC value of responders ([1.33 (± 0.21)] × 10-3mm2/s) was significantly higher than that of non-responders ([1.09 (± 0.08)] × 10-3mm2/s) (P < .001). Most of the pretreatment ADC histogram parameters (Mean, 10th, 25th, 50th, 75th, and 90th percentiles) of responders were significantly higher than that of non-responders (P < .001). The AUC was highest for the pretreatment ADC value (0.88; 95% confidence interval: 0.77, 0.95; P < .001). CONCLUSION: Diffusion-weighted MR imaging with ADC value and histogram analysis of ADC are useful to predict NAC response in patients with MIBC.
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