Comparison of dynamic contrast-enhanced and diffusion weighted magnetic resonance image in staging and grading of carcinoma bladder with histopathological correlation

  • N. G
  • B. S
  • M.M. K
 et al. 
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Abstract

Background: Bladder cancer is the second most common neoplasm of the urinary tract worldwide. Dynamic contrast-enhanced and diffusion-weighted MRI has been introduced in clinical MRI protocols of bladder cancer because of its accuracy in staging and grading. Aim: To evaluate and compare accuracy of Dynamic contrast enhanced (DCE) and Diffusion weighted (DW) MRI for preoperative T staging of urinary bladder cancer and find correlation between apparent diffusion coefficient (ADC) and maximum enhancement with histological grade. Materials and Methods: Sixty patients with bladder cancer were included in study. All patients underwent Magnetic Resonance Imaging (MRI) on a 1.5-T scanner with a phased-array pelvic coil. MR images were evaluated and assigned a stage which was compared with the histolopathological staging. ADC value and maximum enhancement curve were used based on previous studies. Subsequently histological grade was compared with MR characteristics. Results: The extent of agreement between the radiologic staging and histopathological staging was relatively greater with the DW-MRI (kappa=0.669) than DCE-MRI (kappa=0.619). The sensitivity, specificity, and accuracy are maximum and similar for stage T4 tumors in both DCEMRI (100.0, 96.2 and 96.7) and DW-MRI (100.0, 96.2 and 96.7) while minimum for stage T2 tumors-DCEMRI (83.3, 72.2, and 76.7) and DWI-MRI (91.7, 72.2, and 80). Conclusion: MRI is an effective tool for determining T stage and histological grade of urinary bladder cancers. Stage T2a and T2b can be differentiated only by DCE-MRI. Results were more accurate when both ADC and DCE-MRI were used together and hence a combined approach is suggested.

Author-supplied keywords

  • *bladder carcinoma/di [Diagnosis]
  • *cancer grading
  • *cancer staging
  • *diffusion weighted imaging
  • *dynamic contrast enhanced magnetic resonance imag
  • *histopathology
  • *nuclear magnetic resonance imaging
  • adult
  • aged
  • article
  • contrast enhancement
  • controlled study
  • diagnostic accuracy
  • diagnostic imaging
  • diagnostic test accuracy study
  • disease association
  • female
  • human
  • human tissue
  • image analysis
  • major clinical study
  • male
  • outcome assessment
  • prediction
  • predictive value
  • priority journal
  • sensitivity and specificity
  • syndrome delineation
  • tumor differentiation

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Authors

  • Gupta N.

  • Sureka B.

  • Kumar M.M.

  • Malik A.

  • Bhushan T.B.

  • Mohanty N.K.

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