Amide Proton Transfer-weighted MRI in Predicting Histologic Grade of Bladder Cancer

Citations Over TimeTop 10% of 2022 papers

Abstract

Background Bladder cancer is classified into high and low grades with different clinical treatments and prognoses. Thus, accurate preoperative evaluation of the histologic grade through imaging techniques is essential. Purpose To investigate the potential of amide proton transfer-weighted (APTw) MRI in evaluating the grade of bladder cancer and to evaluate whether APTw MRI can add value to diffusion-weighted imaging (DWI) at MRI. Materials and Methods In this single-center prospective study, participants with pathologic analysis-confirmed bladder cancer with no previous treatment, lesions larger than 10 mm, and adequate MRI quality were enrolled from July 2020 to September 2021 in a university teaching hospital. All participants underwent preoperative multiparametric MRI, including APTw MRI and DWI. The mean APTw and apparent diffusion coefficient (ADC) values of the primary tumor were measured independently by two radiologists. Receiver operating characteristic curves were generated to evaluate the diagnostic performance of these quantitative parameters. Results In total, 83 participants (mean age, 64 years ± 13 [SD]; 72 men) were evaluated: 51 with high-grade and 32 with low-grade bladder cancer. High-grade bladder cancer showed higher APTw values (6% [IQR, 4%-12%] vs 2% [IQR, 1%-3%]; P -3 mm2/sec ± 0.17 vs 1.21 × 10-3 mm2/sec ± 0.25; P P = .94). Moreover, the combination of the two techniques improved the diagnostic performance (AUC, 0.93; all P = .01). Conclusion The combination of amide proton transfer-weighted and diffusion-weighted MRI has the potential to improve the histologic characterization of bladder cancer by differentiating low- from high-grade cancers. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Milot in this issue. An earlier incorrect version appeared online. This article was corrected on July 7, 2022.

Related Papers

• → Diagnostic Performance of Clinical Examination and Selective Magnetic Resonance Imaging in the Evaluation of Intraarticular Knee Disorders in Children and Adolescents(2001)241 cited
• → Targeting splicing factors as molecular non-muscle invasive bladder cancer predictors(2018)1 cited
• → The Molecular Basis of Muscle Invasive Bladder Cancer(2021)
• → Xpert bladder cancer monitor in the follow up of patients affected by non muscle invasive bladder cancer (NMIBC): An update(2019)