ArticleEuropean radiology2019
Usefulness of the inchworm sign on DWI for predicting pT1 bladder cancer progression.
Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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19 citing papers in PubMed, 37 citations in OpenAlex.
- Application of transformer-enhanced convolutional neural network: multicenter MRI assessment of muscle invasion in bladder cancer.European radiology · 2026Article
- A non-invasive MRI-based multimodal fusion deep learning model (MF-DLM) for predicting overall survival in bladder cancer: a multicentre retrospective study.EClinicalMedicine · 2025Article
- Recurrence risk prediction for non-muscle-invasive bladder urothelial carcinoma using diffusion and clinicopathology features.Abdominal radiology (New York) · 2025Article
- A study on predicting recurrence of non-muscle-invasive bladder cancer within 2 years using mp-MRI radiomics.BMC cancer · 2025Article
- Diffusion-weighted MRI-Derived ADC and tumor volume as predictive imaging markers for neoadjuvant chemotherapy response in muscle-invasive bladder cancer.BMC medical imaging · 2025Article
- Enhancing recurrence risk prediction for bladder cancer using multi-sequence MRI radiomics.Insights into imaging · 2024Article
- Progress of Multiparameter Magnetic Resonance Imaging in Bladder Cancer: A Comprehensive Literature Review.Diagnostics (Basel, Switzerland) · 2024Review
- Vesical imaging reporting and data system (VI-RADS) could predict the survival of bladder-cancer patients who received radical cystectomy.Scientific reports · 2023Article
- Unclear tumor border in magnetic resonance imaging as a prognostic factor of squamous cell cervical cancer.Scientific reports · 2023Article
- Differentiation of bladder cancer stages using the vesical imaging -reporting and data system and apparent diffusion coefficient.Quantitative imaging in medicine and surgery · 2023Article
- Evaluation of Whole-Tumor Texture Analysis Based on MRI Diffusion Kurtosis and Biparametric VI-RADS Model for Staging and Grading Bladder Cancer.Bioengineering (Basel, Switzerland) · 2023Article
- Article
- Accuracy of Inchworm Sign on Diffusion-Weighted MRI in Differentiating Muscle-Invasive Bladder Cancer.Bladder cancer (Amsterdam, Netherlands) · 2022Article
- Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions.European radiology · 2021Article
- Study Progress of Noninvasive Imaging and Radiomics for Decoding the Phenotypes and Recurrence Risk of Bladder Cancer.Frontiers in oncology · 2021Review
- The invasion depth measurement of bladder cancer using T2-weighted magnetic resonance imaging.Biomedical engineering online · 2020Article
- Elaboration of a multisequence MRI-based radiomics signature for the preoperative prediction of the muscle-invasive status of bladder cancer: a double-center study.European radiology · 2020Article
- A predictive nomogram for individualized recurrence stratification of bladder cancer using multiparametric MRI and clinical risk factors.Journal of magnetic resonance imaging : JMRI · 2019Article
- What are roles of multiparametric magnetic resonance imaging prior to transurethral resection of bladder tumor?Translational andrology and urology · 2019Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the significance of the presence or absence of an "inchworm sign" on DWI for the recurrence and progression of T1 bladder cancer. MATERIALS AND
methodsWe retrospectively analyzed 91 patients with pT1 urothelial carcinoma who underwent DWI prior to transurethral resection between 2007 and 2016. DWI of the dominant tumors was scrutinized for inchworm signs at b = 1000 s/mm
resultsAn inchworm sign was seen in 65 cases (71%), while it was absent in 26 cases. Among the 65, 25 (38%) had confirmed tumor recurrence, while in the remaining 26, 14 (54%) had confirmed recurrence (median time post TURB = 7.9 and 10.1 months for each). At the time of recurrence, the tumor had progressed in one (2%) inchworm-sign-positive and seven (27%) inchworm-sign-negative cases. The progression rate of inchworm-sign-negative cases was significantly higher than that of inchworm-sign-positive cases (hazard ratio = 17.2, p = 0.0017), whereas there was no significant difference in the recurrence rate between two groups. The absence of an inchworm sign and histological grade 3 were independent risk factors for progression (p < 0.001 and 0.010, respectively).
conclusionsThe absence of an inchworm sign on DWI was a significant prognostic factor for progression of T1 bladder cancer. Morphological evaluation of DWI signals may therefore be a useful adjunct to preoperative assessment of biological aggressiveness. KEY POINTS: • An inchworm sign is a simple diagnostic criterion that characterizes only the shape of the tumor signal on DWI, and potentially serves as an imaging biomarker to predict clinical aggressiveness. • The absence of an inchworm sign on DWI is a significant indicator of progression of T1 bladder cancer.
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