ArticleDiagnostic and interventional radiology (Ankara, Turkey)2025
The role of multiparametric magnetic resonance imaging in the differentiation of low- and high-grade non-muscle invasive bladder cancer
Article in Diagnostic and interventional radiology (Ankara, Turkey), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the diagnostic efficacy of apparent diffusion coefficient (ADC) measurements and semi-quantitative dynamic contrast enhancement (DCE) parameters in predicting the differentiation between low- and high-grade tumors in non-muscle invasive bladder cancers (NMIBC).
methodsPatients with NMIBC, who were histopathologically confirmed between August 2020 and July 2023, were analyzed by 2 radiologists with different levels of experience. DCE semi-quantitative parameters such as wash-in rate (WiR), wash-out ratio (WoR), time to peak (TTP), and peak enhancement (PE) were calculated. ADC measurements were performed using the three-region-of-interest (ADCt) and whole volume (ADCw) methods; ADCt ratio (ADCtR) and ADCw ratio (ADCwR) were also calculated. Receiver operating characteristic curve analysis was performed to demonstrate the cut-off values of ADCt, ADCw, ADCtR, and ADCwR to differentiate low- and high-grade tumors. The intraclass correlation coefficient was used to evaluate inter-reader agreement.
resultsA total of 89 patients were included in this study. Of these patients, 48 had low-grade NMIBC, and 41 had high-grade NMIBC. There was no significant difference in mean WoR, WiR, TTP, and PE values between low- and high-grade NMIBC (
conclusionWhile DCE semiquantative parameters did not yield significant outcomes in distinguishing between low and high grades, ADCtR holds promise for enhancing patient management in NMIBC cases and stands as a potential preoperative radiological asset. CLINICAL SIGNIFICANCE: Individuals diagnosed with NMIBC may require different treatment approaches; therefore, it is very important to distinguish between low- and high-grade cases preoperatively. The differentiation between the Ta- and T1-stages is recognized as crucial in patient treatment strategies. Furthermore, ADCtR shows promise for improving patient management in NMIBC cases.
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