ArticleAbdominal radiology (New York)2026
Coronal reduced field-of-view diffusion-weighted imaging improves image quality and T staging of upper tract urothelial carcinoma compared with conventional axial DWI: a retrospective study.
Article in Abdominal radiology (New York), 2026. 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 whether coronal reduced field-of-view (r-FOV) diffusion-weighted imaging (DWI) improves image quality and local T staging of upper tract urothelial carcinoma (UTUC) compared with conventional axial full field-of-view (f-FOV) DWI.
methodsIn this retrospective single-center study, 60 patients with pathologically confirmed UTUC who underwent preoperative magnetic resonance urography (MRU) were included. The imaging protocol comprised both axial f-FOV DWI and coronal r-FOV DWI acquired on a 3.0-T scanner. Two radiologists independently assessed subjective image quality (sharpness, distortion, artifacts, and lesion conspicuity). Tumor contrast and apparent diffusion coefficient (ADC) values were measured. Local T staging was performed using each DWI sequence, with particular focus on identifying locally advanced disease (≥ T3). Histopathology from radical nephroureterectomy served as the reference standard.
resultsCoronal r-FOV DWI demonstrated significantly higher image quality scores across all subjective parameters than axial f-FOV DWI (all p ≤ 0.003). Tumor contrast was higher on r-FOV DWI (p < 0.001), and ADC values measured on r-FOV DWI were significantly lower than those on f-FOV DWI (p < 0.001), with a strong correlation between the two techniques (r = 0.765). High-grade UTUC showed significantly lower ADC values than low-grade tumors on both sequences (p < 0.05). For detecting locally advanced disease (≥ T3), coronal r-FOV DWI achieved higher sensitivity (91.7% vs. 75.0%), specificity (80.6% vs. 75.0%), and overall accuracy (85.0% vs. 75.0%) compared with axial f-FOV DWI. The addition of coronal r-FOV DWI was subjectively considered diagnostically useful in 91.7% of cases.
conclusionCoronal r-FOV DWI significantly improves image quality, tumor conspicuity, and local T staging performance in UTUC compared with conventional axial f-FOV DWI. When incorporated as a complementary sequence in MRU, coronal r-FOV DWI provides added diagnostic value, particularly for identifying locally advanced disease.
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