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A : Linear regression curve of the correlation between ADC and the recurrence score B : Linear regression curve of the correlation between ADC and the progression score
Source publication
AIMS: To evaluate the relationship between the apparent diffusion coefficient (ADC) value for bladder cancer and the recurrence/progression risk of post-transurethral resection (TUR).
METHODS: Forty-one patients with initial and non-muscle-invasive bladder cancer underwent MRI from 2009 to 2012. Two radiologists measured ADC values. A pathologist c...
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Citations
... P = .027). 29 Also, Kikuchi et al. 30 calculated ADC value for 41 patients with no muscle invasive bladder cancer and calculated recurrence and progression score, then stratified them into risk groups. They showed that ADC value correlate significantly with recurrence and progression score ( P < .01, ...
... respectively). 30 ROC analysis showed that ADC cut value was 1.024 for high recurrence risk groups (sensitivity 47.4; specificity 100%), 1.252%) and 0.955 high progression risk groups (sensitivity 87.5%; specificity 63.2%). 30 They concluded that ADC value can be used to predicate the recurrence and progression of NMIBC. ...
... 30 ROC analysis showed that ADC cut value was 1.024 for high recurrence risk groups (sensitivity 47.4; specificity 100%), 1.252%) and 0.955 high progression risk groups (sensitivity 87.5%; specificity 63.2%). 30 They concluded that ADC value can be used to predicate the recurrence and progression of NMIBC. 30 Kobayashi et al. 19 showed that ADC value was significantly lower in tumors with sessile tumors (vs. ...
Background
Prediction of recurrence and progression and the choice of type of management are largely based on stage and grade; however, these prognostic features are limited in the prediction of clinical outcomes.
Objective
To investigate the relation between the apparent diffusion coefficient (ADC) value and recurrence and progression of T1G3 of urothelial carcinoma after TURBT and BCG instillation.
Design, Setting, Participants
Prospective study included sixty-five patients with single bladder mass T1G3 less than 3 cm without CIS or lymphovascular invasion. Mean ADC values of the tumors were compared between patients with and without recurrence and progression following TURBT. The relation of ADC value and other factors were determined by Univariate and multivariate analyses.
Outcome Measurement and Statistical Analysis
The following tests were used to test differences for significance; difference and association of qualitative variable by Chi square test (X²). Differences between quantitative independent groups by t test or Mann Whitney, survival by Kaplan, Cox regression (or Cox proportional hazards model) was used to analyze the effect of several risk factors on time till event (recurrence and progression), correlation by Pearson's correlation or Spearman's and we calculated most suitable cutoff and validity by ROC curve.
Results
In relation to recurrence, smoking, non-papillary shape and higher size and lower ADC were significant predictors for recurrence. In relation to progression, Female, non-papillary shape and lower ADC were significant predictors for progression. Multivariate analysis showed that ADC <1.09 was the only significant independent predictors for recurrence. Also, it showed that ADC <0.98 was the only significant independent predictors for progression.
Conclusion
Low ADC value group of T1G3 bladder cancer showed significant recurrence and progression than high ADC value group of T1G3 bladder cancer.
Patient Summary
ADC value in conjunction with other risk stratifications will have promising role in stratifying patient with T1G3 who need proceeding to early radical cystectomy versus conservative treatment.
... The combination of ADC and wash-out rate determined the BCa aggressiveness with 96.7% sensitivity, 94.9% specificity, and 95.7% accuracy [43]. Also, ADC was useful for determining the recurrence and progression risk of BCa [19,40,[44][45][46]. DWI-MRI however, helps distinguish benign and malignant bladder lesions, for staging, and for the assessment of efficacy of chemo-radiotherapy treatment [36]. ...
Purpose
Early and accurate diagnosis of bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons.
Methods
Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as “bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging”.
Results
A total of 81 published papers were retrieved and are included in the review. For patients with hematuria and suspected of BCa, cystoscopy, and CT are most commonly recommended. Ultrasonography, MRI, PET/CT using ¹⁸F-FDG, or ¹¹C-choline and recently PET/MRI using ¹⁸F-FDG also play a prominent role in detection of BCa.
Conclusion
For initial diagnosis of BCa, cystoscopy is generally performed. However, cystoscopy cannot accurately detect carcinoma in situ and cannot distinguish benign masses from malignant lesions. CT is used in two modes, CT and computed tomographic urography, both for diagnosis and for staging of BCa. However, they cannot differentiate T1 and T2 BCa. MRI is performed to diagnose invasive BCa and can differentiate muscle invasive bladder carcinoma from non-muscle invasive bladder carcinoma. However, CT and MRI have low sensitivity for nodal staging. For nodal staging, PET/CT is preferred. PET/MRI provides a better differentiation of normal and pathologic structures as compared with PET/CT. Nonetheless none of the approaches can address all issues related for the management of BCa. Novel imaging methods that target specific biomarkers, image BCa early and accurately, and stage the disease are warranted.
Bladder cancer (BCa) is among the ten most frequent cancers globally. It is the tumor with the highest lifetime treatment‐associated costs, and among the tumors with the heaviest impacts on postoperative quality of life. The purpose of this article is to review the current applications and future perspectives of the Vesical Imaging Reporting and Data System (VI‐RADS). VI‐RADS is a newly developed scoring system aimed at standardization of MRI acquisition, interpretation, and reporting for BCa. An insight will be given on the BCa natural history, current MRI applications for local BCa staging with assessment of muscle invasiveness, and clinical implications of the score for disease management. Future applications include risk stratification of nonmuscle invasive BCa, surveillance, and prediction and monitoring of therapy response.
Level of Evidence
3
Technical Efficacy Stage
2
