Feasibility of Early Evaluation for the Recurrence of Bladder Cancer after Trans-Urethral Resection: A Comparison between Magnetic Resonance Imaging and Multidetector Computed Tomography

Yiqian Wang; Wei Zhang; Weixiong Xiao; Shaobin Chen; Yongbao Wei; Min Luo

doi:10.3390/tomography9010003

Feasibility of Early Evaluation for the Recurrence of Bladder Cancer after Trans-Urethral Resection: A Comparison between Magnetic Resonance Imaging and Multidetector Computed Tomography

Tomography. 2022 Dec 22;9(1):25-35. doi: 10.3390/tomography9010003.

Authors

Yiqian Wang^{1

2}, Wei Zhang^{1

2}, Weixiong Xiao^{1

2}, Shaobin Chen^{1

2}, Yongbao Wei^{1

3}, Min Luo^{1

2}

Affiliations

¹ Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China.
² Department of Radiology, Fujian Provincial Hospital, Fuzhou 350001, China.
³ Department of Urology, Fujian Provincial Hospital, Fuzhou 350001, China.

Abstract

(1) Background: This study investigates the early evaluation value of magnetic resonance imaging (MRI) and multidetector computed tomography (MDCT) in diagnosing the recurrence of bladder cancer (BC) after trans-urethral resection (TUR) alone or combined with intravesical perfusion chemotherapy. (2) Methods: This retrospective study enrolled 92 patients with BC who underwent MRI and MDCT after TUR. The time interval between MRI and MDCT was no more than 1 week. Tumor recurrence was recorded by two experienced radiologists who were double-blind. Recurrent patients were divided into nodular masses, irregular wall thickening and smooth wall thickening groups according to tumor morphology in cystoscopy and resected gross specimens. Inter- and intra-observer agreement was evaluated using the Kappa test. Imaging diagnostic performance was assessed using receiver operating characteristic (ROC) analysis and McNemar’s test based on pathology. (3) Results: There were 56 relapsed and 36 non-relapsed patients. The intra-observer agreement for the imaging diagnosis was excellent (κ = 0.96 for MRI and κ = 0.91 for MDCT, both p < 0.001). The area under the ROC curve of MRI was higher than that for MDCT (0.91 vs. 0.74, p < 0.001) in identifying tumor recurrence and benign treatment-related changes. The sensitivity, specificity and accuracy of MRI (87.5%, 94.4% and 90.2%, respectively) were higher than those of MDCT (67.9%, 80.6% and 72.8%, respectively) in diagnosing tumor recurrence. Two observers missed 10 cases of small lesions (<1 cm) on MDCT. The accuracy of MRI (100%, 90.0% and 25.0%, respectively) was higher than that of MDCT (92.1%, 30.0% and 0%, respectively) in diagnosing nodular masses, irregular wall thickening and smooth wall thickening recurrence patterns. (4) Conclusions: Compared with MDCT, MRI had a higher accuracy in detecting BC recurrence early, especially for nodular masses and irregular wall thickening, and could better differentiate tumor recurrence from benign treatment-related changes.

Keywords: bladder cancer; magnetic resonance imaging; multidetector computed tomography; recurrence; trans-urethral resection.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Feasibility Studies
Humans
Magnetic Resonance Imaging / methods
Multidetector Computed Tomography* / methods
Neoplasm Recurrence, Local / diagnostic imaging
Retrospective Studies
Urinary Bladder Neoplasms* / diagnostic imaging
Urinary Bladder Neoplasms* / surgery

Grants and funding

This research was funded by the Joint Funds for the Innovation of Science and Technology, Fujian Province, grant number 2017Y9064; the Middle-aged Backbone Project Health and Family Planning Commission, grant number 2017-ZQN-13; and the Fujian Natural Science Foundation, grant number 2021J05177.