Detecting the muscle invasiveness of bladder cancer: An application of diffusion kurtosis imaging and tumor contact length

Qing Li; Bohong Cao; Kai Liu; Haitao Sun; Yuqin Ding; Cheng Yan; Pu-Yeh Wu; Chenchen Dai; Shengxiang Rao; Mengsu Zeng; Shuai Jiang; Jianjun Zhou

doi:10.1016/j.ejrad.2022.110329

Detecting the muscle invasiveness of bladder cancer: An application of diffusion kurtosis imaging and tumor contact length

Eur J Radiol. 2022 Jun:151:110329. doi: 10.1016/j.ejrad.2022.110329. Epub 2022 Apr 22.

Authors

Qing Li¹, Bohong Cao¹, Kai Liu², Haitao Sun¹, Yuqin Ding¹, Cheng Yan², Pu-Yeh Wu³, Chenchen Dai¹, Shengxiang Rao¹, Mengsu Zeng¹, Shuai Jiang⁴, Jianjun Zhou⁵

Affiliations

¹ Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
² Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China.
³ GE Healthcare, MR Research China, Beijing, China.
⁴ Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Urology, Zhongshan Hospital Wusong Branch, Fudan University, Shanghai, China.
⁵ Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Fujian Province, China. Electronic address: zhoujianjunzs@126.com.

PMID: 35487092
DOI: 10.1016/j.ejrad.2022.110329

Abstract

Purpose: To evaluate the diagnostic efficacy of diffusion kurtosis imaging (DKI) parameters and tumor contact length (TCL) among clinical and radiological factors for preoperative prediction of muscle-invasive bladder cancer (MIBC).

Method: A total of ninety-seven patients underwent 3.0 T MRI scan with propeller fast spin-echo T2WI, echo planar imaging diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE). Two radiologists independently viewed multiparametric MRI (mpMRI) of each patient, graded the VI-RADS, drew the region of interest (ROI) and measured TCL. Interclass correlation coefficients (ICCs), Kappa statistics, Kolmogorov-Smirnov test, Mann-Whitney U tests, chi-square tests, logistic regression analyses, Hosmer-Lemeshow tests, receiver operating characteristic curve (ROC) analysis, and area under the curve (AUC) were applied.

Results: The mean K_app of NMIBC group (0.62 ± 0.01) was significantly lower than that of MIBC group (0.79 ± 0.08). The mean TCL of MIBC group (4.66 ± 1.89) was significantly larger than TCL of NMIBC group (1.88 ± 1.50) (all p < 0.01). At the corresponding cut-off, AUC of TCL, K_app, VI-RADS and the combination of K_app and TCL were 0.87, 0.92, 0.90, and 0.95, respectively. TCL and K_app were risk factors of BC muscle invasion at both univariate and multivariate analysis.

Conclusions: K_app performed better than conventional DWI in predicting MIBC. K_app and TCL were independent risk factors of MIBC and could complement VI-RADS for predicting muscle invasion. The combination of K_app and TCL had the largest AUC and highest accuracy among all parameters.

Keywords: Diagnostic efficacy; Diffusion kurtosis imaging; Neoplasm invasiveness; Tumor contact length; Urinary bladder neoplasms.

MeSH terms

Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Female
Humans
Magnetic Resonance Imaging
Male
Multiparametric Magnetic Resonance Imaging*
Muscles
Retrospective Studies
Urinary Bladder Neoplasms* / diagnostic imaging
Urinary Bladder Neoplasms* / surgery