Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer

Essam A Shalaby; Ahmed R Mohamed; Tarek H Elkammash; Rasha T Abouelkheir; Ahmed M Housseini

doi:10.1097/CU9.0000000000000128

Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer

Curr Urol. 2022 Sep;16(3):127-135. doi: 10.1097/CU9.0000000000000128. Epub 2022 Aug 31.

Authors

Essam A Shalaby¹, Ahmed R Mohamed², Tarek H Elkammash², Rasha T Abouelkheir³, Ahmed M Housseini²

Affiliations

¹ Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
² Department of Diagnostic Radiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
³ Diagnostic Radiology, Urology and Nephrology Center, Mansura University, Mansura, Egypt.

Abstract

Objectives: To assess the role of multiparametric magnetic resonance imaging (mp-MRI) in the diagnosis and staging of urinary bladder cancer (BC).

Materials and methods: Fifty patients diagnosed with bladder masses underwent mp-MRI study. The results of 3 image sets were analyzed and compared with the histopathological results as a reference standard: T2-weighted image (T2WI) plus dynamic contrast-enhanced (DCE), T2WI plus diffusion-weighted images (DWI), and mp-MRI, including T2WI plus DWI and DCE. The diagnostic accuracy of mp-MRI was evaluated using receiver operating characteristic curve analysis.

Results: The accuracy of T2WI plus DCE for detecting muscle invasion of BC was 79.5% with a fair agreement with histopathological examination (κ = 0.59); this percentage increased up to 88.6% using T2WI plus DWI, with good agreement with histopathological examination (κ = 0.74), whereas mp-MRI had the highest overall accuracy (95.4%) and excellent agreement with histopathological data (κ = 0.83). Multiparametric MRI can differentiate between low- and high-grade bladder tumors with a high sensitivity and specificity of 93.3% and 98.3%, respectively.

Conclusions: Multiparametric MRI is an acceptable method for the preoperative detection and accurate staging of BC, with reasonable accuracy in differentiating between low- and high-grade BC.

Keywords: Apparent diffusion coefficient; Bladder cancer; Diffusion-weighted imaging; Multiparametric magnetic resonance imaging; Transurethral resection of bladder tumor.