Mp18-07 Multiparametric Mri Is More Accurate to Distinguish T1 Versus T2 Primary Bladder Tumours Compared to Conventional Mri: A Prospective Study

You have accessJournal of UrologyImaging/Uroradiology I (MP18)1 May 2024MP18-07 MULTIPARAMETRIC MRI IS MORE ACCURATE TO DISTINGUISH T1 VERSUS T2 PRIMARY BLADDER TUMOURS COMPARED TO CONVENTIONAL MRI: A PROSPECTIVE STUDY Uttam Mete, Prajwal Paudyal, Ujjwal Gorsi, and Nandita Kakkar Uttam MeteUttam Mete , Prajwal PaudyalPrajwal Paudyal , Ujjwal GorsiUjjwal Gorsi , and Nandita KakkarNandita Kakkar View All Author Informationhttps://doi.org/10.1097/01.JU.0001008672.83391.ed.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Accurate T staging of primary tumour of patients with bladder cancer is decisive for the allocation to optimal treatment algorithms. Contrast-enhanced CT as well as conventional MRI imaging have been the guideline-recommended standard for years , but they are not accurate to differentiate T1 & T2 lesion and sensitivity and specificity are limited with significant inter-rater variability . Current improvements in MRI technology due to addition of functional MR sequences i.e. dynamic contrast-enhanced (DCE) imaging and diffusion-weighted imaging (DWI) have enhanced its clinical utility. The current study was designed to look for staging accuracy of multiparametric MRI (mp-MRI) i.e. T2W+DCE+DWI, over conventional MRI. METHODS: Forty patients with bladder cancer were subjected to mp-MRI on a 1.5T scanner with a phased array body coil. Four MR image sets i.e. T2W, T2W+DCE, T2W+DWI and T2W+DCE+DWI were interpreted. Accuracy of each image set was determined separately and was compared with the gold standard histolopathological staging. ADC values were compared with histological grade and stage. RESULTS: Staging accuracy of different image set increased from T2W (55%) to DCE (72.5%) to DWI (80%). Maximum accuracy was seen in mp-MRI (T2W+DWI+DCE) (87.5%). While differentiating non muscle invasive from muscle invasive disease (≤T1 versus ≥T2 stage) staging accuracy increased from T2W (65%) to DCE (80%) to DWI (85%) with maximum in mp-MRI (90%) (Table 1). A cut-off ADC value of 1.02×10-3 mm2/s best differentiated high grade from low grade cancer with a sensitivity of 95.5% and a specificity of 94.4%. ADC values were significantly lower (p<0.001) in high grade (median 0.745×10-3 mm2/s) and in higher stage carcinomas ≥T2, (median 0.666×10-3 mm2/s) compared to low-grade (median 1.18×10-3 mm2/s) and low stage disease (median 1.12×10-3 mm2/s). CONCLUSIONS: mp-MRI could potentially serve as an accurate and non-invasive technique to differentiate T1 Vs. T2 />T2 bladder tmours as it offers high staging accuracy for bladder cancer. ADC values in mp-MRI showed inverse correlations with histological grade also thereby improves the performance of mpMRI for staging as well as grading. Source of Funding: nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e303 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Uttam Mete More articles by this author Prajwal Paudyal More articles by this author Ujjwal Gorsi More articles by this author Nandita Kakkar More articles by this author Expand All Advertisement PDF downloadLoading ...