CT and MRI findings of small cell neuroendocrine carcinoma of the urinary bladder: comparison with urothelial carcinoma

Masaya Kawaguchi; Hiroki Kato; Takuya Koie; Yoshifumi Noda; Fuminori Hyodo; Tatsuhiko Miyazaki; Masayuki Matsuo

doi:10.1007/s00261-024-04274-z

CT and MRI findings of small cell neuroendocrine carcinoma of the urinary bladder: comparison with urothelial carcinoma

Abdom Radiol (NY). 2024 Apr 8. doi: 10.1007/s00261-024-04274-z. Online ahead of print.

Authors

Masaya Kawaguchi^{1

2}, Hiroki Kato³, Takuya Koie⁴, Yoshifumi Noda³, Fuminori Hyodo^{3

5}, Tatsuhiko Miyazaki⁶, Masayuki Matsuo³

Affiliations

¹ Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan. kawamasaya0713@yahoo.co.jp.
² Department of Radiology, Ogaki Municipal Hospital, 4-86 Minaminokawacho, Ogaki, 503-0864, Japan. kawamasaya0713@yahoo.co.jp.
³ Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
⁴ Department of Urology, Gifu University, Gifu, Japan.
⁵ Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Gifu, Japan.
⁶ Department of Pathology, Gifu University, Gifu, Japan.

PMID: 38584191
DOI: 10.1007/s00261-024-04274-z

Abstract

Objective: This study aimed to evaluate the efficacy of CT and MRI findings to differentiate small cell neuroendocrine carcinoma (SCNEC) from urothelial carcinoma (UC) of the urinary bladder.

Materials and methods: This study included 90 patients with histopathologically confirmed bladder cancer (10 SCNECs and 80 UCs). Eight patients with bladder SCNEC and 80 with UC underwent CT and MRI, whereas the remaining two patients with SCNEC underwent CT alone before treatment. CT and MRI findings were retrospectively evaluated and compared between the two pathologies.

Results: The maximum diameter (36.5 mm vs. 19.0 mm, p < 0.01) and height (22.0 mm vs. 14.0 mm, p < 0.01) of the tumor in bladder SCNEC were higher than in UC. The pedunculated configuration (20% vs. 61%, p < 0.05) and irregular tumor margins (20% vs. 76%, p < 0.01) in bladder SCNEC were less common than in UC. The CT attenuation of the solid component in unenhanced CT images was higher in bladder SCNEC than in UC (37 Hounsfield unit [HU] vs. 34 HU, p < 0.01). The apparent diffusion coefficient (ADC) of the solid component in bladder SCNEC was lower than in UC (0.49 × 10^-3 mm²/s vs. 1.02 × 10^-3 mm²/s, p < 0.01).

Conclusion: In comparison with UC, bladder SCNEC was larger, had higher unenhanced CT attenuation, and had a lower ADC value. The pedunculated configuration and irregular tumor margins were typical of bladder UC.

Keywords: Bladder cancer; CT; MRI; Small cell carcinoma.