Prediction of muscle invasion of bladder cancer: A comparison between DKI and conventional DWI

Qing Li; Bohong Cao; Qinxuan Tan; Kai Liu; Shuai Jiang; Jianjun Zhou

doi:10.1016/j.ejrad.2021.109522

Prediction of muscle invasion of bladder cancer: A comparison between DKI and conventional DWI

Eur J Radiol. 2021 Mar:136:109522. doi: 10.1016/j.ejrad.2021.109522. Epub 2021 Jan 6.

Authors

Qing Li¹, Bohong Cao², Qinxuan Tan³, Kai Liu⁴, Shuai Jiang⁵, Jianjun Zhou⁶

Affiliations

¹ Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China. Electronic address: liqing_0413@163.com.
² Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China. Electronic address: cao.bohong@zs-hospital.sh.cn.
³ Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China. Electronic address: tanqinxuan1994@163.com.
⁴ Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China. Electronic address: 195347478@qq.com.
⁵ Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China. Electronic address: jiang.shuai@zs-hospital.sh.cn.
⁶ Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China; Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, 668 Jinhu Road, Huli District, Xiamen City 361015, Fujian Province, People's Republic of China. Electronic address: zhoujianjunzs@126.com.

PMID: 33434860
DOI: 10.1016/j.ejrad.2021.109522

Abstract

Objectives: To prospectively compare the diagnostic efficacy of conventional diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in differentiating between muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC).

Methods: Multiple b value DWIs were performed using a 3-T magnetic resonance (MR) imaging unit in fifty-one patients with bladder cancer including MIBC and NMIBC confirmed by histopathological findings. DWI data were postprocessed using mono-exponential and DKI models to calculate the apparent diffusion coefficient (ADC), apparent diffusional kurtosis (K_app), and kurtosis-corrected diffusion coefficient (D_app). Receiver-operating characteristic (ROC) analysis was performed to compare the diagnostic efficacy of all diffusion parameters.

Results: All parameters differed significantly between MIBC and NIMBC including increased K_app, decreased D_app and ADC (all p < 0.001). Only the combination of D_app and K_app was significantly higher than ADC (p < 0.05), whilst D_app and K_app were not statistically different from ADC.

Conclusions: Both conventional DWI and DKI models are beneficial in differentiating between MIBC and NMIBC, whilst the combination of D_app and K_app can produce a more robust value than conventional ADC value in evaluating aggressiveness of bladder cancer.

Keywords: Diagnostic efficacy; Diffusion kurtosis imaging; Diffusion-weighted MRI; Urinary bladder neoplasms.

MeSH terms

Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Humans
Magnetic Resonance Imaging
Muscles
Urinary Bladder Neoplasms* / diagnostic imaging