Abstract
Background
The purposes of our study were to investigate the feasibility of diffusion-weighted
imaging in the detection of malignant bladder tumors, with comparison to the high-resolution
thin-section fast spin-echo (FSE) T2-weighted MRI, and also to compare the apparent
diffusion coefficient (ADC) values of the bladder tumors with the surrounding structures.
Material and Methods
Fifty-three consecutive patients consisting of 44 males and 9 females who presented
with a bladder mass were prospectively enrolled in this study. Mean age was 62.53±12.03
(age range, 33–86 years). These patients were evaluated by high-resolution thin-section
FSE T2-weighted and diffusion-weighted MRI for the detection of bladder masses. Following
MRI, within 2 weeks, all patients were subjected to either surgery or cystoscopic
biopsy, and the obtained histopathological proofs were used as the reference standard.
Furthermore, ADC values of the bladder tumors, urine, the normal bladder wall, the
central and peripheral zones of the prostate, the seminal vesicule, and the uterus
outer myometrium were also calculated. ADC values of the bladder carcinomas and the
related surrounding structures were compared as to whether a statistically significant
difference was present or not.
Results
In a total of 47 patients, consisting of 39 males and 8 females, bladder carcinomas
were clearly shown as having conspicuous high and intermediate signal intensity masses,
relative to the surrounding structures on diffusion-weighted and T2-weighted images,
respectively. An 89% sensitivity and a 100% positive predictive value were obtained
for both FSE T2-weighted and diffusion-weighted MRI in the diagnosis of bladder carcinoma.
Mean ADC values and standard deviations of the bladder tumors and the surrounding
structures were as follows: bladder carcinomas (n=47): 1.28±0.31, normal bladder wall (n=47): 1.98±0.41, urine (n=47): 3.12±0.24, seminal vesicle (n=39): 1.82±0.33, peripheral zone of prostate (n=39): 1.80±0.29, central zone of prostate (n=39): 1.55±0.33, and uterus outer myometrium (n=8): 1.53±0.19. It can be clearly seen that the mean ADC values of the bladder carcinomas
were significantly lower than the surrounding structures (P<.05).
Conclusıon
High-resolution thin-section FSE T2 and diffusion-weighted MRI show high diagnostic
performance and are comparable in the detection of bladder tumors. Diffusion-weighted
MRI provides high quality images of the malignant bladder tumors against a suppressed
background signal. Diffusion-weighted MRI using ADC measurements may be useful in
the evaluation of tumor invasion to the adjacent organs.
Keywords
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Article info
Publication history
Published online: August 01, 2013
Accepted:
April 12,
2013
Received in revised form:
February 28,
2013
Received:
September 30,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
