Diagnostic significance of peritumoral enhancement in distinguishing between muscle-invasive and non-muscle-invasive bladder cancer.

IF 2.3 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2024-10-30 DOI:10.1007/s00261-024-04658-1

Mitsuru Takeuchi, Atsushi Higaki, Yuichi Kojima, Kentaro Ono, Takuma Maruhisa, Takatoshi Yokoyama, Hiroyuki Watanabe, Akira Yamamoto, Tsutomu Tamada

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引用次数: 0

Abstract

Objective: The aim of this study was to assess the prevalence of peritumoral enhancement (PTE) in patients with muscle-invasive bladder cancer (MIBC) and non-MIBC (NMIBC) and to propose a modified diagnostic criterion for Vesical Imaging Reporting and Data System (VI-RADS) that incorporates PTE.

Materials and methods: This retrospective study included 95 patients with bladder cancer (age, 72 ± 11; 77 men; 36 MIBCs and 59 Non-MIBCs) who underwent multiparametric MRI in our referral center between 2011 and 2023. The images were interpreted by four radiologists. The readers classified the possibility of muscle layer invasion into categories 1-5, based on the VI-RADS categorical diagnostic criterion. PTE was defined as a linear contrast enhancement observed at the edge of tumor invasion which is convex outward from the normal bladder wall and contrasts more than the normal muscle layer and tumor. A modified VI-RADS that upgrades the final VI-RADS category to 4 if PTE is present when the original VI-RADS category is 3 or less was proposed. The frequency of PTE in the MIBC and NMIBC groups was compared using the Fisher's exact test. Sensitivity and specificity for the diagnosis of MIBC were compared with the original VI-RADS using McNemar test. Pathologic diagnosis was used as the reference standard.

Results: PTE was present in 70-81% (25/36-29/36) of MIBC and absent in 92-98% (54/59-58/59) of non-MIBC. For all readers, the PTE was significantly more frequent (p < 0.001) in the MIBC group than the NMIBC group. The sensitivities of modified VI-RADS (75.0-86.1%) were significantly higher than those of original VI-RADS (41.7-55.6%) (p = 0.002-0.008). The specificity of modified VI-RADS (91.5-98.3%) were not statistically different from original VI-RADS (98.3-100%).

Conclusions: In conclusion, PTE is a highly specific finding for MIBC. modified VI-RADS incorporating PTE increases sensitivity for MIBC.

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瘤周强化对区分肌层浸润性和非肌层浸润性膀胱癌的诊断意义。

研究目的本研究旨在评估肌层浸润性膀胱癌（MIBC）和非肌层浸润性膀胱癌（NMIBC）患者瘤周增强（PTE）的发生率，并为膀胱影像报告和数据系统（VI-RADS）提出一个包含PTE的修正诊断标准：这项回顾性研究纳入了 2011 年至 2023 年期间在我们的转诊中心接受多参数 MRI 检查的 95 名膀胱癌患者（年龄 72 ± 11；77 名男性；36 名 MIBC 和 59 名非 MIBC）。图像由四位放射科医生解读。阅片人员根据 VI-RADS 分类诊断标准将肌层受侵的可能性分为 1-5 类。PTE被定义为在肿瘤侵犯边缘观察到的线性对比度增强，从正常膀胱壁向外凸，对比度高于正常肌层和肿瘤。提出了一种修改后的 VI-RADS，即当原始 VI-RADS 类别为 3 或更低时，如果出现 PTE，则最终 VI-RADS 类别升至 4。采用费雪精确检验比较了 MIBC 组和 NMIBC 组中 PTE 的发生频率。使用 McNemar 检验比较了 MIBC 诊断的敏感性和特异性。病理诊断作为参考标准：70%-81%（25/36-29/36）的 MIBC 存在 PTE，92%-98%（54/59-58/59）的非 MIBC 不存在 PTE。在所有读者中，PTE 的发生率明显更高（P 结论：PTE 是一种高发的肿瘤标志物：修改后的 VI-RADS 纳入了 PTE，提高了对 MIBC 的敏感性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits