Accuracy of Inchworm Sign on Diffusion-Weighted MRI in Differentiating Muscle-Invasive Bladder Cancer.

IF 1 4区医学 Q4 ONCOLOGY

Bladder Cancer Pub Date : 2022-03-11 eCollection Date: 2022-01-01 DOI:10.3233/BLC-211535

Huseyin Ozgur Kazan, Meftun Culpan, Nesrin Gunduz, Ferhat Keser, Ayberk Iplikci, Ramazan Gokhan Atis, Asif Yildirim

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引用次数: 0

Abstract

Background: Inchworm sign is a finding on diffusion-weighted magnetic resonance imaging (DWI-MRI) and is used to better stratify T-staging in muscle invasive (MIBC) and non-muscle-invasive bladder cancer (NMIBC). An uninterrupted low submucosal signal on DWI, defined as inchworm sign (IS), indicates NMIBC.

Objective: We aimed to define the diagnostic accuracy of IS in primary bladder cancer, as well as find agreement between the urologists and the radiologist.

Methods: Between December 2018 and December 2020, we retrospectively analyzed 95 primary bladder cancer patients who had undergone multiparametric-MRI before transurethral resection. Patients with former bladder cancer history, tumors smaller than 10 mm, and MRI without proper protocol, as well as patients who did not attend follow-up, were excluded. In total, 71 patients' images were evaluated by a genitourinary specialist radiologist and two urologists. Sensitivity, specificity, positive and negative predictive values of IS and VI-RADS in differentiating MIBC and NMIBC, and interreader agreement between the radiologist and urologists were analyzed.

Results: During follow-up, 38 patients (53.5%) were IS-positive, while 33 patients (46.5%) were negative. Among the 33 patients with negative IS, 14 patients (42.4%) had MIBC. Meanwhile, two out of the 38 IS-positive patients (5.3%) had MIBC (p = 0.00). Sensitivity, specificity, and positive and negative predictive values of IS in predicting MIBC were 87.5%, 63.6%, 41.2%and 94.6%, respectively. The interobserver agreement between the urologists and radiologist was almost perfect ( _K = 0.802 and _K = 0.745).

Conclusion: The absence of IS on DWI is useful in differentiating MIBC from NMIBC. It is a simple finding that can be interpreted by urologists.

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扩散加权MRI尺蠖征象鉴别肌肉浸润性膀胱癌的准确性

背景:尺蠖征象是扩散加权磁共振成像(DWI-MRI)的一个发现，用于更好地划分肌肉浸润性(MIBC)和非肌肉浸润性膀胱癌(NMIBC)的t分期。DWI上不间断的粘膜下低信号，定义为尺蠖征(IS)，提示NMIBC。目的:我们旨在确定IS在原发性膀胱癌中的诊断准确性，并找到泌尿科医生和放射科医生之间的一致性。方法:2018年12月至2020年12月，回顾性分析95例经尿道膀胱切除术前行多参数mri检查的原发性膀胱癌患者。排除既往膀胱癌病史、肿瘤小于10mm、MRI无适当方案的患者以及未参加随访的患者。一名泌尿生殖专科放射科医生和两名泌尿科医生对71名患者的图像进行了评估。分析IS和VI-RADS鉴别MIBC和NMIBC的敏感性、特异性、阳性和阴性预测值，以及放射科医生和泌尿科医生之间的解读一致性。结果:随访中is阳性38例(53.5%)，阴性33例(46.5%)。33例IS阴性患者中，14例(42.4%)有MIBC。同时，38例is阳性患者中有2例(5.3%)发生MIBC (p = 0.00)。IS预测MIBC的敏感性为87.5%，特异性为63.6%，阳性预测值为41.2%，阴性预测值为94.6%。结论:DWI上IS的缺失是鉴别MIBC与NMIBC的重要依据。这是一个简单的发现，可以被泌尿科医生解释。

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

Bladder Cancer Medicine-Urology

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.