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Investigation of diffusion kurtosis imaging for discriminating tumors from inflammatory lesions after treatment for bladder cancer
Author(s) -
Wang Fang,
Jin Di,
Hua XiaoLan,
Zhao ZiZhou,
Wu LianMing,
Chen WeiBo,
Wu GuangYu,
Chen XiaoXi,
Chen HaiGe
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25924
Subject(s) - medicine , bladder cancer , receiver operating characteristic , kurtosis , diffusion mri , effective diffusion coefficient , chemotherapy , nuclear medicine , magnetic resonance imaging , cancer , radiology , statistics , mathematics
Background The bladder wall may thicken resulting from chronic inflammation after initial treatment (transurethral resection [TUR] or neoadjuvant chemotherapy), which may mimic the feature of recurrent or residual bladder tumors (RBT). Therefore, it is critical to discriminate RBT from benign lesions after initial treatment. Purpose To investigate whether diffusion kurtosis imaging (DKI) could discriminate RBT from post‐therapy bladder inflammatory lesions. Study Type Retrospective. Subjects Fifty patients diagnosed with bladder cancer underwent TUR or received neoadjuvant chemotherapy. Field Strength/Sequence 3.0T MRI/conventional T 1 ‐weighted imaging (T 1 WI), T 2 WI, and diffusion‐weighted imaging (DWI) with nine b‐values ranging from 0–2000 s/mm 2 . Assessment Mean diffusion coefficients (MD a , MD b , and MD c ) and mean kurtosis values (MK a , MK b , and MK c ) were obtained from three different measurement methods. The region of interest (ROI) was placed 1) to encompass the entire portion of the thickening bladder wall or to portions that were the most restricted, with a b‐value of 2) 2000 s/mm 2 or 3) 1000 s/mm 2 . Statistical Tests The independent‐samples t ‐test was used to compare the differences between RBT and the inflammatory group. Differences in DKI parameters were analyzed by comparing the areas under the receiver‐operator characteristic curves (AUCs). Results In patients with RBT, the MD (MD a , MD b , MD c ) values were significantly lower and the MK (MK a , MK b , MK c ) values were significantly higher than those in patients in the inflammatory lesions group (all P < 0.01). The AUC of MK b (0.934) was significantly larger than those of MD b , MK a , and MK c (0.793, P < 0.05; 0.694, P < 0.01; 0.719, P < 0.01, respectively). Data Conclusion MK obtained from DKI provided better performance than conventional DWI in distinguishing RBT from inflammatory lesions after bladder cancer treatment. MK calculated with high b‐values setting provided better performance in differentiation. Level of Evidence : 1 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2017.