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Diffusion‐weighted magnetic resonance imaging in patients selected for radical cystectomy: detection rate of pelvic lymph node metastases
Author(s) -
Papalia Rocco,
Simone Giuseppe,
Grasso Rosario,
Augelli Raffaele,
Faiella Eliodoro,
Guaglia Salvatore,
Cazzato Roberto,
Vescovo Riccardo Del,
Ferriero Mariaconsiglia,
Zobel Bruno,
Gallucci Michele
Publication year - 2012
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2011.10446.x
Subject(s) - medicine , cystectomy , magnetic resonance imaging , lymph node , diffusion mri , lymph , bladder cancer , radiology , diffusion weighted magnetic resonance imaging , receiver operating characteristic , nuclear medicine , cancer , pathology
Study Type – Diagnostic (exploratory cohort) Level of Evidence 3a What's known on the subject? and What does the study add? Preoperative imaging of nodal status in patients undergoing radical cystectomy for bladder cancer lacks diagnostic accuracy. This is the first study that has investigated nodal metastates in bladder cancer using DW‐MRI. ADC derived from DW‐MRI may be used to differentiate metastatic from non‐metastatic lymph nodes. OBJECTIVE • To evaluate whether DW‐MRI improves the detection of pelvic lymph nodes metastates in patients with bladder cancer undergoing radical cystectomy. PATIENTS AND METHODS • 36 patients with CT scan negative for nodal metastates underwent DW‐MRI before surgery. Diagnostic accuracy of DW‐MRI was compared with histopathological findings. RESULTS • Mean ADC value was 0.85 × 10 −3 mm 3 /s in the nodal metastatic group and 1 × 10 −3 mm 3 /s in the nodal non‐metastatic group ( P = 0.02). • The ADC cut‐off value, obtained by the ROC curve was 0.86 × 10 −3 mm 3 /s. • Patient‐based sensitivity, specificity and positive and negative predictive values were 76.4%, 89.4%, 26.6%, and 71.4%, respectively. CONCLUSION • DW‐MRI may be used to differentiate metastatic from non‐metastatic lymph nodes in patients with high‐grade bladder cancer.