Comparison of the Diagnostic Value of Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MRI in Differentiating Tumor Stage and Histological Grade of Bladder Cancer

Yanchun Wang, Daoyu Hu, Hao Yu, Yaqi Shen, Hao Tang, Ihab R. Kamel, Zhen Li

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale and Objectives: We aimed to determine the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging (DWI) models in differentiating tumor stage and grade of bladder cancer. Materials and Methods: Forty-five patients with pathologically confirmed bladder cancer underwent multi-b-value DWI. An apparent diffusion coefficient (ADC) was calculated from DWI by using a monoexponential model. A true diffusion coefficient (D), perfusion-related pseudo-diffusion coefficient (D*), and perfusion fraction (f) were calculated from DWI by using a biexponential model. A water molecular diffusion heterogeneity index (α) and distributed diffusion coefficient (DDC) were calculated from DWI by using a stretched exponential model. All parameters were compared between different stages and grades by using the Mann-Whitney U test. Receiver operating characteristic and intrareader correlation coefficient analysis were used for statistical evaluations. Results: ADC, D, f, and DDC values were significantly higher in the non–muscle-invasive vs muscle-invasive bladder cancers (P =.000,.000,.002, and.000, respectively) and in low-grade vs high-grade ones (P =.000,.000,.018, and.000, respectively). D* value was significantly lower in the low-grade bladder cancers compared to high-grade ones (P =.012). The areas under the receiver operating characteristic curve of ADC, D, and DDC values were 0.945, 0.912, and 0.946 in staging bladder cancers; 0.866, 0.862, and 0.856 in grading bladder cancers, respectively. Conclusion: Biexponential and stretched exponential DWI models may provide more parameters in staging and grading bladder cancers and show a slight difference between DDC and ADC values in staging bladder cancers. These two DWI models, as well as the monoexponential models, were very helpful in staging and grading bladder cancers.

Original languageEnglish (US)
Pages (from-to)239-246
Number of pages8
JournalAcademic radiology
Volume26
Issue number2
DOIs
StatePublished - Feb 2019

Keywords

  • Monoexponential model
  • biexponential model
  • bladder cancer
  • magnetic resonance imaging
  • stretched exponential model

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Comparison of the Diagnostic Value of Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MRI in Differentiating Tumor Stage and Histological Grade of Bladder Cancer'. Together they form a unique fingerprint.

Cite this