Dynamic MRI of bladder cancer

Evaluation of staging accuracy

Aylin Tekes, Ihab R Kamel, Khursheed Imam, Gilberto Szarf, Mark Schoenberg, Khurram Nasir, Richard Thompson, David Bluemke

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study was to evaluate the accuracy of gadolinium-enhanced MRI in staging bladder cancer in a series of patients with surgically proven bladder cancer. MATERIALS AND METHODS. Seventy-one patients with biopsy-proven bladder cancer underwent MRI on a 1.5-T scanner with a phased-array pelvic coil. Conventional T1-weighted spin-echo, T2-weighted spin-echo, and unenhanced and enhanced (0.1 mmol/kg gadolinium) fast spoiled gradient-echo images with fat suppression were obtained. Two blinded reviewers evaluated the MR images and assigned a stage that was compared with the pathologic stage (n = 67) or with clinical follow-up for at least 2 years after MRI (n = 4). RESULTS. Agreement among the reviewers was good in assigning a radiologic stage for bladder cancer (kappa = 0.80). On a stage-by-stage basis, MRI accuracy was 62%, and overstaging was the most common error (32%). Staging accuracy improved to 85% and 82% in differentiating superficial from invasive tumors and organ-confined from non-organ-confined tumors, respectively. The time interval between MRI and transurethral resection (≤60 days and ≥61 days) was not a statistically significant factor in differentiating superficial from invasive and organ-confined from non-organ-confined tumors (p > 0.05). MRI accuracy in staging transitional cell carcinoma was not significantly different from that obtained in staging non-transitional cell carcinoma (p > 0.05). CONCLUSION. MRI shows good reproducibility between reviewers for staging bladder cancer. Although overall staging accuracy was only moderate, the accuracy for differentiating superficial versus invasive disease and organ-confined versus non-organ-confined disease was high.

Original languageEnglish (US)
Pages (from-to)121-127
Number of pages7
JournalAmerican Journal of Roentgenology
Volume184
Issue number1
StatePublished - Jan 2005

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Neoplasm Staging
Urinary Bladder Neoplasms
Gadolinium
Neoplasms
Transitional Cell Carcinoma
Fats
Carcinoma
Biopsy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Tekes, A., Kamel, I. R., Imam, K., Szarf, G., Schoenberg, M., Nasir, K., ... Bluemke, D. (2005). Dynamic MRI of bladder cancer: Evaluation of staging accuracy. American Journal of Roentgenology, 184(1), 121-127.

Dynamic MRI of bladder cancer : Evaluation of staging accuracy. / Tekes, Aylin; Kamel, Ihab R; Imam, Khursheed; Szarf, Gilberto; Schoenberg, Mark; Nasir, Khurram; Thompson, Richard; Bluemke, David.

In: American Journal of Roentgenology, Vol. 184, No. 1, 01.2005, p. 121-127.

Research output: Contribution to journalArticle

Tekes, A, Kamel, IR, Imam, K, Szarf, G, Schoenberg, M, Nasir, K, Thompson, R & Bluemke, D 2005, 'Dynamic MRI of bladder cancer: Evaluation of staging accuracy', American Journal of Roentgenology, vol. 184, no. 1, pp. 121-127.
Tekes A, Kamel IR, Imam K, Szarf G, Schoenberg M, Nasir K et al. Dynamic MRI of bladder cancer: Evaluation of staging accuracy. American Journal of Roentgenology. 2005 Jan;184(1):121-127.
Tekes, Aylin ; Kamel, Ihab R ; Imam, Khursheed ; Szarf, Gilberto ; Schoenberg, Mark ; Nasir, Khurram ; Thompson, Richard ; Bluemke, David. / Dynamic MRI of bladder cancer : Evaluation of staging accuracy. In: American Journal of Roentgenology. 2005 ; Vol. 184, No. 1. pp. 121-127.
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N2 - OBJECTIVE. The purpose of this study was to evaluate the accuracy of gadolinium-enhanced MRI in staging bladder cancer in a series of patients with surgically proven bladder cancer. MATERIALS AND METHODS. Seventy-one patients with biopsy-proven bladder cancer underwent MRI on a 1.5-T scanner with a phased-array pelvic coil. Conventional T1-weighted spin-echo, T2-weighted spin-echo, and unenhanced and enhanced (0.1 mmol/kg gadolinium) fast spoiled gradient-echo images with fat suppression were obtained. Two blinded reviewers evaluated the MR images and assigned a stage that was compared with the pathologic stage (n = 67) or with clinical follow-up for at least 2 years after MRI (n = 4). RESULTS. Agreement among the reviewers was good in assigning a radiologic stage for bladder cancer (kappa = 0.80). On a stage-by-stage basis, MRI accuracy was 62%, and overstaging was the most common error (32%). Staging accuracy improved to 85% and 82% in differentiating superficial from invasive tumors and organ-confined from non-organ-confined tumors, respectively. The time interval between MRI and transurethral resection (≤60 days and ≥61 days) was not a statistically significant factor in differentiating superficial from invasive and organ-confined from non-organ-confined tumors (p > 0.05). MRI accuracy in staging transitional cell carcinoma was not significantly different from that obtained in staging non-transitional cell carcinoma (p > 0.05). CONCLUSION. MRI shows good reproducibility between reviewers for staging bladder cancer. Although overall staging accuracy was only moderate, the accuracy for differentiating superficial versus invasive disease and organ-confined versus non-organ-confined disease was high.

AB - OBJECTIVE. The purpose of this study was to evaluate the accuracy of gadolinium-enhanced MRI in staging bladder cancer in a series of patients with surgically proven bladder cancer. MATERIALS AND METHODS. Seventy-one patients with biopsy-proven bladder cancer underwent MRI on a 1.5-T scanner with a phased-array pelvic coil. Conventional T1-weighted spin-echo, T2-weighted spin-echo, and unenhanced and enhanced (0.1 mmol/kg gadolinium) fast spoiled gradient-echo images with fat suppression were obtained. Two blinded reviewers evaluated the MR images and assigned a stage that was compared with the pathologic stage (n = 67) or with clinical follow-up for at least 2 years after MRI (n = 4). RESULTS. Agreement among the reviewers was good in assigning a radiologic stage for bladder cancer (kappa = 0.80). On a stage-by-stage basis, MRI accuracy was 62%, and overstaging was the most common error (32%). Staging accuracy improved to 85% and 82% in differentiating superficial from invasive tumors and organ-confined from non-organ-confined tumors, respectively. The time interval between MRI and transurethral resection (≤60 days and ≥61 days) was not a statistically significant factor in differentiating superficial from invasive and organ-confined from non-organ-confined tumors (p > 0.05). MRI accuracy in staging transitional cell carcinoma was not significantly different from that obtained in staging non-transitional cell carcinoma (p > 0.05). CONCLUSION. MRI shows good reproducibility between reviewers for staging bladder cancer. Although overall staging accuracy was only moderate, the accuracy for differentiating superficial versus invasive disease and organ-confined versus non-organ-confined disease was high.

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