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Conventional and diffusion-weighted MRI features in diagnosis of metastatic lymphadenopathy in bladder cancer

Daniel A. Wollin1, Fang-Ming Deng2, William C. Huang1, James S. Babb3, Andrew B. Rosenkrantz3

1 Department of Urology, NYU Langone Medical Center, New York, New York, USA
2 Department of Pathology, NYU Langone Medical Center, New York, New York, USA
3 Department of Radiology, NYU Langone Medical Center, New York, New York, USA
Address correspondence to Dr. Daniel Wollin, Department of Urology, NYU Langone Medical Center, 150 E. 32nd Street, New York, NY 10016 USA

Canadian Journal of Urology 2014, 21(5), 7454-7459.

Abstract

Introduction: To compare qualitative and quantitative imaging features from conventional and diffusion-weighted (DW) magnetic resonance imaging (MRI) in detection of metastatic pelvic lymph nodes in bladder cancer patients undergoing cystectomy.
Materials and methods: Thirty-six patients who had undergone cystectomy for bladder cancer with preoperative MRI with DWI sequence prior to surgery were included. Imaging features on conventional and DW-MRI were compared with histopathology at cystectomy.
Results: Nodal features associated with metastatic lymphadenopathy were short axis (AUC = 0.85, p < 0.001; when SA > 5 mm: sensitivity = 88%, specificity = 75%), long axis (AUC = 0.80, p < 0.001; when LA > 6 mm: sensitivity = 88%, specificity = 71%), apparent diffusion coefficient (ADC) on DWI, normalized to muscle (AUC = 0.66, p = 0.113; when nADC < 1.35: sensitivity = 75%, specificity = 68%), and absence of fatty hilum on conventional imaging (AUC = 0.73, p = 0.012; when fatty hilum absent, sensitivity = 75%, specificity = 71%).
ADC without normalization was not associated with metastasis (p = 0.303).
Conclusions: Imaging findings from conventional MRI and DWI achieved reasonable accuracy for detecting metastatic lymph nodes in bladder cancer, although sensitivity was higher than specificity. A short axis greater than 5 mm on conventional MRI had the highest accuracy of any individual finding. When using DWI, normalization of ADC values to muscle ADC may improve diagnostic performance.

Keywords

bladder cancer, cystectomy, diffusion-weighted MRI, imaging, lymph node metastasis

Cite This Article

APA Style
Wollin, D.A., Deng, F., Huang, W.C., Babb, J.S., Rosenkrantz, A.B. (2014). Conventional and diffusion-weighted MRI features in diagnosis of metastatic lymphadenopathy in bladder cancer. Canadian Journal of Urology, 21(5), 7454–7459.
Vancouver Style
Wollin DA, Deng F, Huang WC, Babb JS, Rosenkrantz AB. Conventional and diffusion-weighted MRI features in diagnosis of metastatic lymphadenopathy in bladder cancer. Can J Urology. 2014;21(5):7454–7459.
IEEE Style
D.A. Wollin, F. Deng, W.C. Huang, J.S. Babb, and A.B. Rosenkrantz, “Conventional and diffusion-weighted MRI features in diagnosis of metastatic lymphadenopathy in bladder cancer,” Can. J. Urology, vol. 21, no. 5, pp. 7454–7459, 2014.



cc Copyright © 2014 The Author(s). Published by Tech Science Press.
This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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