@Article{,
AUTHOR = {Daniel A. Wollin, Fang-Ming Deng, William C. Huang, 
James S. Babb, Andrew B. Rosenkrantz},
TITLE = {Conventional and diffusion-weighted MRI features in diagnosis of metastatic lymphadenopathy in bladder cancer},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {21},
YEAR = {2014},
NUMBER = {5},
PAGES = {7454--7459},
URL = {http://www.techscience.com/CJU/v21n5/61388},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> 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.
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<b>Materials and methods:</b> 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.
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<b>Results:</b> 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%).
<br/>
ADC without normalization was not associated with metastasis (p = 0.303).
<br/>
<b>Conclusions:</b> 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.},
DOI = {}
}