Volume 47, Issue 4 pp. 1054-1060

Original Research

Intravoxel incoherent motion diffusion-weighted imaging in assessing bladder cancer invasiveness and cell proliferation

Fang Wang MD,

Fang Wang MD

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The first two authors contributed equally to this work.

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Lian-Ming Wu MD, PhD,

Lian-Ming Wu MD, PhD

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The first two authors contributed equally to this work.

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Xiao-Lan Hua BS,

Xiao-Lan Hua BS

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

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Zi-Zhou Zhao BS,

Zi-Zhou Zhao BS

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

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Xiao-Xi Chen MD,

Xiao-Xi Chen MD

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The last two authors contributed equally to this work.

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Jian-Rong Xu MD, PhD,

Corresponding Author

Jian-Rong Xu MD, PhD

[email protected]

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The last two authors contributed equally to this work.

Address reprint requests to: J.X., Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China. E-mail: [email protected]Search for more papers by this author

Fang Wang MD,

Fang Wang MD

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The first two authors contributed equally to this work.

Search for more papers by this author

Lian-Ming Wu MD, PhD,

Lian-Ming Wu MD, PhD

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The first two authors contributed equally to this work.

Search for more papers by this author

Xiao-Lan Hua BS,

Xiao-Lan Hua BS

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

Search for more papers by this author

Zi-Zhou Zhao BS,

Zi-Zhou Zhao BS

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

Search for more papers by this author

Xiao-Xi Chen MD,

Xiao-Xi Chen MD

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The last two authors contributed equally to this work.

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Jian-Rong Xu MD, PhD,

Corresponding Author

Jian-Rong Xu MD, PhD

[email protected]

Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China

The last two authors contributed equally to this work.

First published: 17 August 2017

https://doi.org/10.1002/jmri.25839

Citations: 23

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Abstract

Background

Nonmuscle-invasive bladder cancer (NMIBC, Stage T1 or lower) is treated with transurethral resection (TUR), while muscle-invasive bladder cancer (MIBC, Stage T2 or more) requires neoadjuvant chemotherapy before radical cystectomy. Hence, preoperative differentiation is vital.

Purpose

To investigate whether intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) can differentiate NMIBC from MIBC and to assess whether there were correlations between IVIM parameters and the Ki-67 labeling index (LI).

Study Type

Retrospective.

Subjects

Thirty-six patients diagnosed with bladder cancer confirmed by histopathological findings.

Field Strength/Sequence

3.0T magnetic resonance imaging (MRI) DWI with eight b-values ranging from 0 to 1000 s/mm².

Assessment

Molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were calculated by biexponential and monoexponential models fits, respectively.

Statistical Tests

Comparisons were made between the MIBC and NMIBC group, and differences were analyzed by comparing the areas under the receiver-operating characteristic curves (AUCs). The correlations between these parameters and Ki-67 LI were assessed by Spearman's rank correlation analysis.

Results

The ADC and D value were significantly lower in patients with MIBC compared to those with NMIBC (P < 0.01). No significant (P > 0.05) differences were observed in D* and f. The AUC of D value (0.894) was significantly (P < 0.05) larger than the ADC value (0.786), with sensitivities and specificities of 95% and 87.5% (D) and 80% and 68.7% (ADC), respectively. In addition, the D and ADC values were significantly correlated with Ki-67 LI (r = –0.785, r = –0.643, respectively; both P < 0.01).

Data Conclusion

The D value obtained from IVIM exhibited better performance than conventional DWI for distinguishing NMIBC from MIBC and may serve as a potential imaging biomarker for bladder cancer invasion.

Level of Evidence: 1

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2018;47:1054–1060.

References

1Griffiths TR. Current perspectives in bladder cancer management. Int J Clin Pract 2013; 67: 435–448.
10.1111/ijcp.12075
CAS PubMed Web of Science® Google Scholar
2Apolo AB, Vogelzang NJ, Theodorescu D. New and promising strategies in the management of bladder cancer. Am Soc Clin Oncol Educ Book 2015; 35: 105–112.
10.14694/EdBook_AM.2015.35.105
Google Scholar
3Stein JP, Skinner DG. Radical cystectomy for invasive bladder cancer: long-term results of a standard procedure. World J Urol 2006; 24: 296–304.
10.1007/s00345-006-0061-7
PubMed Web of Science® Google Scholar
4Takeuchi M, Sasaki S, Ito M, et al. Urinary bladder cancer: diffusion-weighted MR imaging—accuracy for diagnosing T stage and estimating histologic grade. Radiology 2009; 251: 112–121.
10.1148/radiol.2511080873
PubMed Web of Science® Google Scholar
5Tekes A, Kamel I, Imam K, et al. Dynamic MRI of bladder cancer: evaluation of staging accuracy. AJR Am J Roentgenol 2005; 184: 121–127.
10.2214/ajr.184.1.01840121
PubMed Web of Science® Google Scholar
6Rabie E, Faeghi F, lzadpanahi MH, Dayani MA. Role of dynamic contrast-enhanced magnetic resonance imaging in staging of bladder cancer. J Clin Diagn Res 2016; 10: TC01–5.
CAS PubMed Web of Science® Google Scholar
7Kim B, Semelka RC, Ascher SM, Chalpin DB, Carroll PR, Hricak H. Bladder tumor staging: comparison of contrast-enhanced CT, T1- and T2-weighted MR imaging, dynamic gadolinium-enhanced imaging, and late gadolinium-enhanced imaging. Radiology 1994; 193: 239–245.
10.1148/radiology.193.1.8090898
CAS PubMed Web of Science® Google Scholar
8Tanimoto A, Yuasa Y, Imai Y, et al. Bladder tumor staging: comparison of conventional and gadolinium-enhanced dynamic MR imaging and CT. Radiology 1992; 185: 741–747.
10.1148/radiology.185.3.1438756
CAS PubMed Web of Science® Google Scholar
9Pesapane F, Patella F, Fumarola EM, et al. Intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) in the periferic prostate cancer detection and stratification. Med Oncol 2017; 34: 35.
10.1007/s12032-017-0892-7
PubMed Web of Science® Google Scholar
10Klauβ M, Maier-Hein K, Tjaden C, Hackert T, Grenacher L, Stieltjes B. IVIM DW-MRI of autoimmune pancreatitis: therapy monitoring and differentiation from pancreatic cancer. Eur Radiol 2016; 26: 2099–2106.
10.1007/s00330-015-4041-4
PubMed Web of Science® Google Scholar
11Klauss M, Mayer P, Maier-Hein K, et al. IVIM-diffusion-MRI for the differentiation of solid benign and malign hypervascular liver lesions—Evaluation with two different MR scanners. Eur J Radiol 2016; 85: 1289–1294.
10.1016/j.ejrad.2016.04.011
PubMed Web of Science® Google Scholar
12Federau C, O'Brien K, Meuli R, Hagmann P, Maeder P. Measuring brain perfusion with intravoxel incoherent motion (IVIM): initial clinical experience. J Magn Reson Imaging 2014; 39: 624–632.
10.1002/jmri.24195
CAS PubMed Web of Science® Google Scholar
13Lee YJ, Kim SH, Kang BJ, et al. Intravoxel incoherent motion (IVIM)-derived parameters in diffusion-weighted MRI: associations with prognostic factors in invasive ductal carcinoma. J Magn Reson Imaging 2017; 45: 1394–1406.
10.1002/jmri.25514
PubMed Web of Science® Google Scholar
14Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979; 86: 420–428.
10.1037/0033-2909.86.2.420
CAS PubMed Web of Science® Google Scholar
15Busing KA, Kilian AK, Schaible T, Debus A, Weiss C, Neff KW. Reliability and validity of MR image lung volume measurement in fetuses with congenital diaphragmatic hernia and in vitro lung models. Radiology 2008; 246: 553–561.
10.1148/radiol.2462062166
PubMed Web of Science® Google Scholar
16Padhani AR, Liu G, Koh DM, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 2009; 11: 102–125.
10.1593/neo.81328
CAS PubMed Web of Science® Google Scholar
17Kobayashi S, Koga F, Yoshida S, et al. Diagnostic performance of diffusion-weighted magnetic resonance imaging in bladder cancer: potential utility of apparent diffusion coefficient values as a biomarker to predict clinical aggressiveness. Eur Radiol 2011; 21: 2178–2186.
10.1007/s00330-011-2174-7
PubMed Web of Science® Google Scholar
18Rosenkrantz AB, Mussi TC, Spieler B, Melamed J, Taneja SS, Huang WC. High-grade bladder cancer: association of the apparent diffusion coefficient with metastatic disease: preliminary results. J Magn Reson Imaging 2012; 35: 1478–1483.
10.1002/jmri.23590
PubMed Web of Science® Google Scholar
19Kobayashi S, Koga F, Kajino K, et al. Apparent diffusion coefficient value reflects invasive and proliferative potential of bladder cancer. J Magn Reson Imaging 2014; 39: 172–178.
10.1002/jmri.24148
CAS PubMed Web of Science® Google Scholar
20Daggulli M, Onur MR, Firdolas F, Onur R, Kocakoc E, Orhan i. Role of diffusion MRI and apparent diffusion coefficient measurement in the diagnosis, staging and pathological classification of bladder tumors. Urol Int 2011; 87: 346–352.
10.1159/000330925
PubMed Web of Science® Google Scholar
21El-Assmy A, Abou-El-Ghar ME, Mosbah A, et al. Bladder tumour staging: comparison of diffusion- and T2-weighted MR imaging. Eur Radiol 2009; 19: 1575–1581.
10.1007/s00330-009-1340-7
PubMed Web of Science® Google Scholar
22Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988; 168: 497–505.
10.1148/radiology.168.2.3393671
PubMed Web of Science® Google Scholar
23Sumi M, Van Cauteren M, Sumi T, Obara M, Ichikawa Y, Nakamura T. Salivary gland tumors: use of intravoxel incoherent motion MR imaging for assessment of diffusion and perfusion for the differentiation of benign from malignant tumors. Radiology 2012; 263: 770–777.
10.1148/radiol.12111248
PubMed Web of Science® Google Scholar
24Liu C, Wang K, Chan Q, et al. Intravoxel incoherent motion MR imaging for breast lesions: comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging. Eur Radiol 2016; 26: 3888–3898.
10.1007/s00330-016-4241-6
PubMed Web of Science® Google Scholar
25Ichikawa S, Motosugi U, Ichikawa T, Sano K, Morisaka H, Araki T. Intravoxel incoherent motion imaging of focal hepatic lesions. J Magn Reson Imaging 2013; 37: 1371–1376.
10.1002/jmri.23930
PubMed Web of Science® Google Scholar
26Bokacheva L, Kaplan JB, Giri DD, et al. Intravoxel incoherent motion diffusion-weighted MRI at 3.0T differentiates malignant breast lesions from benign lesions and breast parenchyma. J Magn Reson Imaging 2014; 40: 813–823.
10.1002/jmri.24462
PubMed Web of Science® Google Scholar
27Sigmund EE, Cho GY, Kim S, et al. Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer. Magn Reson Med 2011; 65: 1437–1447.
10.1002/mrm.22740
CAS PubMed Web of Science® Google Scholar
28Liu C, Liang C, Liu Z, Zhang S, Huang B. Intravoxel incoherent motion (IVIM) in evaluation of breast lesions: comparison with conventional DWI. Eur J Radiol 2013; 82: e782–e789.
10.1016/j.ejrad.2013.08.006
PubMed Web of Science® Google Scholar
29Li YT, Cercueil JP, Yuan J, et al. Liver intravoxel incoherent motion (IVIM) magnetic resonance imaging: a comprehensive review of published data on normal values and applications for fibrosis and tumor evaluation. Quant Imaging Med Surg 2017; 7: 59–78.
10.21037/qims.2017.02.03
PubMed Web of Science® Google Scholar
30Pang Y, Turkbey B, Bernardo M, et al. Intravoxel incoherent motion MR imaging for prostate cancer: an evaluation of perfusion fraction and diffusion coefficient derived from different b-value combinations. Magn Reson Med 2013; 69: 553–562.
10.1002/mrm.24277
CAS PubMed Web of Science® Google Scholar
31Jerome NP, d'Arcy JA, Feiweier T, et al. Extended T2-IVIM model for correction of TE dependence of pseudo-diffusion volume fraction in clinical diffusion-weighted magnetic resonance imaging. Phys Med Biol 2016; 61: N667–N680.
10.1088/1361-6560/61/24/N667
CAS PubMed Web of Science® Google Scholar
32Margulis V, Shariat SF, Ashfaq R, Sagalowsky AI, Lotan Y. Ki-67 is an independent predictor of bladder cancer outcome in patients treated with radical cystectomy for organ-confined disease. Clin Cancer Res 2006; 12: 7369–7373.
10.1158/1078-0432.CCR-06-1472
CAS PubMed Web of Science® Google Scholar
33Quintero A, Alvarez-Kindelan J, Luque RJ, et al. Ki-67 MIB1 labelling index and the prognosis of primary TaT1 urothelial cell carcinoma of the bladder. J Clin Pathol 2006; 59: 83–88.
10.1136/jcp.2004.022939
CAS PubMed Web of Science® Google Scholar
34Margulis V, Lotan Y, Karakiewicz PI, et al. Multi-institutional validation of the predictive value of Ki-67 labeling index in patients with urinary bladder cancer. J Natl Cancer Inst 2009; 101: 114–119.
10.1093/jnci/djn451
PubMed Web of Science® Google Scholar
35Sevcenco S, Haitel A, Ponhold L, et al. Quantitative apparent diffusion coefficient measurements obtained by 3-Tesla MRI are correlated with biomarkers of bladder cancer proliferative activity. PLoS One 2014; 9: e106866.
10.1371/journal.pone.0106866
PubMed Web of Science® Google Scholar
36Rosenkrantz AB, Ego-Osuala IO, Khalef V, Deng FM, Taneja SS, Huang WC. Investigation of multisequence magnetic resonance imaging for detection of recurrent tumor after transurethral resection for bladder cancer. J Comput Assist Tomogr 2016; 40: 201–205.
10.1097/RCT.0000000000000363
PubMed Web of Science® Google Scholar

Citing Literature

Volume47, Issue4

April 2018

Pages 1054-1060

Intravoxel incoherent motion diffusion-weighted imaging in assessing bladder cancer invasiveness and cell proliferation

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Information

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Intravoxel incoherent motion diffusion-weighted imaging in assessing bladder cancer invasiveness and cell proliferation

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Related

Information