Volume 48, Issue 1 pp. 259-265

Original Research

Investigation of diffusion kurtosis imaging for discriminating tumors from inflammatory lesions after treatment for bladder cancer

Fang Wang MD,

Fang Wang MD

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

Search for more papers by this author

Di Jin MD,

Di Jin MD

Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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, 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, China

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, China

Search for more papers by this author

Wei-Bo Chen PhD,

Wei-Bo Chen PhD

Philips Healthcare, Shanghai, China

Search for more papers by this author

Guang-Yu Wu MD,

Corresponding Author

Guang-Yu Wu MD

[email protected]

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

Address reprint requests to: G.-Y.W., Department of Radiology, Ren Ji Hospital, No. 1630, Dongfang Road, Pudong, Shanghai, 200127, China. E-mail: [email protected]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, China

Search for more papers by this author

Hai-Ge Chen MD,

Hai-Ge Chen MD

Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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, China

Search for more papers by this author

Di Jin MD,

Di Jin MD

Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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, 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, China

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, China

Search for more papers by this author

Wei-Bo Chen PhD,

Wei-Bo Chen PhD

Philips Healthcare, Shanghai, China

Search for more papers by this author

Guang-Yu Wu MD,

Corresponding Author

Guang-Yu Wu MD

[email protected]

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

Xiao-Xi Chen MD,

Xiao-Xi Chen MD

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

Search for more papers by this author

Hai-Ge Chen MD,

Hai-Ge Chen MD

Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Search for more papers by this author

First published: 12 December 2017

https://doi.org/10.1002/jmri.25924

Citations: 14

Fang Wang and Di Jin contributed equally to this work.

Guang-Yu Wu, Xiao-Xi Chen, and Hai-Ge Chen contributed equally to this work.

Share a link

Email
Wechat
Bluesky

Abstract

Background

The bladder wall may thicken resulting from chronic inflammation after initial treatment (transurethral resection [TUR] or neoadjuvant chemotherapy), which may mimic the feature of recurrent or residual bladder tumors (RBT). Therefore, it is critical to discriminate RBT from benign lesions after initial treatment.

Purpose

To investigate whether diffusion kurtosis imaging (DKI) could discriminate RBT from post-therapy bladder inflammatory lesions.

Study Type

Retrospective.

Subjects

Fifty patients diagnosed with bladder cancer underwent TUR or received neoadjuvant chemotherapy.

Field Strength/Sequence

3.0T MRI/conventional T₁-weighted imaging (T₁WI), T₂WI, and diffusion-weighted imaging (DWI) with nine b-values ranging from 0–2000 s/mm².

Assessment

Mean diffusion coefficients (MD_a, MD_b, and MD_c) and mean kurtosis values (MK_a, MK_b, and MK_c) were obtained from three different measurement methods. The region of interest (ROI) was placed 1) to encompass the entire portion of the thickening bladder wall or to portions that were the most restricted, with a b-value of 2) 2000 s/mm² or 3) 1000 s/mm².

Statistical Tests

The independent-samples t-test was used to compare the differences between RBT and the inflammatory group. Differences in DKI parameters were analyzed by comparing the areas under the receiver-operator characteristic curves (AUCs).

Results

In patients with RBT, the MD (MD_a, MD_b, MD_c) values were significantly lower and the MK (MK_a, MK_b, MK_c) values were significantly higher than those in patients in the inflammatory lesions group (all P < 0.01). The AUC of MK_b (0.934) was significantly larger than those of MD_b, MK_a, and MK_c (0.793, P < 0.05; 0.694, P < 0.01; 0.719, P < 0.01, respectively).

Data Conclusion

MK obtained from DKI provided better performance than conventional DWI in distinguishing RBT from inflammatory lesions after bladder cancer treatment. MK calculated with high b-values setting provided better performance in differentiation.

Level of Evidence: 1

Technical Efficacy Stage 3

J. Magn. Reson. Imaging 2017.

References

1 Verma S, Rajesh A, Prasad SR, et al. Urinary bladder cancer: Role of MR imaging. Radiographics 2012; 32: 371–387.
10.1148/rg.322115125
PubMed Web of Science® Google Scholar
2 Griffiths 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
3 Tuncbilek N, Kaplan M, Altaner S, et al. Value of dynamic contrast-enhanced MRI and correlation with tumor angiogenesis in bladder cancer. AJR Am J Roentgenol 2009; 192: 949–995.
10.2214/AJR.08.1332
PubMed Web of Science® Google Scholar
4 Rosenkrantz 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
5 Wang HJ, Pui MH, Guo Y, Yang D, Pan BT, Zhou XH. Diffusion-weighted MRI in bladder carcinoma: The differentiation between tumor recurrence and benign changes after resection. Abdom Imaging 2014; 39: 135–141.
10.1007/s00261-013-0038-0
PubMed Google Scholar
6 Donaldson SB, Bonington SC, Kershaw LE, et al. Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumor and post-chemotherapy effect. Eur J Radiol 2013; 82: 2161–2168.
10.1016/j.ejrad.2013.08.008
PubMed Web of Science® Google Scholar
7 Khosravi-Shahi P, Cabezón-Gutiérrez L. Selective organ preservation in muscle-invasive bladder cancer: Review of the literature. Surg Oncol 2012; 21: e17–e22.
10.1016/j.suronc.2011.10.004
PubMed Web of Science® Google Scholar
8 Sun K, Chen X, Chai W, et al. Breast cancer: Diffusion kurtosis MR imaging—Diagnostic accuracy and correlation with clinical-pathologic factors. Radiology 2015; 277: 46–55.
10.1148/radiol.15141625
PubMed Web of Science® Google Scholar
9 Nogueira L, Brandão S, Matos E, et al. Application of the diffusion kurtosis model for the study of breast lesions. Eur Radiol 2014; 24: 1197–1203.
10.1007/s00330-014-3146-5
PubMed Web of Science® Google Scholar
10 Suo S, Chen X, Ji X, et al. Investigation of the non-Gaussian water diffusion properties in bladder cancer using diffusion kurtosis imaging: A preliminary study. J Comput Assist Tomogr 2015; 39: 281–285.
10.1097/RCT.0000000000000197
PubMed Web of Science® Google Scholar
11 Tamura C, Shinmoto H, Soga S, et al. Diffusion kurtosis imaging study of prostate cancer: preliminary findings. J Magn Reson Imaging 2014; 40: 723–729.
10.1002/jmri.24379
PubMed Web of Science® Google Scholar
12 Shrout 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
13 Büsing 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
14 Sadow CA, Silverman SG, O'Leary MP, Signorovitch JE. Bladder cancer detection with CT urography in an academic medical center. Radiology 2008; 249: 195–202.
10.1148/radiol.2491071860
PubMed Web of Science® Google Scholar
15 Matsuki M, Inada Y, Tatsugami F, Tanikake M, Narabayashi I, Katsuoka Y. Diffusion-weighted MR imaging for urinary bladder carcinoma: Initial results. Eur Radiol 2007; 17: 201–249.
10.1007/s00330-006-0281-7
PubMed Web of Science® Google Scholar
16 EL-Assmy A, Abou-El-Ghar ME, Refaie HF, EL-Diasty T. Diffusion-weighted MR Imaging in diagnosis of superficial and invasive urinary bladder carcinoma: A preliminary prospective study. Sci World J 2008; 8: 364–370.
10.1100/tsw.2008.55
Web of Science® Google Scholar
17 Kiliçkesmez O, Cimilli T, Inci E, et al. Diffusion-weighted MRI of urinary bladder and prostate cancers. Diagn Interv Radiol 2009; 15: 104–110.
PubMed Web of Science® Google Scholar
18 EI-Assmy A, Abou-EI-Ghar ME, Refaie HF, Mosbah A, EI-Diasty T. Diffusion-weighted magnetic resonance imaging in follow-up of superficial urinary bladder carcinoma after transurethral resection: Initial experience. BJU Int 2012; 110: E622–E627.
10.1111/j.1464-410X.2012.11345.x
PubMed Web of Science® Google Scholar
19 Jensen JH, Helpern JA, Ramani A, Lu H, Kaczynski K. Diffusional kurtosis imaging: The quantification of non-Gaussian water diffusion by means of magnetic resonance imaging. Magn Reson Med 2005; 53: 1432–1440.
10.1002/mrm.20508
PubMed Web of Science® Google Scholar
20 Jensen JH, Falangola MF, Hu C, et al. Preliminary observations of increased diffusional kurtosis in human brain following recent cerebral infarction. NMR Biomed 2011; 24: 452–457.
10.1002/nbm.1610
PubMed Web of Science® Google Scholar
21 Pentang G, Lanzman RS, Heusch P, et al. Diffusion kurtosis imaging of the human kidney: a feasibility study. Magn Reson Imaging 2014; 32: 413–420.
10.1016/j.mri.2014.01.006
PubMed Web of Science® Google Scholar
22 Suo S, Chen X, Wu L, et al. Non-Gaussian water diffusion kurtosis imaging of prostate cancer. Magn Reson Imaging 2014; 32: 421–427.
10.1016/j.mri.2014.01.015
PubMed Web of Science® Google Scholar
23 Van Cauter S, Veraart J, Sijbers J, et al. Gliomas: Diffusion kurtosis MR imaging in grading. Radiology 2012; 263: 492–501.
10.1148/radiol.12110927
PubMed Web of Science® Google Scholar
24 Rosenkrantz AB, Sigmund EE, Johnson G, et al. Prostate cancer: Feasibility and preliminary experience of a diffusional kurtosis model for detection and assessment of aggressiveness of peripheral zone cancer. Radiology 2012; 264: 126–135.
10.1148/radiol.12112290
PubMed Web of Science® Google Scholar
25 Roethke MC, Kuder TA, Kuru TH, et al. Evaluation of diffusion kurtosis imaging versus standard diffusion imaging for detection and grading of peripheral zone prostate cancer. Invest Radiol 2015; 50: 483–489.
10.1097/RLI.0000000000000155
CAS PubMed Web of Science® Google Scholar
26 Kitajima K, Takahashi S, Ueno Y, et al. Clinical utility of apparent diffusion coefficient values obtained using high b-value when diagnosing prostate cancer using 3 Tesla MRI: Comparison between ultra-high b-value (2000 s/mm²) and standard high b-value (1000 s/mm²). J Magn Reson Imaging 2012; 36: 198–205.
10.1002/jmri.23627
CAS PubMed Web of Science® Google Scholar
27 Steven AJ, Zhuo J, Melhem ER. Diffusion kurtosis imaging: An emerging technique for evaluating the microstructural environment of the brain. AJR Am J Roentgenol 2014; 202: W26–33.
10.2214/AJR.13.11365
PubMed Web of Science® Google Scholar
28 André ED, Grinberg F, Farrher E, et al. Influence of noise correction on intra- and inter-subject variability of quantitative metrics in diffusion kurtosis imaging. PLoS One 2014; 9: e94531.
10.1371/journal.pone.0094531
PubMed Web of Science® Google Scholar
29 Clark PE, Agarwal N, Biagioli MC, et al. Bladder cancer. J Natl Compr Canc Netw 2013; 11: 446–475.
10.6004/jnccn.2013.0059
CAS PubMed Web of Science® Google Scholar

Citing Literature

Volume48, Issue1

July 2018

Pages 259-265

Investigation of diffusion kurtosis imaging for discriminating tumors from inflammatory lesions after treatment for bladder cancer

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Investigation of diffusion kurtosis imaging for discriminating tumors from inflammatory lesions after treatment for bladder cancer

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Related

Information