MR Imaging of Urinary Bladder Carcinoma and Beyond
ABSTRACT Detection of muscle invasion is a critical aspect in management of urinary bladder cancer. MR imaging has the potential and promise of delivering this premise noninvasively. This article reviews the current status of MR imaging in evaluation of bladder cancer. Also discussed are other important neoplastic and nonneoplastic conditions affecting the bladder.
SourceAvailable from: Fumitaka Koga[Show abstract] [Hide abstract]
ABSTRACT: Bladder-sparing strategy for muscle-invasive bladder cancer (MIBC) is increasingly demanded instead of radical cystectomy plus urinary diversion. Multimodal therapeutic approaches consisting of transurethral resection, chemotherapy, radiotherapy and/or partial cystectomy improve patients' quality of life by preserving their native bladder and sexual function without compromising oncological outcomes. Because a favorable response to chemoradiotherapy (CRT) is a prerequisite for successful bladder preservation, predicting and monitoring therapeutic response is an essential part of this approach. Diffusion-weighted magnetic resonance imaging (DW-MRI) is a functional imaging technique increasingly applied to various types of cancers. Contrast in this imaging technique derives from differences in the motion of water molecules among tissues and this information is useful in assessing the biological behavior of cancers. Promising results in predicting and monitoring the response to CRT have been reported in several types of cancers. Recently, growing evidence has emerged showing that DW-MRI can serve as an imaging biomarker in the management of bladder cancer. The qualitative analysis of DW-MRI can be applied to detecting cancerous lesion and monitoring the response to CRT. Furthermore, the potential role of quantitative analysis by evaluating apparent diffusion coefficient values has been shown in characterizing bladder cancer for biological aggressiveness and sensitivity to CRT. DW-MRI is a potentially useful tool for the management of bladder cancer, particularly in multimodal bladder-sparing approaches for MIBC.
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ABSTRACT: The main imaging modality of the urinary tract in children is ultrasound. When further cross-sectional morphologic examination and/or functional evaluation is required, magnetic resonance (MR) imaging is the logical and optimal second step, particularly in pediatric patients. There are two main exceptions to this. The first one is when after an ultrasound, additional diagnostic imaging for urolithiasis is needed. The second one involves severe polytrauma, including blunt abdominal trauma. In this review, an overview of the MR imaging and computed tomography examinations important for current and future daily pediatric uroradiologic practice is presented.Radiologic Clinics of North America 07/2013; 51(4):583-98. DOI:10.1016/j.rcl.2013.03.004 · 1.83 Impact Factor
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ABSTRACT: Diffusion-weighted magnetic resonance imaging is a type of functional imaging that is increasingly being applied in the management of upper tract urothelial carcinoma and bladder cancer. The image contrast is derived from differences in the Brownian motion of water molecules in tissues. The homogenous high signal intensity of upper tract urothelial carcinoma and bladder cancer on diffusion-weighted magnetic resonance imaging provides helpful diagnostic information for the presence of cancerous lesions in a non-invasive manner. Recently, growing evidence has emerged showing that diffusion-weighted magnetic resonance imaging can serve as an imaging biomarker for characterizing cancer pathophysiology, because the signal reflects biophysical information about the tissues. Quantitative analysis by evaluating the apparent diffusion coefficient values potentially reflects the histological grade and the biological aggressiveness of urothelial carcinoma. The apparent diffusion coefficient value could be a biomarker predicting the clinical course of upper tract urothelial carcinoma and bladder cancer. In addition, in chemoradiotherapy-based bladder-sparing approaches against muscle-invasive bladder cancer, the role of diffusion-weighted magnetic resonance imaging for predicting the chemoradiosensitivity and for monitoring therapeutic response has been shown. Diffusion-weighted magnetic resonance imaging is expected to improve the diagnostic accuracy, and this qualitative information might allow individualized treatment strategies for patients with urothelial carcinoma.International Journal of Urology 08/2014; DOI:10.1111/iju.12587 · 1.80 Impact Factor