Amide Proton Transfer-Weighted Imaging in Assessing the Aggressive and Proliferative Potential of Bladder Cancer

Area of Science:

• Biomedical imaging
• Oncology
• Radiology

Background:

• Ki-67 and HER2 are key oncogenes for bladder cancer (BCa) risk stratification.
• Preoperative assessment of Ki-67 and HER2 aids clinical decisions.
• Amide proton transfer-weighted (APTw) MRI is emerging for malignancy diagnosis, but its role in BCa Ki-67/HER2 evaluation is understudied.

Purpose of the Study:

• To evaluate the feasibility of APTw MRI in assessing the proliferative and aggressive potential of BCa.
• To correlate APTw MRI values with Ki-67 and HER2 expression levels in BCa patients.

Main Methods:

• Retrospective study of 114 BCa patients using 3.0T APTw MRI.
• Pathologic findings (histologic grade, Ki-67, HER2) were reviewed.
• APTw values were measured and compared between different tumor grades and expression levels using statistical analyses including ROC curves.

Main Results:

• Significantly higher APTw values were observed in high-grade BCa, high-Ki-67, and HER2-positive BCa.
• APTw values showed a positive correlation with Ki-67 (r=0.769) and HER2 (r=0.356) expression.
• APTw MRI demonstrated good diagnostic performance for detecting high Ki-67 and HER2 expression (AUCs 0.883 and 0.713, respectively).

Conclusions:

• APTw MRI is a feasible imaging technique for assessing BCa biological and proliferation potential.
• APTw MRI may serve as a non-invasive tool for preoperative risk stratification in BCa.