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  11. Retrospective Analysis Of Multiparametric Mri In Predicting Complete Pathologic Response Of Neo-adjuvant Chemotherapy In Bladder Cancer

Retrospective analysis of multiparametric MRI in predicting complete pathologic response of neo-adjuvant chemotherapy in bladder cancer

Daan De Maeseneer1,2, Pieter De Visschere3, Mats Van den Broecke3

  • 1Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium. daan.demaeseneer@uzgent.be.

BMC Medical Imaging
|October 7, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Multiparametric MRI (mpMRI) can predict pathological complete response (pCR) in muscle-invasive bladder cancer (MIBC) patients undergoing neoadjuvant chemotherapy (NAC). Radiologic complete response (rCR) on mpMRI shows high specificity for pCR and correlates with improved disease-free survival.

Area of Science:

  • Oncology
  • Radiology
  • Urology

Background:

  • Muscle-invasive bladder cancer (MIBC) treatment involves systemic therapy and radical cystectomy or radiotherapy.
  • Predicting response to neoadjuvant chemotherapy (NAC) is crucial for treatment planning but challenging pre-operatively.

Purpose of the Study:

  • To evaluate the accuracy of multiparametric MRI (mpMRI) in predicting pathological complete response (pCR) after NAC in MIBC patients.
  • To assess the inter-observer agreement for mpMRI scoring methods.

Main Methods:

  • Analysis of mpMRI scans in MIBC patients before and after NAC cycles.
  • Independent scoring of mpMRI using a qualitative 3-step method and nacVI-RADS by two blinded readers.
  • Correlation of mpMRI findings with pathological outcomes and disease-free survival (DFS).
Keywords:
Bladder cancerMultiparametric MRINeoadjuvant chemotherapyPathologic complete response

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Main Results:

  • Twenty-eight percent of patients achieved pCR.
  • Radiologic complete response (rCR) on mpMRI was significantly associated with pCR (96% specificity, 36% sensitivity).
  • High inter-observer agreement was observed for mpMRI scoring; rCR correlated with DFS benefit.

Conclusions:

  • nacVI-RADS predicts pCR with high specificity but low sensitivity.
  • A 3-step mpMRI score aids in assessing local residual disease and correlates with DFS.
  • mpMRI shows promise as a predictive tool in MIBC management and warrants prospective evaluation.
Radiologic complete response