Evaluating Neoadjuvant Immunochemotherapeutic Response for Bladder Carcinoma Using Amide Proton Transfer-Weighted MRI

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Bladder cancer (BCa) treatment response assessment is critical.
• Neoadjuvant immunochemotherapy is a standard BCa treatment.
• Non-invasive imaging biomarkers are needed to monitor treatment efficacy.

Purpose of the Study:

• To evaluate amide proton transfer-weighted (APTw) and diffusion-weighted MRI for assessing BCa response to neoadjuvant immunochemotherapy.
• To identify imaging parameters that predict pathological complete response (pCR).

Main Methods:

• Prospective MRI acquisition (APTw and diffusion-weighted) before and after neoadjuvant immunochemotherapy.
• Histogram analysis of APTw and apparent diffusion coefficient (ADC) maps.
• Correlation of imaging parameters with pathological response (pCR vs. non-pCR).

Main Results:

• Significant differences in pre-treatment imaging biomarkers between response groups.
• Baseline APTw mean values demonstrated high diagnostic performance (AUC=0.85) for predicting response.
• APTw values decreased and ADC values increased post-treatment in the pCR group, unlike the non-pCR group.

Conclusions:

• APTw and diffusion-weighted MRI parameters are valuable non-invasive biomarkers for evaluating BCa immunochemotherapy response.
• These MRI techniques may guide personalized treatment strategies for bladder cancer.