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MRI morphometric features and apparent diffusion coefficients predict muscle invasion in VI-RADS 3 bladder cancers
1The First Department of Urology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, China.
Aim:
The present study investigated the clinical value of tumor MRI morphometric features and apparent diffusion coefficient (ADC) for predicting muscle invasion in bladder cancer of the vesical imaging reporting and data system (VI-RADS) 3.
Materials And Methods:
Patients with VI-RADS 3 urothelial carcinoma of the bladder who had undergone radical cystectomy (RC) or partial cystectomy (PC) at our hospital between January 2018 and December 2024 were included. Two radiologists independently quantified tumor morphometrics and ADC parameters under expert supervision.
Results:
A total of 96 patients were included, with 52 and 44 in the non-muscle invasive bladder cancer (NMIBC) group and muscle invasive bladder cancer (MIBC) group, respectively. Variables screened in the least absolute shrinkage and selection operator (LASSO) regression were the vertical diameter of the tumors, ADCmin of the tumors, ADCmean of the tumors, and ADCmean of the tumors' bases. Logistic multifactorial analysis showed that ADCmin of the tumors emerged as the sole independent predictor of MIBC (p<0.001) [OR=0.361 (95%CI: 0.21-0.62), p<0.001], with each 0.1 × 10-3 mm2/s increment reducing MIBC risk by 63.9 %. The area under the ROC curve for diagnosing MIBC and NMIBC with ADCmin of the tumor was 0.946 (95%CI: 0.904-0.988), achieving 88.6 % sensitivity and 90.4 % specificity at the cut off value of 0.854 × 10-3 mm2/s.
Conclusions:
The ADCmin of the tumor is the sole MRI-derived biomarker for predicting muscle invasion in VI-RADS 3 bladder cancer and is a valuable adjunct in the diagnosis.