Role of Dynamic
Role of Dynamic Contrast Enhancement MRI and Cystourethroscopy in the Diagnosis and Local Staging of Urinary Bladder Cancer with Pathologic Correlation
Mohammed M. S. Mostafa1 and Alsayed S. Abdel-Azez 2
Radiodiagnosis1 and Urology 2 Departments, Faculty of Medicine, Al-Azhar University, Al-Azhar, Egypt
Abstract: Purpose: To evaluate the role of the dynamic contrast enhancement MRI andcystourethroscopy in the diagnosis and local staging of urinary bladder cancer with histopathological correlation. Materials and methods: Dynamic contrast enhancement MRI and cystourethroscopy were done in this prospective study for 50 patients on the bases of suspected UB cancer after pelvic US and laboratory investigations. The definitive diagnosis was provided by histopathological examination of the resected tissue by cystourethroscopic biopsy or radical cystectomy. MRI results were compared with cystourethroscopic examination and histopathological results; the latter was regarded as the standard reference. Results: Dynamic contrast enhanced T1WIs has revealed 29 patients with organ confined and 21 patients with non organ confined tumors. The histopathological results had revealed 31 patients with organ confined and 19 patients with non organ confined tumors. In addition dynamic contrast enhanced T1WIs has revealed 21 patients with stage T1, 8 patients with stage T2, 11 patients with stage T3, and 10 patients with stage T4. The histopathological results had revealed 21 patients with stage T1, 9 patients with stage T2, 11 patients with stage T3, and 9 patients with stage T4. Moreover, dynamic contrast enhanced T1WIs, sensitivity, specificity, PPV, NPV and accuracy were 74.83%, 93.1%, 77.51%, 91.91% and 89% respectively. Regarding the superficial ( ≤ T1) and invasive tumors ( ≥ T2) dynamic contrast enhanced T1WIs, sensitivity, specificity, PPV, NPV and accuracy were 85.71%, 89.66%, 85.71%, 89.66% and 88% respectively. Conclusion: Dynamic Gadolinium enhanced MRI was considered the most accurate radiological modality in the diagnosis and local staging of urinary bladder cancer especially in invasive tumors but cystourethroscopy was considered the standard in the diagnosis of non invasive tumors. The histopathological results were regarded as the golden standard reference.
[Mohammed M. S. Mostafa and Alsayed S. Abdel-Azez. Role of Dynamic Contrast Enhancement MRI and Cystourethroscopy in the Diagnosis and Local Staging of Urinary Bladder Cancer with Pathologic Correlation. J Am Sci 2013;9(3):435-445]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 68
Key Words: MRI (Magnetic resonance imaging); dynamic contrast; cystourethroscopy
