Preoperative staging of invasive bladder cancer with dynamic gadolinium-enhanced magnetic resonance imaging: Results from a prospective study

Siamak Daneshmand, Hamed Ahmadi, Ly N. Huynh, Nora Dobos

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: To evaluate the accuracy of dynamic gadolinium-enhanced magnetic resonance imaging (DGE-MRI) to detect extravesical bladder cancer (BC) and lymph node-positive disease in patients with invasive BC. Material and Methods: In a prospective single-center study from 2004 to 2009, patients with clinically invasive BC, who were candidates for curative surgery, underwent preoperative DGE-MRI. Radiologic T and N staging was determined by 2 MRI expert radiologists, and the interobserver agreement was calculated. The sensitivity, specificity, positive and negative predictive values, and accuracy of radiologic staging in differentiating lymph node-negative organ-confined vs nonorgan-confined BC and negative vs positive nodal disease was determined and compared with the postoperative pathologic staging as the reference standard method. Results: A total of 122 patients (72 men) with a mean age of 67.8 years were included. Pathologic examination revealed invasive BC in 80/122 (65.5%), including stage pT4 in 15/122 (12.3%), pT3 in 27/122 (22.1%), and pT2 in 38/122 (31.1%), and 27 patients (22.1%) had node-positive disease. The interobserver agreement for T and N staging according to the κ score was 0.44 and 0.49, respectively. The sensitivity, specificity, and accuracy of DGE-MRI in differentiating lymph node-negative organ-confined from nonorgan-confined BC was 87.5%, 47.6%, and 74% and for the detection of positive nodal disease was 40.7%, 91.5%, and 80.3%, respectively. Conclusion: We have presented the results of the largest cohort of patients with invasive BC underwent preoperative DGE-MRI. Although DGE-MRI improved T and N staging of invasive BC, it is still not the ideal modality and needs a standardized protocol for interpretation of the imaging findings.

Original languageEnglish (US)
Pages (from-to)1313-1318
Number of pages6
JournalUrology
Volume80
Issue number6
DOIs
StatePublished - Dec 2012

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Gadolinium
Urinary Bladder Neoplasms
Magnetic Resonance Imaging
Prospective Studies
Lymph Nodes
Sensitivity and Specificity

ASJC Scopus subject areas

  • Urology

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Preoperative staging of invasive bladder cancer with dynamic gadolinium-enhanced magnetic resonance imaging : Results from a prospective study. / Daneshmand, Siamak; Ahmadi, Hamed; Huynh, Ly N.; Dobos, Nora.

In: Urology, Vol. 80, No. 6, 12.2012, p. 1313-1318.

Research output: Contribution to journalArticle

Daneshmand, Siamak ; Ahmadi, Hamed ; Huynh, Ly N. ; Dobos, Nora. / Preoperative staging of invasive bladder cancer with dynamic gadolinium-enhanced magnetic resonance imaging : Results from a prospective study. In: Urology. 2012 ; Vol. 80, No. 6. pp. 1313-1318.
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abstract = "Objective: To evaluate the accuracy of dynamic gadolinium-enhanced magnetic resonance imaging (DGE-MRI) to detect extravesical bladder cancer (BC) and lymph node-positive disease in patients with invasive BC. Material and Methods: In a prospective single-center study from 2004 to 2009, patients with clinically invasive BC, who were candidates for curative surgery, underwent preoperative DGE-MRI. Radiologic T and N staging was determined by 2 MRI expert radiologists, and the interobserver agreement was calculated. The sensitivity, specificity, positive and negative predictive values, and accuracy of radiologic staging in differentiating lymph node-negative organ-confined vs nonorgan-confined BC and negative vs positive nodal disease was determined and compared with the postoperative pathologic staging as the reference standard method. Results: A total of 122 patients (72 men) with a mean age of 67.8 years were included. Pathologic examination revealed invasive BC in 80/122 (65.5{\%}), including stage pT4 in 15/122 (12.3{\%}), pT3 in 27/122 (22.1{\%}), and pT2 in 38/122 (31.1{\%}), and 27 patients (22.1{\%}) had node-positive disease. The interobserver agreement for T and N staging according to the κ score was 0.44 and 0.49, respectively. The sensitivity, specificity, and accuracy of DGE-MRI in differentiating lymph node-negative organ-confined from nonorgan-confined BC was 87.5{\%}, 47.6{\%}, and 74{\%} and for the detection of positive nodal disease was 40.7{\%}, 91.5{\%}, and 80.3{\%}, respectively. Conclusion: We have presented the results of the largest cohort of patients with invasive BC underwent preoperative DGE-MRI. Although DGE-MRI improved T and N staging of invasive BC, it is still not the ideal modality and needs a standardized protocol for interpretation of the imaging findings.",
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N2 - Objective: To evaluate the accuracy of dynamic gadolinium-enhanced magnetic resonance imaging (DGE-MRI) to detect extravesical bladder cancer (BC) and lymph node-positive disease in patients with invasive BC. Material and Methods: In a prospective single-center study from 2004 to 2009, patients with clinically invasive BC, who were candidates for curative surgery, underwent preoperative DGE-MRI. Radiologic T and N staging was determined by 2 MRI expert radiologists, and the interobserver agreement was calculated. The sensitivity, specificity, positive and negative predictive values, and accuracy of radiologic staging in differentiating lymph node-negative organ-confined vs nonorgan-confined BC and negative vs positive nodal disease was determined and compared with the postoperative pathologic staging as the reference standard method. Results: A total of 122 patients (72 men) with a mean age of 67.8 years were included. Pathologic examination revealed invasive BC in 80/122 (65.5%), including stage pT4 in 15/122 (12.3%), pT3 in 27/122 (22.1%), and pT2 in 38/122 (31.1%), and 27 patients (22.1%) had node-positive disease. The interobserver agreement for T and N staging according to the κ score was 0.44 and 0.49, respectively. The sensitivity, specificity, and accuracy of DGE-MRI in differentiating lymph node-negative organ-confined from nonorgan-confined BC was 87.5%, 47.6%, and 74% and for the detection of positive nodal disease was 40.7%, 91.5%, and 80.3%, respectively. Conclusion: We have presented the results of the largest cohort of patients with invasive BC underwent preoperative DGE-MRI. Although DGE-MRI improved T and N staging of invasive BC, it is still not the ideal modality and needs a standardized protocol for interpretation of the imaging findings.

AB - Objective: To evaluate the accuracy of dynamic gadolinium-enhanced magnetic resonance imaging (DGE-MRI) to detect extravesical bladder cancer (BC) and lymph node-positive disease in patients with invasive BC. Material and Methods: In a prospective single-center study from 2004 to 2009, patients with clinically invasive BC, who were candidates for curative surgery, underwent preoperative DGE-MRI. Radiologic T and N staging was determined by 2 MRI expert radiologists, and the interobserver agreement was calculated. The sensitivity, specificity, positive and negative predictive values, and accuracy of radiologic staging in differentiating lymph node-negative organ-confined vs nonorgan-confined BC and negative vs positive nodal disease was determined and compared with the postoperative pathologic staging as the reference standard method. Results: A total of 122 patients (72 men) with a mean age of 67.8 years were included. Pathologic examination revealed invasive BC in 80/122 (65.5%), including stage pT4 in 15/122 (12.3%), pT3 in 27/122 (22.1%), and pT2 in 38/122 (31.1%), and 27 patients (22.1%) had node-positive disease. The interobserver agreement for T and N staging according to the κ score was 0.44 and 0.49, respectively. The sensitivity, specificity, and accuracy of DGE-MRI in differentiating lymph node-negative organ-confined from nonorgan-confined BC was 87.5%, 47.6%, and 74% and for the detection of positive nodal disease was 40.7%, 91.5%, and 80.3%, respectively. Conclusion: We have presented the results of the largest cohort of patients with invasive BC underwent preoperative DGE-MRI. Although DGE-MRI improved T and N staging of invasive BC, it is still not the ideal modality and needs a standardized protocol for interpretation of the imaging findings.

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