Diffusion-weighted magnetic resonance imaging in patients selected for radical cystectomy: detection rate of pelvic lymph node metastases

BJU Int. 2012 Apr;109(7):1031-6. doi: 10.1111/j.1464-410X.2011.10446.x. Epub 2011 Aug 25.

Abstract

Objective: To evaluate whether DW-MRI improves the detection of pelvic lymph nodes metastates in patients with bladder cancer undergoing radical cystectomy.

Patients and methods: 36 patients with CT scan negative for nodal metastates underwent DW-MRI before surgery. Diagnostic accuracy of DW-MRI was compared with histopathological findings.

Results: Mean ADC value was 0.85 × 10(-3) mm(3)/s in the nodal metastatic group and 1 × 10(-3) mm(3)/s in the nodal non-metastatic group (P = 0.02). The ADC cut-off value, obtained by the ROC curve was 0.86 × 10(-3) mm(3)/s. Patient-based sensitivity, specificity and positive and negative predictive values were 76.4%, 89.4%, 26.6%, and 71.4%, respectively.

Conclusion: DW-MRI may be used to differentiate metastatic from non-metastatic lymph nodes in patients with high-grade bladder cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cystectomy*
  • Diffusion Magnetic Resonance Imaging*
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Pelvis
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*