BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study

Abstract Background The preoperative evaluation of bladder cancer (BC) pathological grade and muscle invasion is crucial for effective management outcomes. MRI is noninvasive and has no radiation exposure. MRI sequences enable anatomical and functional assessment with the capability of using functio...

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Main Authors: Omnia Ezz Eldin, Mohamed Ragab Nouh, Khaled Refaai, Marwa Shawky Abdou, Heba Refaat Gouda, Dina Altarawy, Ahmed Samir
Format: Article
Language:English
Published: SpringerOpen 2025-02-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
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Online Access:https://doi.org/10.1186/s43055-025-01432-1
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author Omnia Ezz Eldin
Mohamed Ragab Nouh
Khaled Refaai
Marwa Shawky Abdou
Heba Refaat Gouda
Dina Altarawy
Ahmed Samir
author_facet Omnia Ezz Eldin
Mohamed Ragab Nouh
Khaled Refaai
Marwa Shawky Abdou
Heba Refaat Gouda
Dina Altarawy
Ahmed Samir
author_sort Omnia Ezz Eldin
collection DOAJ
description Abstract Background The preoperative evaluation of bladder cancer (BC) pathological grade and muscle invasion is crucial for effective management outcomes. MRI is noninvasive and has no radiation exposure. MRI sequences enable anatomical and functional assessment with the capability of using functional quantitative parameters as biomarkers to analyze tissue characteristics. This study aimed to investigate the utility of apparent diffusion coefficient (ADC) and apparent transverse relaxation rate (R2*) in predicting preoperative histopathological grade and detrusor muscle invasion in bladder cancer (BC). Results This ethically approved prospective clinical study included 53 patients with suspected bladder tumors (mean age 62.85 years ± 10.02 [SD]; 49 males). Two independent readers had strong concordance in measuring ADC and R2* values (ICC > 0.9), with significantly negative correlation observed between R2* and ADC (p < 0.001). ADC cutoff value of (0.79 × 10–3 mm2/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (90.57%) and (84.9%); respectively. R2* cutoff values of (17.8/s) and (18.1/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (88.68%) and (83.02%); respectively. The conjugate R2* and ADC exhibited high diagnostic accuracies that were more impressive for predicting the histologic grade (94.2%) than for muscle invasiveness (82.7%). Conclusions ADC and R2* deployment for preoperative bladder cancer evaluation has excellent potential to predict tumor grades and detrusor muscle invasion, aiding in management planning.
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spelling doaj-art-4aa878f9c97d4eaf8a24e9103e4f4df52025-08-20T03:13:17ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622025-02-0156111110.1186/s43055-025-01432-1BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective studyOmnia Ezz Eldin0Mohamed Ragab Nouh1Khaled Refaai2Marwa Shawky Abdou3Heba Refaat Gouda4Dina Altarawy5Ahmed Samir6Diagnostic and Interventional Radiology Department, Faculty of Medicine, Alexandria UniversityDiagnostic and Interventional Radiology Department, Faculty of Medicine, Alexandria UniversityUrology Department, Faculty of Medicine, Alexandria UniversityDepartment of Epidemiology, High Institute of Public Health, Alexandria UniversityPathology Department, Faculty of Medicine, Alexandria UniversityDiagnostic and Interventional Radiology Department, Faculty of Medicine, Alexandria UniversityDiagnostic and Interventional Radiology Department, Faculty of Medicine, Alexandria UniversityAbstract Background The preoperative evaluation of bladder cancer (BC) pathological grade and muscle invasion is crucial for effective management outcomes. MRI is noninvasive and has no radiation exposure. MRI sequences enable anatomical and functional assessment with the capability of using functional quantitative parameters as biomarkers to analyze tissue characteristics. This study aimed to investigate the utility of apparent diffusion coefficient (ADC) and apparent transverse relaxation rate (R2*) in predicting preoperative histopathological grade and detrusor muscle invasion in bladder cancer (BC). Results This ethically approved prospective clinical study included 53 patients with suspected bladder tumors (mean age 62.85 years ± 10.02 [SD]; 49 males). Two independent readers had strong concordance in measuring ADC and R2* values (ICC > 0.9), with significantly negative correlation observed between R2* and ADC (p < 0.001). ADC cutoff value of (0.79 × 10–3 mm2/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (90.57%) and (84.9%); respectively. R2* cutoff values of (17.8/s) and (18.1/s) predicted high-grade and muscle invasive bladder cancers with diagnostic accuracies of (88.68%) and (83.02%); respectively. The conjugate R2* and ADC exhibited high diagnostic accuracies that were more impressive for predicting the histologic grade (94.2%) than for muscle invasiveness (82.7%). Conclusions ADC and R2* deployment for preoperative bladder cancer evaluation has excellent potential to predict tumor grades and detrusor muscle invasion, aiding in management planning.https://doi.org/10.1186/s43055-025-01432-1Bladder cancer (BC)Blood oxygen level-dependent (BOLD)Diffusion-weighted imaging (DWI)Apparent diffusion coefficient (ADC)Muscle invasion
spellingShingle Omnia Ezz Eldin
Mohamed Ragab Nouh
Khaled Refaai
Marwa Shawky Abdou
Heba Refaat Gouda
Dina Altarawy
Ahmed Samir
BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study
The Egyptian Journal of Radiology and Nuclear Medicine
Bladder cancer (BC)
Blood oxygen level-dependent (BOLD)
Diffusion-weighted imaging (DWI)
Apparent diffusion coefficient (ADC)
Muscle invasion
title BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study
title_full BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study
title_fullStr BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study
title_full_unstemmed BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study
title_short BOLD and DW- MRI metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion: a prospective study
title_sort bold and dw mri metrics in predicting bladder urothelial carcinoma histologic grade and muscle invasion a prospective study
topic Bladder cancer (BC)
Blood oxygen level-dependent (BOLD)
Diffusion-weighted imaging (DWI)
Apparent diffusion coefficient (ADC)
Muscle invasion
url https://doi.org/10.1186/s43055-025-01432-1
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