Yoshida Soichiro, Koga Fumitaka, Kobayashi Shuichiro, Tanaka Hiroshi, Satoh Shiro, Fujii Yasuhisa, Kihara Kazunori
Soichiro Yoshida, Fumitaka Koga, Shuichiro Kobayashi, Yasuhisa Fujii, Kazunori Kihara, Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8677, Japan.
World J Radiol. 2014 Jun 28;6(6):344-54. doi: 10.4329/wjr.v6.i6.344.
Bladder-sparing strategy for muscle-invasive bladder cancer (MIBC) is increasingly demanded instead of radical cystectomy plus urinary diversion. Multimodal therapeutic approaches consisting of transurethral resection, chemotherapy, radiotherapy and/or partial cystectomy improve patients' quality of life by preserving their native bladder and sexual function without compromising oncological outcomes. Because a favorable response to chemoradiotherapy (CRT) is a prerequisite for successful bladder preservation, predicting and monitoring therapeutic response is an essential part of this approach. Diffusion-weighted magnetic resonance imaging (DW-MRI) is a functional imaging technique increasingly applied to various types of cancers. Contrast in this imaging technique derives from differences in the motion of water molecules among tissues and this information is useful in assessing the biological behavior of cancers. Promising results in predicting and monitoring the response to CRT have been reported in several types of cancers. Recently, growing evidence has emerged showing that DW-MRI can serve as an imaging biomarker in the management of bladder cancer. The qualitative analysis of DW-MRI can be applied to detecting cancerous lesion and monitoring the response to CRT. Furthermore, the potential role of quantitative analysis by evaluating apparent diffusion coefficient values has been shown in characterizing bladder cancer for biological aggressiveness and sensitivity to CRT. DW-MRI is a potentially useful tool for the management of bladder cancer, particularly in multimodal bladder-sparing approaches for MIBC.
与根治性膀胱切除术加尿流改道术不同，肌肉浸润性膀胱癌（MIBC）的保膀胱策略需求日益增加。由经尿道切除术、化疗、放疗和/或部分膀胱切除术组成的多模式治疗方法，通过保留患者的天然膀胱和性功能，同时不影响肿瘤学结果，从而提高患者的生活质量。由于对放化疗（CRT）的良好反应是成功保膀胱的先决条件，因此预测和监测治疗反应是该方法的重要组成部分。扩散加权磁共振成像（DW-MRI）是一种越来越多地应用于各种癌症的功能成像技术。这种成像技术中的对比度源于组织间水分子运动的差异，该信息有助于评估癌症的生物学行为。在几种癌症中，已有关于DW-MRI预测和监测CRT反应的 promising 结果报道。最近，越来越多的证据表明，DW-MRI可作为膀胱癌管理中的一种成像生物标志物。DW-MRI的定性分析可用于检测癌性病变和监测对CRT的反应。此外，通过评估表观扩散系数值进行定量分析在表征膀胱癌的生物学侵袭性和对CRT的敏感性方面的潜在作用也已得到证实。DW-MRI是膀胱癌管理中一种潜在有用工具，尤其在MIBC的多模式保膀胱方法中。 （注：“promising”此处翻译为“有前景的、有希望的”，文中未明确给出中文释义，根据语境翻译为“promising”，你可根据实际情况调整。）
