Kikuchi Ken, Shigihara Takeshi, Hashimoto Yuko, Miyajima Masayuki, Haga Nobuhiro, Kojima Yoshiyuki, Shishido Fumio
Departments of Radiology, Division of Medicine, Fukushima Medical University, School of Medicine.
Departments of Diagnostic Pathology, Division of Medicine, Fukushima Medical University, School of Medicine.
Fukushima J Med Sci. 2017 Aug 9;63(2):90-99. doi: 10.5387/fms.2017-05. Epub 2017 Jul 5.
To evaluate the relationship between the apparent diffusion coefficient (ADC) value for bladder cancer and the recurrence/progression risk of post-transurethral resection (TUR).
Forty-one patients with initial and non-muscle-invasive bladder cancer underwent MRI from 2009 to 2012. Two radiologists measured ADC values. A pathologist calculated the recurrence/progression scores, and risk was classified based on the scores. Pearson's correlation was used to analyze the correlations of ADC value with each score and with each risk group, and the optimal cut-off value was established based on receiver operating characteristic (ROC) curve analysis. Furthermore, the relationship between actual recurrence / progression of cases and ADC values was examined by Unpaird U test.
There were significant correlations between ADC value and the recurrence score as well as the progression score (P<0.01, P<0.01, respectively). There were also significant correlations between ADC value and the recurrence risk group as well as progression risk group (P=0.042, P<0.01, respectively). The ADC cut-off value on ROC analysis was 1.365 (sensitivity 100%; specificity 97.4%) for the low and intermediate recurrence risk groups, 1.024 (sensitivity 47.4%; specificity 100%) for the intermediate and high recurrence risk groups, 1.252 (sensitivity 83.3%; specificity 81.3%) for the low and intermediate progression risk groups, and 0.955 (sensitivity 87.5%; specificity 63.2%) between the intermediate and high progression risk groups. The difference between the ADC values of the recurrence and nonrecurrence group in Unpaired t test was significant (P<0.05).
ADC on MRI in bladder cancer could potentially be useful, non-invasive measurement for estimating the risks of recurrence and progression.
评估膀胱癌表观扩散系数（ADC）值与经尿道膀胱肿瘤切除术（TUR）后复发/进展风险之间的关系。
2009年至2012年，41例初发非肌层浸润性膀胱癌患者接受了MRI检查。两名放射科医生测量ADC值。一名病理学家计算复发/进展评分，并根据评分对风险进行分类。采用Pearson相关性分析ADC值与各评分以及各风险组之间的相关性，并基于受试者工作特征（ROC）曲线分析确定最佳截断值。此外，通过非配对U检验研究病例实际复发/进展与ADC值之间的关系。
ADC值与复发评分以及进展评分之间存在显著相关性（分别为P<0.01，P<0.01）。ADC值与复发风险组以及进展风险组之间也存在显著相关性（分别为P=0.042，P<0.01）。ROC分析中，低和中度复发风险组的ADC截断值为1.365（敏感性100%；特异性97.4%），中高度复发风险组为1.024（敏感性47.4%；特异性100%），低和中度进展风险组为1.252（敏感性83.3%；特异性81.3%），中高度进展风险组为0.955（敏感性87.5%；特异性63.2%）。非配对t检验中复发组与未复发组的ADC值差异具有统计学意义（P<0.05）。
膀胱癌MRI中的ADC值可能是一种用于评估复发和进展风险的有用的非侵入性测量方法。
