Department of radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
GE Healthcare, Beijing 100176, China.
Acad Radiol. 2024 Oct;31(10):4076-4084. doi: 10.1016/j.acra.2024.03.011. Epub 2024 Mar 27.
To evaluate the potential of Synthetic Magnetic Resonance Imaging (SynMRI) in identifying muscular invasion in bladder cancer (BCa), and explore whether there is additional value in combination with the Vesical Imaging-Reporting and Data System (VI-RADS).
In this prospective single-center study, pathologically-confirmed BCa were enrolled between May 2023 and November 2023. All participants underwent preoperative multiparametric MRI, including T1/T2 weighted, SynMRI and diffusion-weighted imaging. T1/T2/PD values and apparent diffusion coefficient (ADC) values were compared between muscle invasive (MIBC) and non-invasive (NMIBC) groups. Receiver operating characteristic (ROC) analysis with the variables and their combination was performed to explore the performance of distinguishing the MIBC from NMIBC, and the ROC curves were compared using DeLong's test.
A total of 54 BCa patients were enrolled (38 males; NMIBC/MIBC=37/19) and all assessed with VI-RADS without dynamic enhanced imaging (DCE). Compared to NMIBC group, MIBC group had significantly larger diameter, higher VI-RADS score, lower T2 and ADC values (P < 0.05). VI-RADS score and T2 showed independent predictive value in differentiating NMIBC and MIBC. The combined model (T2 + VI-RADS+Diameter) resulted in significantly improved specificity (0.842), sensitivity (0.914), and AUC (0.943), in comparison to VI-RADS or ADC alone (P < 0.05).
T2 relaxation time can be easily obtained from SynMRI in routine clinical protocol and assist VI-RADS score system without DCE to improve differentiation performance in identifying NMIBC and MIBC.
评估合成磁共振成像（SynMRI）在膀胱癌（BCa）中识别肌肉侵犯的潜力，并探讨其与膀胱成像报告和数据系统（VI-RADS）联合应用是否具有额外价值。
在这项前瞻性单中心研究中，2023 年 5 月至 2023 年 11 月间入组了经病理证实的 BCa 患者。所有患者均接受术前多参数 MRI 检查，包括 T1/T2 加权、SynMRI 和弥散加权成像。比较肌肉浸润性（MIBC）和非浸润性（NMIBC）组之间 T1/T2/PD 值和表观扩散系数（ADC）值。使用受试者工作特征（ROC）分析和变量及其组合，以探索区分 MIBC 和 NMIBC 的性能，并使用 DeLong 检验比较 ROC 曲线。
共纳入 54 例 BCa 患者（38 例男性；NMIBC/MIBC=37/19），所有患者均未进行动态增强成像（DCE）的 VI-RADS 评估。与 NMIBC 组相比，MIBC 组的直径更大、VI-RADS 评分更高、T2 值和 ADC 值更低（P<0.05）。VI-RADS 评分和 T2 值在区分 NMIBC 和 MIBC 方面具有独立的预测价值。与单独使用 VI-RADS 或 ADC 相比，联合模型（T2+VI-RADS+直径）显著提高了特异性（0.842）、敏感性（0.914）和 AUC（0.943）（P<0.05）。
在常规临床方案中，SynMRI 可轻松获得 T2 弛豫时间，并协助 VI-RADS 评分系统，无需 DCE，可提高区分 NMIBC 和 MIBC 的能力。
