Nouh Mohamed Ragab, Ezz Eldin Omnia
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Armed Force Hospital, King Abdulaziz Airbase, Daharan, Saudi Arabia.
Abdom Radiol (NY). 2024 Dec 27. doi: 10.1007/s00261-024-04786-8.
Urinary bladder cancer is a global disease that poses medical and socioeconomic challenges to patients and healthcare systems. Predicting detrusor invasiveness and pathological grade of bladder cancer by the radiologist is imperative for informed decision-making and effective patient-tailored therapy. Cystoscopy and TURBT are the current gold standard for preoperative histologic diagnosis and local pathological staging but are compromised by their intrusiveness, under-sampling, and staging inaccuracies. Over the last few decades, incredible imaging technology advancements have enabled radiologists to progress in these grading and staging tasks. MRI has become widely accepted as a noninvasive alternative. It supplements morphologic data with functional insights into the tumor microenvironment, enhancing tumor characterization and predicting the detrusor's histologic grade and invasiveness status. Radiomics is a promising field that helps radiologists achieve higher accuracies in bladder cancer staging, re-staging, and direct treating teams to potential management readjustments. Such knowledge leaps hold promise for personalized management of bladder cancer in a precision medicine era.
膀胱癌是一种全球性疾病，给患者和医疗系统带来了医学和社会经济方面的挑战。放射科医生预测膀胱癌的逼尿肌浸润性和病理分级对于做出明智的决策以及进行有效的个体化患者治疗至关重要。膀胱镜检查和经尿道膀胱肿瘤电切术（TURBT）是目前术前组织学诊断和局部病理分期的金标准，但因其侵入性、取样不足和分期不准确而受到影响。在过去几十年中，令人难以置信的成像技术进步使放射科医生在这些分级和分期任务中取得了进展。磁共振成像（MRI）已被广泛接受为一种非侵入性替代方法。它通过对肿瘤微环境的功能洞察补充形态学数据，增强肿瘤特征描述，并预测逼尿肌的组织学分级和浸润状态。放射组学是一个很有前景的领域，有助于放射科医生在膀胱癌分期、重新分期方面实现更高的准确性，并指导治疗团队进行潜在的管理调整。在精准医学时代，这些知识飞跃有望实现膀胱癌的个性化管理。
