The clinical study of preoperative normalized apparent diffusion coefficient of 3.0-T MRI in predicting muscular invasion of bladder cancer

作者：Yiqian Wang, Weixiong Xiao, Zhichao Zhang, Yuhui Wu, Shaobin Chen, Wei Zhang, Min Luo · 发表于：BMC Medical Imaging · 年份：2025 · DOI：10.1186/s12880-025-02005-4 · 被引用次数：2 · 研究领域：Bladder and Urothelial Cancer Treatments、MRI in cancer diagnosis、Urinary and Genital Oncology Studies

BACKGROUND: To investigate the clinical application value of preoperative normalized apparent diffusion coefficient (nADC) from 3.0-T magnetic resonance imaging (MRI) in predicting muscular invasion of bladder cancer (BC). METHODS: This retrospective study enrolled BC patients confirmed by surgical pathology at a tertiary hospital between November 2019 and May 2022. All patients underwent preoperative pelvic MRI with two-orientation diffusion-weighted imaging: axial image was acquired routinely, followed by sagittal or coronal image to display the tumor base optimally (selecting based on three-orientation T2-weighted imaging). Patients were divided into muscle-invasive BC (MIBC) and non-muscle-invasive BC (NMIBC) groups based on histopathology. Tumor ADC normalized to urine as reference. Two radiologists who were double-blind, measured the two-orientation ADC values of tumors and bladder urine on the same slice three times respectively, and calculated the average as ADCtumor value and ADCurine value. One of the radiologists repeated the measurements after 6 months. NADC = ADCtumor value / ADCurine value. Intraclass correlation coefficient (ICC) was used to assess inter- and intra-reader consistency, with ICC ≥ 0.75 indicating good consistency. With histopathology as the reference standard, receiver operating characteristic curves were used to compared the diagnostic performance of nADC and ADCtumor value, and to determine cut-off value, sensitivity, and specificity using the ...