European Radiology: Evaluation of FROC model and two-parameter VI-RADS for staging and grading of bladder urothelial carcinoma

Bladder cancer is the tenth most common cancer worldwide, with 549,000 new cases and approximately 200,000 deaths in 2018
.

The majority of bladder cancers are histologically classified as urothelial carcinomas, and treatment options are based primarily on the depth of invasion and histological grade

Clinically, TURBT is the standard method for determining muscle invasiveness and histological grade
.

However, it has been reported that tumors may be underestimated in up to 25% of muscle-invasive bladder cancers, and up to 15% of tumors have inaccurate grades due to sampling errors

Clinically, TURBT is the standard method for determining muscle invasiveness and histological grade

The introduction of Bladder Imaging-Reporting and Data System (VI-RADS) provides the basis for the standardized assessment and interpretation of bladder cancer in clinical practice

Recently, a study published in the journal European Radiology explored the feasibility of staging and grading urothelial carcinoma using DWI and FROC models at high b-values, compared the performance of FROC parameters with ADCs, and investigated The improved diagnostic performance of FROC parameters when combined with a simplified version of VI-RADS provides strong support for noninvasive and accurate preoperative assessment of bladder cancer .
 

This prospective study included 58 patients with bladder and urethral cancer

D and μ in the MIBC group were significantly lower than those in the NMIBC group (P = 0.

Top row: NMIBC patients .
Axial (a) and sagittal (b) T2-weighted images show an exophytic tumor in the left posterior wall with a hypointense stalk (arrow) and an intact muscularis propria line, indicating a T2-weighted imaging score of 2 .
Diffusion-weighted image (c) at b = 1000 s/mm2 shows a hyperintense tumor with a hypointense stalk (arrow) indicating a DWI score of ² .
Bottom row: MIBC patient .
Axial (d) and sagittal (e) T2-weighted images show tumor on the left wall extending into the surrounding fat (arrows), indicating a T2-weighted imaging score of 5 .
Diffusion-weighted image (f) at b = 1000 s/mm2 ^shows hyperintense tumor extending into surrounding fat (arrow), indicating a DWI score of 5 .
The final two-parameter VI-RADS score was 5 points .
 

Top row: NMIBC patients .

Axial (a) and sagittal (b) T2-weighted images show an exophytic tumor in the left posterior wall with a hypointense stalk (arrow) and an intact muscularis propria line, indicating a T2-weighted imaging score of 2 .
Diffusion-weighted image (c) at b = 1000 s/mm2 shows a hyperintense tumor with a hypointense stalk (arrow) indicating a DWI score of ² .
Bottom row: MIBC patient .
Axial (d) and sagittal (e) T2-weighted images show tumor on the left wall extending into the surrounding fat (arrows), indicating a T2-weighted imaging score of 5 .
Diffusion-weighted image (f) at b = 1000 s/mm2 ^shows hyperintense tumor extending into surrounding fat (arrow), indicating a DWI score of 5 .
The final two-parameter VI-RADS score was 5 points .
 Top row: NMIBC patients .
Axial (a) and sagittal (b) T2-weighted images show an exophytic tumor in the left posterior wall with a hypointense stalk (arrow) and an intact muscularis propria line, indicating a T2-weighted imaging score of 2 .
Diffusion-weighted image (c) at b = 1000 s/mm ² 2 shows a hyperintense tumor with a hypointense stalk (arrow), indicating a DWI score of 2 .
Bottom row: MIBC patient .
Axial (d) and sagittal (e) T2-weighted images show tumor on the left side wall, extending to the periphery Fat (arrow), indicating a score of 5 on T2-weighted imaging

This study demonstrates that the FROC model parameters, either alone or in combination , can be used to classify NMIBC and MIBC as well as low-grade and high-grade bladder urothelial carcinomas .
The FROC model parameters can surpass traditional ADCs and improve the diagnostic performance of two-parameter VI-RADS .
With further validation, the FROC diffusion model may become a potential imaging-based tool to assist histopathology and VI-RADS to characterize and grade bladder urothelial carcinoma .

Original source :

Original source :

Cui Feng , Yanchun Wang , Guangyu Dan , et al .

Evaluation of a fractional-order calculus diffusion model and bi-parametric VI-RADS for staging and grading bladder urothelial carcinoma.
DOI: 10.
1007/s00330-021-08203-2

Cui Feng Yanchun Wang Guangyu Dan ,et al 10.
1007/s00330-021-08203-2 10.
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