Skip to main content

Advertisement

SpringerLink
Log in

The value of adding diffusion-weighted images for tumor detection and preoperative staging in renal pelvic carcinoma for the reader’s experience

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

This retrospective study aimed to assess the value of adding diffusion-weighted magnetic resonance imaging (DWI) or gadolinium-enhanced fat-suppressed T1WI (CEI) to T2-weighted imaging (T2WI) for preoperative T categorization in renal pelvic carcinoma by the reader’s experience using surgical specimens as the reference standard.

Methods

Two radiologists (Reader 1; 3 years, 2; 13 years) reviewed 49 cases with urothelial carcinoma who underwent magnetic resonance imaging examination before surgery, independently, using three image sets: T2WI alone, T2WI plus DWI, and T2WI plus CEI for tumor detection and T categorization. The differences in the apparent diffusion coefficient values between tumors and renal parenchyma, histopathologic grade were analyzed.

Results

T2WI plus CEI or DWI had high detection rates (93.4%) compared to T2WI alone. When discriminating T3a/T3b, for Reader 1, the use of T2WI plus DWI (88.0%) and T2WI plus CEI (92.0%) was significantly more accurate than T2WI alone (73%), with AUCs of 0.86, 0.86 and 0.77, respectively. For Reader 2, the accuracies were high on all image sets, with AUCs of 0.87–0.95, and the mean ADC of the tumors was significantly lower than that of the normal renal parenchyma. In addition, the mean ADC values of high-grade tumors were significantly lower than that of low-grade tumors.

Conclusions

DWI and CEI could be more helpful than T2WI alone for preoperative T categorization by less-experienced reader and DWI could be used for preoperative T categorization and for predicting the histopathologic grade of renal pelvic carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

DWI:

Diffusion-weighted magnetic resonance imaging

CEI:

Gadolinium-enhanced fat-suppressed T1-weighted imaging

DCEI:

Dynamic contrast-enhanced imaging

T2WI:

T2-weighted imaging

MRI:

Magnetic resonance imaging

ADC:

Apparent diffusion coefficient

DICOM:

Digital imaging and communications in medicine

ROI:

Region of interest

ROC curve:

Receiver operating characteristic curve

References

  1. Takeuchi M, Matsuzaki K, Kubo H, et al. (2008) Diffusion-weighted magnetic resonance imaging of urinary epithelial cancer with upper urinary tract obstruction: preliminary results. Acta Radiol 49:1195–1199

    Article  CAS  PubMed  Google Scholar 

  2. Yoshida S, Masuda H, Ishii C, et al. (2008) Initial experience of functional imaging of upper urinary tract neoplasm by diffusion weighted magnetic resonance imaging. Int J Urol 15:140–143

    Article  PubMed  Google Scholar 

  3. Nishizawa S, Imai S, Okaneya T, et al. (2010) Diffusion weighted imaging in the detection of upper urinary tract urothelial tumors. Int Braz J Urol 36:18–28

    Article  PubMed  Google Scholar 

  4. Yoshida S, Masuda H, Ishii C, et al. (2011) Usefulness of diffusion-weighted MRI in diagnosis of upper urinary tract cancer. Am J Roentgenol 196:110–116

    Article  Google Scholar 

  5. Cogley JR, Nguyen DD, Ghobrial PM, et al. (2013) Diffusion-weighted MRI of renal cell carcinoma, upper tract urothelial carcinoma, and renal infection: a pictorial review. Jpn J Radiol. 31:643–652

    Article  PubMed  Google Scholar 

  6. Colin P, Kassouf W, Konety BR, et al. (2015) Diagnosis and evaluation of upper tract urothelial carcinoma (UTUC). upper tract urothelial carcinoma. New York: Springer, pp 31–43

    Google Scholar 

  7. Ye J, Kumar BS, Li Xb, et al. (2015) Clinical applications of diffusion-weighted magnetic resonance imaging in diagnosis of renal lesions–a systematic review. Clin Physiol Funct Imaging. doi: 10.1111/cpf.12313

  8. Akita H, Jinzaki M, Kikuchi E, et al. (2011) Preoperative T categorization and prediction of histopathologic grading of urothelial carcinoma in renal pelvis using diffusion-weighted MRI. Am J Roentgenol 197:1130–1136

    Article  Google Scholar 

  9. Edge SB, Byrd DR, Compton CC, et al. (2015) AJCC cancer staging manual. New York: Springer

    Google Scholar 

  10. Wu CF, Pang ST, Chen CS, et al. (2007) The impact factors on prognosis of patients with pT3 upper urinary tract transitional cell carcinoma. J Urol 178:446–450 (discussion 50)

    Article  PubMed  Google Scholar 

  11. Langner C, Hutterer G, Chromecki T, et al. (2006) pT classification, grade, and vascular invasion as prognostic indicators in urothelial carcinoma of the upper urinary tract. Mod Pathol 19:272–279

    Article  PubMed  Google Scholar 

  12. Yoshimura K, Arai Y, Fujimoto H, et al. (2002) Prognostic impact of extensive parenchymal invasion pattern in pT3 renal pelvic transitional cell carcinoma. Cancer 94:3150–3156

    Article  PubMed  Google Scholar 

  13. Epstein JI, Amin MB, Reuter VR, et al. (1998) The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Am J Surg Pathol 22:1435–1448

    Article  CAS  PubMed  Google Scholar 

  14. Kundel HL, Polansky M (2003) Measurement of observer agreement. Radiology 228:303–308

    Article  PubMed  Google Scholar 

  15. Wassberg C, Akin O, Vargas HA, et al. (2012) The incremental value of contrast-enhanced MRI in the detection of biopsy-proven local recurrence of prostate cancer after radical prostatectomy: effect of reader experience. AJR Am J Roentgenol 199:360–366

    Article  PubMed  PubMed Central  Google Scholar 

  16. Futterer JJ, Engelbrecht MR, Huisman HJ, et al. (2005) Staging prostate cancer with dynamic contrastenhanced endorectal MR imaging prior to radical prostatectomy: experienced versus less experienced readers. Radiology 237:541–549

    Article  PubMed  Google Scholar 

  17. Takeuchi M, Suzuki T, Sasaki S, et al. (2012) Clinicopathologic significance of high signal intensity on diffusion-weighted MR imaging in the ureter, urethra, prostate and bone of patients with bladder cancer. Acad Radiol 19:827–833

    Article  PubMed  Google Scholar 

  18. Uchida Y, Yoshida S, Kobayashi S, et al. (1042) Diffusion-weighted MRI as a potential imaging biomarker reflecting the metastatic potential of upper urinary tract cancer. Br J Radiol 2014(87):20130791

    Google Scholar 

  19. Yoshida S, Koga F, Masuda H, et al. (2014) Role of diffusion weighted magnetic resonance imaging as an imaging biomarker of urothelial carcinoma. Int J Urol 21:1190–1200

    Article  PubMed  Google Scholar 

  20. Tavora F, Fajardo DA, Lee TK, et al. (2009) Small endoscopic biopsies of the ureter and renal pelvis: pathologic pitfalls. Am J Surg Pathol 33:1540–1546

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan

    Rika Yoshida, Takeshi Yoshizako, Minako Maruyama, Hiroshi Mori & Hajime Kitagaki

  2. Department of Organ Pathology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan

    Noriyoshi Ishikawa

  3. Department of Radiation Oncology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo, Shimane, 693-8501, Japan

    Yukihisa Tamaki

Authors
  1. Rika Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takeshi Yoshizako
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Minako Maruyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Noriyoshi Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yukihisa Tamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hajime Kitagaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rika Yoshida.

Ethics declarations

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

The Institutional Review Board approved the retrospective study protocol and all patients consented to the use of their medical records for research purposes.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoshida, R., Yoshizako, T., Maruyama, M. et al. The value of adding diffusion-weighted images for tumor detection and preoperative staging in renal pelvic carcinoma for the reader’s experience. Abdom Radiol 42, 2297–2304 (2017). https://doi.org/10.1007/s00261-017-1116-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-017-1116-5

Keywords

Search

Navigation