Dynamic Contrast-Enhanced Magnetic Resonance Imaging as a Diagnostic Tool in the Assessment of Tumour Angiogenesis in Urinary Bladder Cancer.

The aim of study is to assess the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and correlation with tumour angiogenesis in evaluation of urinary bladder cancer.

The study included 81 patients with recent presumed diagnosis of bladder tumour or who came for follow up after management of histopathologically proven bladder cancer. All had DCE-MRI with time-signal intensity curve. The radiologic results then correlated with the histopathologic results using both haematoxylin and eosin stain and immuno-histochemical staining for localization and evaluation of CD34 immunoreactivity as a detector for the microvessel density (MVD) and tumour angiogenesis.

Seventy-one cases were pathologically proven to be malignant: 41 cases (58%) showed type III time-signal intensity curve (descending); 22 cases (31%) showed type II (plateau); and 8 cases (11%) showed type I (ascending) curve. The sensitivity of DCE-MRI in stage T1 bladder tumour was 80%; in stage T2, it was (90.9%); and in stage T3, it was (96.9%). Overall accuracy of DCE-MRI in tumour staging was 89.5% and P = .001 (significant). Values more than the cutoff value = 76.13 MVD are cystitis with sensitivity (90%), specificity (91%), and P value is .001, which is statistically highly significant.

There is a strong positive association between DCE-MRI (staging and washout slope of the time-signal intensity curve) with histopathologic grade, tumour stage, and MVD in bladder cancer. So, DCE-MRI can be used as reliable technique in preoperative predictions of tumour behavior and affect the planning of antiangiogenetic therapy.

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes. 2019 Mar 25 [Epub ahead of print]

Omar Ahmad Hassanien, Rasha T Abouelkheir, Mohamed Ibrahim Abou El-Ghar, Manal Ezzat Badawy, Samir Abdel-Hakim El Gamal, Mohamed Abd El-Hamid

Faculty of Medicine, Tanta University, Tanta, Gharbia Governorate, Egypt. Electronic address: ., Diagnostic Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Dakahlia Governorate, Egypt., Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt., Faculty of Medicine, Tanta University, Tanta, Gharbia Governorate, Egypt.