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What is it about?
The study investigated the predictive abilities of preoperative diffusion-weighted MRI (dwMRI) among patients with surgically treated upper tract urothelial carcinoma (UTUC). The ADC values at the dwMRI were significantly lower among patients with muscle-invasive disease (MID) and high-grade tumours compared to non-muscle-invasive disease (NMID) and low-grade tumours, respectively. The area under the ROC curve (AUC) in an ROC curve to predict MID was 0.88 (CI 0.77-0.99, p = <0.001). The ADC values <1050 predicted MID with a sensitivity and specificity of 77% and 82%, respectively. The ADC values >1200 predicted a low-grade tumour with a sensitivity and specificity of 53% and 90%, respectively. The study concluded that the ADC in a dwMRI was a strong predictor of both tumour stage and grade at final pathology after radical surgery for UTUC.
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Why is it important?
This research is important because it investigates the predictive abilities of preoperative diffusion-weighted MRI (dwMRI) among patients with surgically treated upper tract urothelial carcinoma (UTUC). Understanding the predictive abilities of dwMRI can help in determining the aggressiveness of the tumor and the likelihood of muscle-invasive disease (MID) and high-grade tumors. This information is crucial in making decisions regarding treatment options and prognosis for patients with UTUC. Key Takeaways: 1. The ADC values at the dwMRI were significantly lower among patients with muscle-invasive disease (MID) and high-grade tumours compared to patients with non-muscle-invasive disease (NMID) and low-grade tumours, respectively. 2. The area under the ROC curve (AUC) in a receiver operating characteristic (ROC) curve was 0.88 for predicting MID and 0.77 for predicting high-grade tumours, indicating good predictive abilities. 3. An ADC cut-off value of 1050 was found to be the most useful in determining tumour stage, with a sensitivity and specificity of 77% and 82%, respectively, for predicting MID. 4. The study findings were consistent between two independent radiologists, indicating the potential clinical usefulness of dwMRI in preoperative staging of UTUC.
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This page is a summary of: A preoperative magnetic resonance imaging can aid in staging and treatment choice for upper tract urothelial carcinoma, BJUI Compass, February 2024, Wiley,
DOI: 10.1002/bco2.337.
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