Editorial for “Significance of Normalized Apparent Diffusion Coefficient in the Vesical Imaging‐Reporting and Data System for Diagnosing Muscle‐Invasive Bladder Cancer”
Year: 2024
Type: editorial
Abstract: The accurate diagnosis of muscle-invasive bladder cancer (MIBC) plays a critical role in the health care of bladder cancer patients to facilitate the treatment decision and provide the prognosis and potential outcomes. 1 Transurethral resection of bladder tumor (TURBT), 2 the current gold standard for the diagnosis of MIBC, can fail to provide accurate diagnosis due to missing detection of detrusor muscle or poor quality of resected tissue with the increased risk of complications. 3 Recently, the Vesical Imaging-Reporting and Data System (VI-RADS), a standardized approach to report findings from the multiparametric bladder magnetic resonance imaging (mp-MRI) including those from T 2 -weighted anatomic imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast enhancement (DCE) imaging, has been applied for the diagnosis of MIBC with demonstrated diagnostic potentials, as well as revealed limitations.4 The VI-RADS can only provide good performance for the diagnosis of MIBC for bladder tumors with either the lowest or the highest scores but poor performance with intermediate scores.5 Overcoming current limitations to improve the diagnosis performance of the VI-RADS has become active research in the past years.The apparent diffusion coefficient (ADC) value, a well-known quantitative measurement of water molecule diffusion in tissues from DWI, has been widely applied for cancer studies due to its great diagnostic potential.It has been shown that ADC value was significantly lower in high-grade bladder cancer.6 Studies have also shown the associations of ADC value with clinicopathological characteristics, including tumor size, T stage, histological grade, lymph node metastasis, and lymphovascular invasion.7 However, ADC measurement can be easily biased and vary largely due to the use of different types of MRI scanners, vendor-specific clinical protocols, and even the age and body temperature of patients, which will compromise the performance of the VI-RADS for the diagnosis of MIBC.To minimize such biases and reduce confounding factor related variability for ADC measurements, the normalized ADC (NADC) value has been proposed and applied for cancer studies with encouraging results.8,9
DOI: 10.1002/jmri.29233
Author: Xiufeng Li
Institution: University of Minnesota
Language: English
Topic: MRI in cancer diagnosis
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4390701798