Assessment of pathological grading in non-muscle invasive bladder cancer based on apparent diffusion coefficient heterogeneity and morphological indicators
10.3969/j.issn.1002-1671.2025.03.020
- VernacularTitle:基于表观扩散系数异质性及形态学指标评估非肌层浸润性膀胱癌病理分级
- Author:
Yihan QIN
1
;
Siyu ZHOU
;
Yutao WU
;
Yueyue LI
;
Jian SHI
;
Xiaolin WANG
;
Feng FENG
Author Information
1. 南通大学附属肿瘤医院放射科,江苏 南通 226000
- Publication Type:Journal Article
- Keywords:
non-muscle invasive bladder cancer;
pathological grading;
diffusion weighted imaging;
morphology
- From:
Journal of Practical Radiology
2025;41(3):447-451
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of combining apparent diffusion coefficient(ADC)heterogeneity with morphological indicators in assessing the pathological grading of non-muscle invasive bladder cancer(NMIBC).Methods The MRI images of 86 patients confirmed with NMIBC by surgical pathology were analyzed retrospectively.All patients underwent T2WI,diffusion weighted ima-ging(DWI),and dynamic contrast enhancement(DCE)examinations.Two radiologists independently measured tumor largest diam-eter(LD),actual tumor-wall contact length(ACTCL),ADCmean,ADCmin,and ADCmax values.ADC heterogeneity was calculated using the formula(ADCmax-ADCmin)/ADCmean.Differences in quantitative parameters between low-and high-grade NMIBC were compared using the Mann-Whitney U test,while differences in qualitative parameters were compared using the chi-square test.Univariate and multivariate logistic regression analyses were used to identify independent predictors of high-grade NMIBC,and receiver operating characteristic(ROC)curves were drawn to evaluate the performance of ADC heterogeneity combined with morphological indicators in assessing high-grade NMIBC.Results ADC heterogeneity and ACTCL were independent predictors for preoperative assessment of NMIBC pathological grading.The area under the curve(AUC)of ADC heterogeneity and ACTCL in assessing high-grade NMIBC were 0.843 and 0.744,respectively.The combined AUC was 0.902.The difference was statistically significant(P<0.05).Conclusion The combination of ADC heterogeneity with ACTCL can effectively improve the efficiency of preoperative assessment of NMIBC pathological grading,and providing more precise clinical decision-making and prognosis monitoring.
