caa a22 4500 605495440 CHVBK 20210128100531.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00261-014-0213-y doi (NATIONALLICENCE)springer-10.1007/s00261-014-0213-y Whole-lesion diffusion metrics for assessment of bladder cancer aggressiveness [Elektronische Daten] [Andrew Rosenkrantz, Chika Obele, Henry Rusinek, Arjun Balar, William Huang, Fang-Ming Deng, Justin Ream] Purpose: To explore associations of whole-lesion histogram diffusion metrics with pathologic findings and subsequent metastatic disease in bladder cancer patients undergoing radical cystectomy. Methods: Twenty-three bladder cancer patients (21M, 2F; mean 70±11years) underwent MRI before cystectomy. A volume-of-interest was placed on all slices on the ADC map encompassing each lesion. Whole-lesion mean, kurtosis, and skewness of ADC were calculated and compared with T stage and pelvic nodal status at cystectomy and with subsequent metastasis in 20/25 patients with available follow-up. Results: At cystectomy, 39% (9/23) were stage T2, 61% (14/23) ≥T3, and 28% (5/23) exhibited positive nodes; 35% (7/20) developed later metastases. Mean ADC was significantly lower in stage ≥T3 than in lower stage tumors (1.20±0.36×10−3 vs. 1.55±0.36×10−3mm2/s; p=0.044), but showed no association with nodal or metastatic disease (p=0.362-0.709). Kurtosis was significantly lower in tumors with, compared to without, nodal disease (−0.05±0.29 vs. 0.91±1.16; p=0.037), and showed a non-significant decrease in tumors with, compared to without, later metastases (0.23±0.63 vs. 0.83±0.89; p=0.088). Kurtosis was not associated with T stage (p=0.811), and skew was not associated with any outcome (p=0.516-0.643). Mean ADC achieved highest AUC for identification of stage ≥T3 (AUC=0.754 vs. 0.516-0.643 for other metrics). Kurtosis achieved highest AUC for nodal disease (AUC=0.811 vs. 0.522-0.556 for other metrics) and metastases (AUC=0.736 vs. 0.516-0.626 for other metrics). Only difference in AUC between skewness and kurtosis for nodal disease was significant (p=0.031). Conclusion: While requiring larger studies, kurtosis has potential to complement mean ADC in bladder cancer prognosis using whole-lesion histogram analysis. Springer Science+Business Media New York, 2014 Bladder cancer nationallicence MRI nationallicence Diffusion-weighted imaging nationallicence Histogram nationallicence Rosenkrantz Andrew Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Obele Chika Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Rusinek Henry Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Balar Arjun Division of Hematology & Oncology, Department of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Huang William Division of Urologic Oncology, Department of Urology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Deng Fang-Ming Department of Pathology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Ream Justin Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/2(2015-02-01), 327-332 0942-8925 40:2<327 2015 40 261 https://doi.org/10.1007/s00261-014-0213-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0213-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rosenkrantz Andrew Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Obele Chika Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Rusinek Henry Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Balar Arjun Division of Hematology & Oncology, Department of Medicine, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Huang William Division of Urologic Oncology, Department of Urology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Deng Fang-Ming Department of Pathology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 700 1- Ream Justin Department of Radiology, NYU Langone Medical Center, 550 First Avenue, 10016, New York, NY, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/2(2015-02-01), 327-332 0942-8925 40:2<327 2015 40 261