Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect

Stephanie B Donaldson; Suzanne C Bonington; Lucy E Kershaw; Richard Cowan; Jeanette Lyons; Tony Elliott; Bernadette M Carrington

doi:10.1016/j.ejrad.2013.08.008

Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect

Stephanie B Donaldson, Suzanne C Bonington, Lucy E Kershaw, Richard Cowan, Jeanette Lyons, Tony Elliott, Bernadette M Carrington

Research output: Contribution to journal › Article › peer-review

Abstract

INTRODUCTION: Treatment of muscle-invasive bladder cancer with chemotherapy results in haemorrhagic inflammation, mimicking residual tumour on conventional MR images and making interpretation difficult. The aim of this study was to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to estimate descriptive and tracer kinetic parameters post-neoadjuvant chemotherapy and to investigate whether parameters differed in areas of residual tumour and chemotherapy-induced haemorrhagic inflammation (treatment effect, Tr-Eff).

METHODS AND MATERIALS: Twenty-one patients underwent DCE-MRI scans with 2.5s temporal resolution before and following neoadjuvant chemotherapy. Regions-of-interest (ROIs) were defined in areas suspicious of residual tumour on T2-weighted MRI scans. Data were analysed semi-quantitatively and with a two-compartment exchange model to obtain parameters including relative signal intensity (rSI80s) and plasma perfusion (Fp) respectively. The bladder was subsequently examined histologically after cystectomy for evidence of residual tumour and/or Tr-Eff. Differences in parameters measured in areas of residual tumour and Tr-Eff were examined using Student's t-test.

RESULTS: Twenty-four abnormal sites were defined after neoadjuvant chemotherapy. On pathology, 10 and 14 areas were identified as residual tumour and Tr-Eff respectively. Median rSI80s and Fp were significantly higher in areas of residual tumour than Tr-Eff (rSI80s = 2.9 vs 1.7, p < 0.001; Fp = 20.7 vs 9.1 ml/100ml/min, p = 0.03). The sensitivity and specificity for differentiating residual tumour from Tr-Eff were 70% and 100% (rSI80s), 60% and 86% (Fp), and 75% and 100% when combined.

CONCLUSION: DCE-MRI parameters obtained post-treatment are capable of distinguishing between residual tumour and treatment effect in patients treated for bladder cancer with neoadjuvant chemotherapy.

Original language	English
Pages (from-to)	2161-8
Number of pages	8
Journal	European Journal of Radiology
Volume	82
Issue number	12
DOIs	https://doi.org/10.1016/j.ejrad.2013.08.008
Publication status	Published - Dec 2013

Keywords

Aged
Carcinoma, Transitional Cell
Chemotherapy, Adjuvant
Contrast Media
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Muscle Neoplasms
Myositis
Neoplasm Invasiveness
Neoplasm, Residual
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome
Urinary Bladder Neoplasms

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ejrad.2013.08.008

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Donaldson, S. B., Bonington, S. C., Kershaw, L. E., Cowan, R., Lyons, J., Elliott, T., & Carrington, B. M. (2013). Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect. European Journal of Radiology, 82(12), 2161-8. https://doi.org/10.1016/j.ejrad.2013.08.008

@article{8c649166b8a349a0af7e4a497d6a105f,

title = "Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect",

abstract = "INTRODUCTION: Treatment of muscle-invasive bladder cancer with chemotherapy results in haemorrhagic inflammation, mimicking residual tumour on conventional MR images and making interpretation difficult. The aim of this study was to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to estimate descriptive and tracer kinetic parameters post-neoadjuvant chemotherapy and to investigate whether parameters differed in areas of residual tumour and chemotherapy-induced haemorrhagic inflammation (treatment effect, Tr-Eff).METHODS AND MATERIALS: Twenty-one patients underwent DCE-MRI scans with 2.5s temporal resolution before and following neoadjuvant chemotherapy. Regions-of-interest (ROIs) were defined in areas suspicious of residual tumour on T2-weighted MRI scans. Data were analysed semi-quantitatively and with a two-compartment exchange model to obtain parameters including relative signal intensity (rSI80s) and plasma perfusion (Fp) respectively. The bladder was subsequently examined histologically after cystectomy for evidence of residual tumour and/or Tr-Eff. Differences in parameters measured in areas of residual tumour and Tr-Eff were examined using Student's t-test.RESULTS: Twenty-four abnormal sites were defined after neoadjuvant chemotherapy. On pathology, 10 and 14 areas were identified as residual tumour and Tr-Eff respectively. Median rSI80s and Fp were significantly higher in areas of residual tumour than Tr-Eff (rSI80s = 2.9 vs 1.7, p < 0.001; Fp = 20.7 vs 9.1 ml/100ml/min, p = 0.03). The sensitivity and specificity for differentiating residual tumour from Tr-Eff were 70% and 100% (rSI80s), 60% and 86% (Fp), and 75% and 100% when combined.CONCLUSION: DCE-MRI parameters obtained post-treatment are capable of distinguishing between residual tumour and treatment effect in patients treated for bladder cancer with neoadjuvant chemotherapy.",

keywords = "Aged, Carcinoma, Transitional Cell, Chemotherapy, Adjuvant, Contrast Media, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Muscle Neoplasms, Myositis, Neoplasm Invasiveness, Neoplasm, Residual, Reproducibility of Results, Sensitivity and Specificity, Treatment Outcome, Urinary Bladder Neoplasms",

author = "Donaldson, {Stephanie B} and Bonington, {Suzanne C} and Kershaw, {Lucy E} and Richard Cowan and Jeanette Lyons and Tony Elliott and Carrington, {Bernadette M}",

year = "2013",

month = dec,

doi = "10.1016/j.ejrad.2013.08.008",

language = "English",

volume = "82",

pages = "2161--8",

journal = "European Journal of Radiology",

issn = "1872-7727",

publisher = "Elsevier BV",

number = "12",

}

Donaldson, SB, Bonington, SC, Kershaw, LE, Cowan, R, Lyons, J, Elliott, T & Carrington, BM 2013, 'Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect', European Journal of Radiology, vol. 82, no. 12, pp. 2161-8. https://doi.org/10.1016/j.ejrad.2013.08.008

Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect. / Donaldson, Stephanie B; Bonington, Suzanne C; Kershaw, Lucy E et al.
In: European Journal of Radiology, Vol. 82, No. 12, 12.2013, p. 2161-8.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect

AU - Donaldson, Stephanie B

AU - Bonington, Suzanne C

AU - Kershaw, Lucy E

AU - Cowan, Richard

AU - Lyons, Jeanette

AU - Elliott, Tony

AU - Carrington, Bernadette M

PY - 2013/12

Y1 - 2013/12

N2 - INTRODUCTION: Treatment of muscle-invasive bladder cancer with chemotherapy results in haemorrhagic inflammation, mimicking residual tumour on conventional MR images and making interpretation difficult. The aim of this study was to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to estimate descriptive and tracer kinetic parameters post-neoadjuvant chemotherapy and to investigate whether parameters differed in areas of residual tumour and chemotherapy-induced haemorrhagic inflammation (treatment effect, Tr-Eff).METHODS AND MATERIALS: Twenty-one patients underwent DCE-MRI scans with 2.5s temporal resolution before and following neoadjuvant chemotherapy. Regions-of-interest (ROIs) were defined in areas suspicious of residual tumour on T2-weighted MRI scans. Data were analysed semi-quantitatively and with a two-compartment exchange model to obtain parameters including relative signal intensity (rSI80s) and plasma perfusion (Fp) respectively. The bladder was subsequently examined histologically after cystectomy for evidence of residual tumour and/or Tr-Eff. Differences in parameters measured in areas of residual tumour and Tr-Eff were examined using Student's t-test.RESULTS: Twenty-four abnormal sites were defined after neoadjuvant chemotherapy. On pathology, 10 and 14 areas were identified as residual tumour and Tr-Eff respectively. Median rSI80s and Fp were significantly higher in areas of residual tumour than Tr-Eff (rSI80s = 2.9 vs 1.7, p < 0.001; Fp = 20.7 vs 9.1 ml/100ml/min, p = 0.03). The sensitivity and specificity for differentiating residual tumour from Tr-Eff were 70% and 100% (rSI80s), 60% and 86% (Fp), and 75% and 100% when combined.CONCLUSION: DCE-MRI parameters obtained post-treatment are capable of distinguishing between residual tumour and treatment effect in patients treated for bladder cancer with neoadjuvant chemotherapy.

AB - INTRODUCTION: Treatment of muscle-invasive bladder cancer with chemotherapy results in haemorrhagic inflammation, mimicking residual tumour on conventional MR images and making interpretation difficult. The aim of this study was to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to estimate descriptive and tracer kinetic parameters post-neoadjuvant chemotherapy and to investigate whether parameters differed in areas of residual tumour and chemotherapy-induced haemorrhagic inflammation (treatment effect, Tr-Eff).METHODS AND MATERIALS: Twenty-one patients underwent DCE-MRI scans with 2.5s temporal resolution before and following neoadjuvant chemotherapy. Regions-of-interest (ROIs) were defined in areas suspicious of residual tumour on T2-weighted MRI scans. Data were analysed semi-quantitatively and with a two-compartment exchange model to obtain parameters including relative signal intensity (rSI80s) and plasma perfusion (Fp) respectively. The bladder was subsequently examined histologically after cystectomy for evidence of residual tumour and/or Tr-Eff. Differences in parameters measured in areas of residual tumour and Tr-Eff were examined using Student's t-test.RESULTS: Twenty-four abnormal sites were defined after neoadjuvant chemotherapy. On pathology, 10 and 14 areas were identified as residual tumour and Tr-Eff respectively. Median rSI80s and Fp were significantly higher in areas of residual tumour than Tr-Eff (rSI80s = 2.9 vs 1.7, p < 0.001; Fp = 20.7 vs 9.1 ml/100ml/min, p = 0.03). The sensitivity and specificity for differentiating residual tumour from Tr-Eff were 70% and 100% (rSI80s), 60% and 86% (Fp), and 75% and 100% when combined.CONCLUSION: DCE-MRI parameters obtained post-treatment are capable of distinguishing between residual tumour and treatment effect in patients treated for bladder cancer with neoadjuvant chemotherapy.

KW - Aged

KW - Carcinoma, Transitional Cell

KW - Chemotherapy, Adjuvant

KW - Contrast Media

KW - Diagnosis, Differential

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Muscle Neoplasms

KW - Myositis

KW - Neoplasm Invasiveness

KW - Neoplasm, Residual

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Treatment Outcome

KW - Urinary Bladder Neoplasms

U2 - 10.1016/j.ejrad.2013.08.008

DO - 10.1016/j.ejrad.2013.08.008

M3 - Article

C2 - 24034835

SN - 1872-7727

VL - 82

SP - 2161

EP - 2168

JO - European Journal of Radiology

JF - European Journal of Radiology

IS - 12

ER -

Dynamic contrast-enhanced MRI in patients with muscle-invasive transitional cell carcinoma of the bladder can distinguish between residual tumour and post-chemotherapy effect

Abstract

Keywords

UN SDGs

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