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Acta Radiol. 2014 Sep;55(7):882-9. doi: 10.1177/0284185113506576. Epub 2013 Oct 3.

Imaging of upper urinary tract cancer: using conventional MRI and diffusion-weighted MRI with different b values.

Author information

1
Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
2
Department of Urinary Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
3
Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China renjixujr@163.com.

Abstract

BACKGROUND:

Diffusion-weighted magnetic resonance imaging (DW-MRI) has been considered to be useful in diagnosing upper urinary tract (UUT) disease; however, the value of DW-MRI with different b values has not been reported.

PURPOSE:

To evaluate the performance of using conventional MRI alone and in combination with DWI with different b values in diagnosing UUT cancer.

MATERIAL AND METHODS:

Seventy patients with suspected UUT cancer underwent conventional MRI (T1-weighted and T2-weighted) and DW-MRI (b = 500 and 1500 s/mm(2)) on a 3 T-MRI scanner. The ureteroscopic and histopathologic findings were compared with the imaging findings. The utility of detecting UUT cancer using conventional MRI (set A), combined DW-MRI (b = 500 s/mm(2)) and conventional MRI (set B), and combined DW-MRI (b = 1500 s/mm(2)) and conventional MRI (set C) were independently evaluated by two readers.

RESULTS:

A total of 32 patients had verified cancer; 23 patients had benign UUT diseases, and 15 had no abnormality. Sets B and C had significantly improved diagnostic accuracy for UUT cancer compared with set A; the specificity in diagnosing UUT cancer was significantly improved when using set C compared with sets A and B. In patients without UUT obstructions, improved sensitivity and accuracy in diagnosis was achieved when using sets B and C compared with set A.

CONCLUSION:

Using DW-MRI in combination with conventional MRI provides increased diagnostic accuracy and sensitivity in patients without UUT obstruction. The combination of conventional MRI and DW-MRI with a higher b value (1500 s/mm(2)) improved the specificity in diagnosing UUT cancer compared to conventional sequences and DW-MRI with a lower b value (500 s/mm(2)).

KEYWORDS:

Magnetic resonance imaging (MRI); b value; diagnosis; differential diagnosis; diffusion-weighted imaging (DW-MRI); upper urinary tract (UUT) cancer

PMID:
24092760
DOI:
10.1177/0284185113506576
[Indexed for MEDLINE]
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