Value of normalized apparent diffusion coefficient for estimating histological grade of vesical urothelial carcinoma

摘要

Aim To compare the efficacy of apparent diffusion coefficient (ADC) and normalized ADC (nADC) for estimating the histological grade of vesical urothelial carcinoma and to identify an optimal reference for nADC calculation. Materials and methods Thirty patients with histologically confirmed vesical urothelial carcinomas underwent preoperative diffusion-weighted magnetic resonance imaging (DW-MRI) of the pelvis. nADC of the tumour was calculated as ADC (tumour)/ADC (reference) using urine in the bladder lumen, and the obturator internus and gluteus maximus muscles as reference. Receiver operating characteristic (ROC) curves were constructed and compared to identify an optimal reference for nADC calculation. Results Both ADC and nADC of low-grade tumours (1.112 ± 0.159 × 10-3 mm2/s, 0.403 ± 0.047 × 10-3 mm2/s) were significantly (p 0.001) higher than those of high-grade tumours (0.772 ± 0.091 × 10-3 mm2/s, 0.276 ± 0.033 × 10-3 mm2/s). The area under the nADC ROC curve using urine as reference was significantly (p = 0.000) larger (0.995) than those using obturator internus (0.960) and gluteus maximus (0.945). Conclusions nADC is superior to ADC for estimating the histological grade of bladder carcinoma using urine in the bladder lumen as an optimal reference for nADC calculation.