[Preoperative staging of bladder carcinomas with Gd-DTPA-supported dynamic magnetic resonance tomography. Comparison with plain and Gd-DTPA-supported spin-echo sequences].
OBJECTIVE
Evaluation of dynamic Gd-DTPA enhanced MR imaging in the staging of bladder cancer.


METHODS
We studied 40 patients with histologically proven bladder cancer. All patients were examined with routine T1- and T2-weighted MRI and late Gd-DTPA enhanced T1-weighted MRI. Additionally, a dynamic study was performed with 10 subsequent short FLASH-2-D gradient echo sequences without delay immediately after bolus injection of Gd-DTPA. Signal intensities of the tumour and of the surrounding tissue as well as image contrast parameters were quantified.


RESULTS
The dynamic study showed a higher accuracy in the evaluation of stage pTa to pT2 cancer compared to spin echo MRI (63% and 46%, respectively) and no difference regarding the sensitivity (87.5%). However, overstaging was a problem with both modalities. The contrast-to-noise ratio of bladder tumour and muscle was equal or significant higher with the dynamic study compared to spin echo MRI. A higher signal-to-contrast ratio of bladder tumour and bladder muscle was calculated for the dynamic study compared with the spin-echo MRI (p < 0.01; Mann-Whitney U test).


CONCLUSIONS
Dynamic Gd-DTPA enhanced MRI is recommended to be used additionally in the preoperative staging of bladder neoplasms.
Venz
S
S
Strahlenklinik und Poliklinik, Universitätsklinikum Rudolf Virchow, FU Berlin.
Hosten
N
N
Ilg
J
J
Mäurer
J
J
Podrabsky
P
P
Fedel
M
M
Ebert
T
T
Nagel
R
R
D000328:Adult; D000368:Aged; D016477:Artifacts; D002277:Carcinoma / Q000473:pathology*; D003287:Contrast Media; D005069:Evaluation Studies as Topic; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA
Präoperatives Staging von Blasenkarzinomen mit der Gd-DTPA-unterstützten dynamischen Magnetresonanztomographie. Vergleich mit nativen und Gd-DTPA-unterstützten Spin-Echo-Sequenzen.