title: MR imaging of urinary bladder cancer for T-staging: a review and a pictorial essay of diffusion-weighted imaging.
abstract: Treatment decisions for bladder cancer patients are mainly based on the depth of bladder wall invasion by the tumor. In this article, we review the conventional MRI and exhibit a recently emerged diffusion-weighted imaging (DWI) of urinary bladder cancer for T-staging. We discuss limitations of conventional MRI, scanning protocols of DWI, normal pelvic findings on DWI, determination of T-stage using DWI, and pitfalls of DWI. DWI provides high contrast between bladder cancer and background tissue because the cancer shows markedly high SI. DWI has high sensitivity for detecting the stalk seen in stage Ta or T1. An inflammatory change or fibrosis surrounding the tumor mimics the invasion of bladder cancer on T2-weighted imaging or enhanced MRI and could lead to over-staging, but DWI could differentiate them clearly because these benign changes do not show high SI on DWI. DWI is also useful for detecting ureteral, urethral, and prostatic extension by means of the urethra. DWI provides more accurate information on the extent of bladder cancer and contributes to determination of the treatment strategy.
authors.affiliation: Nagoya City University, Graduate School of Medical Sciences and Medical school, Department of Radiology, Mizuho-ku, Nagoya, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sasaki
authors.forename: Taku
authors.initials: T
authors.lastname: Naiki
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Kawai
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
authors.forename: Masaki
authors.initials: M
authors.lastname: Hara
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009367:Neoplasm Staging; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
keywords: bladder cancer; diffusion-weighted imaging; staging