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


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) mm(2)/s, 0.403 ± 0.047 × 10(-3) mm(2)/s) were significantly (p < 0.001) higher than those of high-grade tumours (0.772 ± 0.091 × 10(-3) mm(2)/s, 0.276 ± 0.033 × 10(-3) mm(2)/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.
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China.
H J
HJ
Wang
Department of Radiology, Conde de S. Januario Central Hospital, Macau, People's Republic of China.
M H
MH
Pui
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China. Electronic address: dr.guoyan@163.com.
Y
Y
Guo
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China.
S R
SR
Li
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China.
M J
MJ
Liu
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China.
J
J
Guan
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China.
X L
XL
Zhang
Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, People's Republic of China.
Y
Y
Feng
D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012372:ROC Curve; D012015:Reference Standards; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery