title: Apparent diffusion coefficient value for estimating clinicohistological factors in bladder cancer including infiltration style and lymphatic invasion.
abstract: OBJECTIVE
  To evaluate a role of apparent diffusion coefficient (ADC) values measured from diffusion-weighted imaging we investigated its association with clinicopathological tumor characteristics of bladder cancer.
  
  
  METHODS
  Diffusion-weighted MRI at 1.5 Tesla using b-values of 0, 1000 s/mm(2) was taken before transurethral resection by 114 bladder urothelial tumor patients. ADC value was measured and its relationship with pathological factors including T stage, tumor grade, infiltration style (INF) and lymphatic invasion (ly) was analyzed.
  
  
  RESULTS
  Median ADC value was significantly lower in Grade 3 than in Grade 1 (P < 0.001) or in Grade 2 (P = 0.002), in INFb than in INFa (P = 0.004), in INFc than in INFa (P < 0.001), in ly1 than in ly0 (P < 0.001) and lower in T2≦ than in T1≧ (P < 0.001), respectively. Receiver operating curve demonstrated the accuracy of detecting muscle invasive bladder cancer or ly+ by using area under curve (AUC), showing 0.758 and 0.748.
  
  
  CONCLUSIONS
  ADC value is likely to serve as a useful biomarker showing clinicopathological characterictics of bladder cancer.
authors.affiliation: Department of Urology, Chibaken Saiseikai Narashino Hospital, Izumi-cho, Narashino-City, Chiba 275-8550 Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Fujimura
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8677 Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sakamoto
authors.affiliation: Department of Urology, Chibaken Saiseikai Narashino Hospital, Izumi-cho, Narashino-City, Chiba 275-8550 Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sekita
authors.affiliation: Department of Urology, Chibaken Saiseikai Narashino Hospital, Izumi-cho, Narashino-City, Chiba 275-8550 Japan.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Takeuchi
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8677 Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Nishikawa
authors.affiliation: Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-City, Chiba 285-8741 Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Chibaken Saiseikai Narashino Hospital, Izumi-cho, Narashino-City, Chiba 275-8550 Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mikami
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-City, Chiba 260-8677 Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
keywords: Apparent diffusion coefficient (ADC); Bladder cancer; Infiltration style (INF); Lymphatic invasion (ly)