Abstract
Background
Sarcomatoid
urothelial
carcinoma
(SUC)
is
a
rare
and
highly
malignant
form
of
bladder
cancer
with
poor
prognosis.
Currently,
there
limited
information
on
the
imaging
features
SUC
reliable
indicators
for
distinguishing
it
from
conventional
(CUC).
The
objective
our
study
was
to
identify
unique
characteristics
determine
factors
that
aid
in
its
differential
diagnosis.
Materials
methods
This
retrospective
enrolled
22
participants
61
CUC.
clinical,
pathologic,
CT/MRI
data
both
groups
were
recorded,
comparison
conducted
using
univariate
analysis
multinomial
logistic
regression
Results
majority
SUCs
located
trigone
exhibited
large
tumor
size,
irregular
shape,
low
ADC
values,
Vesical
Imaging-Reporting
Data
System
(VI-RADS)
score
≥
4,
presence
necrosis,
an
invasive
nature.
Univariate
revealed
significant
differences
terms
location,
maximum
long-axis
diameter
(LAD),
short-axis
(SAD),
ADC-value,
VI-RADS
scores,
extravesical
extension
(EVE),
pelvic
peritoneal
spread
(PPS),
hydronephrosis/ureteral
effusion
(
p
<
.001
~
=
.037)
between
CUCs.
Multinomial
found
only
SAD
.014)
necrosis
.003)
emerged
as
independent
predictors
differentiating
model
based
these
two
achieved
area
under
curve
(AUC)
0.849
ROC
analysis.
Conclusion
Bladder
demonstrates
several
distinct
features,
including
high
incidence
involvement,
obvious
invasiveness
accompanied
by
necrosis.
A
evidence
more
likely
be
rather
than
Multiparametric
MRI
using
the
Vesical
Imaging
Reporting
and
Data
System
scoring
system
is
a
powerful
diagnostic
tool
to
assess
bladder
cancer
but
requires
standardized
acquisition,
evaluation,
interpretation,
reporting
optimize
accuracy
reproducibility.
Scientific Reports,
Год журнала:
2023,
Номер
13(1)
Опубликована: Дек. 6, 2023
Vesical
Imaging
Reporting
and
Data
System
(VI-RADS)
shows
good
potential
in
determining
muscle-invasive
bladder
cancer
(MIBC)
patients.
However,
whether
VI-RADS
could
predict
the
prognosis
of
radical
cystectomy
(RC)
patients
has
not
been
reported.
Our
purpose
is
to
determine
contributed
oncologic
outcomes.
In
this
retrospective
study,
we
analysed
information
who
admitted
our
centre
from
June
2012
2022.
All
underwent
multiparametric
magnetic
resonance
imaging
(mpMRI)
RC
were
included.
scoring
was
performed
by
two
radiologists
blinded
clinical
data.
Patients'
features,
pathology
data,
recorded.
Kaplan-Meier
method
used
estimate
patients'
overall
survival
(OS)
progression-free
(PFS).
Log-rank
test
assess
statistical
differences.
COX
regression
analysis
risk
factors.
Ultimately,
included
219
patients,
with
188
males
31
females.
The
median
age
66
(IQR
=
61-74.5)
years.
scores
as
follows:
1,
4
(1.8%);
2,
68
(31.1%);
3,
40
(18.3%);
4,
69
(31.5%);
5,
38
(17.4%).
Patients
≥
3
had
poorer
OS
PFS
than
those
<
3.
AUC
predicting
3-year
0.804,
sensitivity
0.824
negative
predictive
value
0.942.
Multivariate
showed
that
factors
for
(HR
3.517,
P
0.003)
4.175,
0.001).
MIBC
subgroup,
PFS.
non-muscle
invasive
(NMIBC)
remained
poorer.
effectively
after
RC.
Abstract
Background
Neoadjuvant
chemotherapy
(NAC)
before
radical
cystectomy
is
standard
of
care
in
patients
with
muscle-invasive
bladder
cancer
(MIBC).
Response
assessment
after
NAC
important
but
suboptimal
using
CT.
We
assessed
MRI
without
vs.
intravenous
contrast
(biparametric
[BP]
multiparametric
[MP])
for
identifying
residual
disease
on
and
explored
its
prognostic
role.
Methods
Consecutive
MIBC
that
underwent
NAC,
MRI,
between
January
2000–November
2022
were
identified.
Two
radiologists
reviewed
BP-MRI
(T2
+
DWI)
MP-MRI
DWI
DCE)
tumor.
Diagnostic
performances
compared
receiver
operating
characteristic
curve
analysis.
Kaplan-Meier
curves
Cox
proportional-hazards
models
used
to
evaluate
association
disease-free
survival
(DFS).
Results
61
(36
men
25
women;
median
age
65
years,
interquartile
range
59–72)
included.
After
no
was
detected
pathology
19
(31.1%)
patients.
more
accurate
than
detecting
NAC:
area
under
the
=
0.75
(95%
confidence
interval
(CI),
0.62–0.85)
0.58
CI,
0.45–0.70;
p
0.043).
Sensitivity
identical
(65.1%;
95%
49.1–79.0)
specificity
higher
determining
disease:
77.8%
52.4–93.6)
38.9%
17.3–64.3),
respectively.
Positive
both
associated
worse
DFS:
hazard
ratio
(HR)
4.01
1.70–9.46;
0.002)
HR
5.13
2.66–17.13;
0.008),
Concordance
results
significantly
DFS.
Concordant
positive
(MRI+/pathology+)
showed
DFS
concordant
negative
(MRI-/pathology-)
(HR
8.75,
2.02–37.82;
0.004)
discordant
group
(MRI+/pathology-
or
MRI-/pathology+)
3.48
1.39–8.71;
0.014).
Conclusion
NAC.
A
better
outcomes,
providing
complementary
information
pathological
specimens.
