Assessment of neoadjuvant immunochemotherapeutic response for bladder carcinoma using amide proton transfer weighted MRI: a feasibility study

Motivation: To accurately predict bladder cancer patient neoadjuvant treatment responses is essential and urgent. Goal(s): To investigate the feasibility of amide proton transfer weighted (APTw) and diffusion weighted MRI in evaluating the response of neoadjuvant therapy for bladder cancer. Approach: Histogram analysis features were extracted from pre- and post-treatment APTw and apparent diffusion coefficient (ADC) map. Results: Several imaging biomarkers derived from pretreatment imaging were statistical significant between pathological complete response (pCR, no residual tumor) and non-pCR group (P < 0.05 for all). For the pCR group, APTw values markedly decreased while ADC values noticeably increased at post-treatment MRI (P < 0.05 for all). Impact: This work establishes that APTw MRI holds promise to evaluate bladder cancer tumor responses to neoadjuvant immunochemotherapy and may be used to guide personalized precision therapy in future.