Predicting Preoperative Pathologic Grades of Bladder Cancer Using Intravoxel Incoherent Motion and Amide Proton Transfer-Weighted Imaging

Motivation: Preoperative grading of bladder cancer (BC) impacts the choice of operative modality and prognosis of patients. Goal(s): We aimed to perform an accurate and non-invasive preoperative grading method for BC by MRI sequences. Approach: IVIM as well as APTw imaging were included in this study. Results: The IVIM-related parameter (D, true-diffusion-coefficient) and APTw values were significantly different in low- and high-grade BC. Robust diagnostic efficacies were separately confirmed with high AUCs for IVIM and APTw in BC grading, and the diagnostic efficacy of the combined IVIM and APTw model was significantly higher compared to the individual parameters on their own. Impact: Our findings suggest a complementary effect between the IVIM and APTw imaging parameters The combined model shows promise as a noninvasive biomarker for predicting BC histologic grading, aiding in the development of clinical therapeutic strategies, and assessing prognosis.