COMPARING DYNAMIC CONTRAST-ENHANCED AND DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING FOR BLADDER CANCER PATIENTS UNDERGOING RADICAL CYSTECTOMY WITH HISTOLOGICAL CORRELATION FOR TUMOR AND LYMPH NODE STAGING

Background Bladder cancer is among the most common types of urinary tract neoplasm worldwide; it’s regarded as second most common types after prostatic carcinoma. Dynamic contrast-enhanced and diffusion-weighted MRI has been inserted in clinical MRI protocols of bladder malignancies, as it’s having high accuracy in staging and grading. Objectives To assess and have comparative evaluation of the accuracy of Dynamic contrast enhanced (DCE) and Diffusion weighted (DW) MRI in the preoperative Tumor and lymph node staging of urinary bladder cancer with histological grade. Materials and Methods In the study, 29 bladder cancer patients were prospectively admitted, all patients had magnetic resonance imaging (MRI) using a phased array pelvic coil on an HDXt 1.5-T GE 2009 scanner. Cancer staging was assessed using Dynamic contrast enhanced (DCE) and Diffusion weighted (DWI) MR images, and then histological staging following radical cystectomy were compared with the MRI study results. Results For tumor staging the extent of agreement and accuracy was relatively close when comparing radiologic staging using both DW-MRI and DCE-MRI and histopathological staging (accuracy was 55.2%), accuracy is maximum for stage (T4) tumors (93%), and less accurate for lower grades tumors (T2) (62%), 24.1% under estimated and 20.7% are over estimated using MRI staging. Accuracy for lymph nodes staging is 75.9%, under estimation in 6.9% and over estimation in 17.24% Conclusion MRI is an effective tool for determining tumor and lymph node staging comparing with histological staging of urinary bladder cancers. Accuracy was high for higher grade tumors (T4) and lymph node staging