Complementary role of diffusion kurtosis imaging combined with amide proton transfer-weighted imaging for VI-RADS

Motivation: Precise preoperative evaluation of the muscular invasion of bladder cancer (MIBC) could guide proper treatment and predict prognosis in clinical practice. Goal(s): Determine the feasibility of diffusion kurtosis imaging (DKI) and amide proton transfer-weighted imaging (APTw) parameters in differentiating MIBC from non-MIBC (NMIBC) and its potential gain effect in vesical imaging reporting and data system (VI-RADS). Approach: A total of 69 patients underwent preoperative MRI. Results: The DKI parameters and APTw values were significantly different in MIBC and NMIBC groups. The combined DKI and APTw model had the highest AUC values and complemented the VI-RADS. Impact: Our results demonstrate that the promising potential of this combined model for the preoperative assessment of muscle invasion in BC as well as being a complement to VI-RADS.