Prospective Investigation of the Value of Arterial Spin Labeling for Evaluating Bladder Cancer

Motivation: Current bladder cancer (BCa) evaluation techniques require contrast agent, which is contraindicated in some patients. Goal(s): We aimed to assess the potential value of arterial spin labeling (ASL) for evaluating BCa. Approach: We conducted ASL scans of patients with BCa and obtained corresponding perfusion values (bladder blood flow [BBF]) of the bladder lesions. We collected pathological and immunohistochemical information, dynamic contrast-enhanced quantitative parameters, and Ktrans values. Results: BBF and Ktrans were moderately positively correlated. BBF values for high-grade urothelial carcinoma, muscle invasion and Ki-67 >25% were higher than those for low-grade urothelial carcinoma, non-muscle invasion and Ki-67 ≤25% (P<0.05). Impact: Non-invasive and quantitative arterial spin labeling is a valuable technique for evaluating bladder cancer because it enables quantifying tumor perfusion and offers insights into the physiological and pathological processes.