The study showed sensitivity ranging from 61% to 94%, specificity ranging from 90% to 99%, and accuracy ranging from 83% to 96% for malignant lymph node detection on a per-patient basis, as well as sensitivity ranging from 55% to 87%, specificity ranging from 94% to 100%, and accuracy ranging from 88% to 96% for malignant lymph node detection on a per-pelvic side basis. MRI Pelvis Without IV Contrast There is little literature to support the use of MRI pelvis without IV contrast in the evaluation of MIBC. The addition of a gadolinium contrast agent on MRI has been found to improve the accuracy of local staging for bladder cancer. In a prospective study by Daneshmand et al [61], 122 patients were examined using contrast-enhanced MRI, which Pretreatment Staging of Urothelial Cancer had an 88% sensitivity, a 48% specificity, and a 74% accuracy in distinguishing organ-confined from non-organ- confined bladder cancer and a 41% sensitivity, a 92% specificity, and an 80% accuracy in detecting positive nodal disease. Moderate interobserver agreement was found for T and N staging, consistent with other studies [53,54]. Other studies demonstrated the sensitivity and specificity of MRI in distinguishing NMIBC from MIBC ranging from 78% to 98% and 82% to 100% and the sensitivity and specificity for distinguishing organ-confined from non- organ-confined bladder tumors ranging from 90% to 94% and 60% to 94%, respectively [51-54]. Multiparametric MRI, which combines dynamic contrast-enhanced imaging with DWI and T2-weighted imaging, is likely the most optimal MRI technique for local staging of bladder cancer [48,55]. MRU Without and With IV Contrast Abdominal MRI, specifically MRU, can be used to stage bladder cancer by evaluating nodal, synchronous upper tract or bladder, and metastatic involvement along with dedicated pelvic imaging to assess local staging. MRU is a viable alternative for CTU in the evaluation of upper tract disease.
Pretreatment Staging of Urothelial Cancer. The study showed sensitivity ranging from 61% to 94%, specificity ranging from 90% to 99%, and accuracy ranging from 83% to 96% for malignant lymph node detection on a per-patient basis, as well as sensitivity ranging from 55% to 87%, specificity ranging from 94% to 100%, and accuracy ranging from 88% to 96% for malignant lymph node detection on a per-pelvic side basis. MRI Pelvis Without IV Contrast There is little literature to support the use of MRI pelvis without IV contrast in the evaluation of MIBC. The addition of a gadolinium contrast agent on MRI has been found to improve the accuracy of local staging for bladder cancer. In a prospective study by Daneshmand et al [61], 122 patients were examined using contrast-enhanced MRI, which Pretreatment Staging of Urothelial Cancer had an 88% sensitivity, a 48% specificity, and a 74% accuracy in distinguishing organ-confined from non-organ- confined bladder cancer and a 41% sensitivity, a 92% specificity, and an 80% accuracy in detecting positive nodal disease. Moderate interobserver agreement was found for T and N staging, consistent with other studies [53,54]. Other studies demonstrated the sensitivity and specificity of MRI in distinguishing NMIBC from MIBC ranging from 78% to 98% and 82% to 100% and the sensitivity and specificity for distinguishing organ-confined from non- organ-confined bladder tumors ranging from 90% to 94% and 60% to 94%, respectively [51-54]. Multiparametric MRI, which combines dynamic contrast-enhanced imaging with DWI and T2-weighted imaging, is likely the most optimal MRI technique for local staging of bladder cancer [48,55]. MRU Without and With IV Contrast Abdominal MRI, specifically MRU, can be used to stage bladder cancer by evaluating nodal, synchronous upper tract or bladder, and metastatic involvement along with dedicated pelvic imaging to assess local staging. MRU is a viable alternative for CTU in the evaluation of upper tract disease.