DIAGNOSTIC ACCURACY OF MRI IN DETECTION OF INVASIVE BLADDER CARCINOMA

Abstract

Background: MRI and clinical staging are considered essential for evaluation of urinary bladder carcinoma. Though clinical staging allows for immediate biopsy, but it can’t accurately distinguish superficial from invasive tumors and is not capable of detecting extent of extra vesical disease.

Objective: To determine diagnostic accuracy of MRI in differentiating non-muscle invasive from muscle invasive bladder carcinoma taking Histopathological staging as a gold standard.

Methods: Total 58 patients of either gender having age 25 to 85 years, cystoscopically proven bladder carcinoma were included and underwent MRI. Patient with radiologically negative tumor was assigned stage T0. When multiple tumors are present, highest T Stage was represent tumor stage. Data was regrouped to evaluate accuracy of MRI in distinguishing superficial (≤ T1) from invasive (≥ T2). Histopathological grading served as standard of reference.

Results: There were 49 males and 9 female with age ranged from 25 to 85 years. Total 52 patients showed presence of bladder tumor. On final histopathological staging 20 patients have Ta-T1, 8 patients have stage T2b, 18 patients have stage T3a-b, 4 patients have stage T4a and 2 patients have stage T4b. Tumor size range was 0.4-7.5cm. 10 patients had more than one tumor detected by MRI. The sensitivity, specificity, and diagnostic accuracy of MRI for detection of invasive tumors were 88%, 81%, and 77% respectively.

 Conclusion: MR imaging has vast advantages and great accuracy is possible in detection of deeply invaded bladder tumor.

 Key Words: Diagnostic Accuracy; MRI; Non-Muscle Invasive Bladder Carcinoma; Muscle Invasive Bladder Carcinoma