Dynamic contrast enhanced MRI-derived parameters are potential biomarkers of therapeutic response in bladder carcinoma. Issue 6 (June 2015)

• Record Type: Journal Article
• Authors: Chakiba, Camille; Cornelis, François; Descat, Edouard; Gross-Goupil, Marine; Sargos, Paul; Roubaud, Guilhem; Houédé, Nadine
• Is Part Of: European journal of radiology. Volume 84:Issue 6(2015)
• Page Start: 1023
• Page End: 1028
• Publication Date: 2015-06
• Subjects: CT computed tomography -- DCE dynamic contrast enhanced -- GE gradient echo -- Gd gadolinium -- MRI magnetic resonance imaging -- ROI region of interest; Bladder carcinoma -- MRI -- Contrast -- Neoadjuvant chemotherapy -- Biomarker -- Therapeutic response; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2015.02.026
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: DCE-MRI parameters could be useful biomarker for patients with localized bladder carcinoma. Rate of relapse is lower for good responders assessed by DCE-MRI. The use of DCE-MRI parameters may improve the standardization of patients' selection before surgery. Abstract: Objectives: To evaluate the performance of dynamic contrast enhanced (DCE) magnetic resonance (MR) imaging to assess the histological response after chemotherapy on bladder carcinoma. Methods: From 2008 to 2010, 12 patients presenting localized urothelial carcinoma of the bladder were prospectively evaluated by DCE-MR imaging before and after two courses of cisplatin-based neoadjuvant chemotherapy. Size and thickness of tumours were measured. Relative enhancement at the arterial (rSI35s ) and venous phases (rSI80s ) of each tumour was obtained. Histological response was assessed and outcomes were recorded. Results: Histological examination after neoadjuvant chemotherapy concluded as pathological complete response (pCR) for 6 out of 12 patients. Five patients developed recurrences (4/6 no pCR and 1/6 pCR). Significant differences, between before and after treatment, were found for patients with complete pathological response after chemotherapy for all MR quantitative values. Tumours decreased in size and thickness (both P = 0.03). After treatment, rSI80s was significantly different between pCR and non-pCR patients ( P = 0.04) with a cut-off value of 40%. For this cut-off, sensitivity, specificity and accuracy were 83.33%. Similar recurrence free survivals were obtained if applying the MR cut-off value or the histopathological findings. Conclusion: Our results suggest that DCE-MR imaging may be a useful biomarker for patients with localized bladder carcinoma, improving selection before surgery.