Combining DWI radiomics features with transurethral resection promotes the differentiation between muscle-invasive bladder cancer and non-muscle-invasive bladder cancer.

Purpose: To investigate the value of radiomics features from diffusion-weighted imaging (DWI) in differentiating muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC).Methods: This retrospective study included 218 pathologically confirmed bladder cancer patients (trai...

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Published in:European Radiology Vol. 30; no. 3; pp. 1804 - 1813
Main Authors: Xu, Shuaishuai, Yao, Qiuying, Liu, Guiqin, Jin, Di, Chen, Haige, Xu, Jianrong, Li, Zhicheng, Wu, Guangyu
Format: research tables/charts Journal Article
Published: Springer Nature 2020
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Combining DWI radiomics features with transurethral resection promotes the differentiation between muscle-invasive bladder cancer and non-muscle-invasive bladder cancer.
      aug:
        au:
          Xu, Shuaishuai
          Yao, Qiuying
          Liu, Guiqin
          Jin, Di
          Chen, Haige
          Xu, Jianrong
          Li, Zhicheng
          Wu, Guangyu
        affil: Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.1630, Dongfang road, Pudong, 200127, Shanghai, China
      sug:
        subj:
          Cystectomy Methods
          Endoscopy Methods
          Magnetic Resonance Imaging Methods
          Bladder Neoplasms Pathology
          Aged, 80 and Over
          Neoplasm Invasiveness
          Urethra
          Adult
          Middle Age
          ROC Curve
          Bladder Neoplasms Surgery
          Retrospective Design
          Aged
          Male
          Female
          Scales
          Funding Source
          Aged, 80 & over
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: To investigate the value of radiomics features from diffusion-weighted imaging (DWI) in differentiating muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC).Methods: This retrospective study included 218 pathologically confirmed bladder cancer patients (training set: 131 patients, 86 MIBC; validation set: 87 patients, 55 MIBC) who underwent DWI before biopsy through transurethral resection (TUR) between July 2014 and December 2018. Radiomics models based on DWI for discriminating state of muscle-invasive were built using random forest (RF) and all-relevant (AR) methods on the training set and were tested on validation set. Combination models based on TUR data were also built. Discrimination performances were evaluated with the area under the receiver operating characteristic (ROC) curve (AUC), accuracy, sensitivity, specificity, and F1 and F2 scores. Qualitative MRI evaluation based on morphology was performed for comparison.Results: No significant difference was found between RF and AR models. RF model was more sensitive than TUR (0.873 vs 0.655, p = 0.019) for discriminating muscle-invasive bladder cancer. When combining RF with TUR, the sensitivity increased to 0.964, significantly higher than TUR (0.655, p < 0.001), MRI evaluation (0.764, p = 0.006), and the combination of TUR and MRI (0.836, p = 0.046). Combining RF and TUR achieved the highest accuracy of 0.897 and F2 score of 0.946.Conclusion: Combining DWI radiomics features with TUR could improve the sensitivity and accuracy in discriminating the presence of muscle invasion in bladder cancer for clinical practice. Multicenter, prospective studies are needed to confirm our results.Key Points: • Twenty-seven to 51% of superficial bladder cancers diagnosed by transurethral resection are upstaged to muscle-invasive at radical cystectomy, suggesting its poor sensitivity for discriminating muscle-invasive bladder cancer. • A small subset of selected all-relevant radiomics features exhibited an equivalent performance compared to that of all the extracted features, confirming that radiomics data contained redundant or irrelevant features and that feature selection should be performed in building radiomics models. • Combining DWI radiomics features with transurethral resection could improve in clinical practice the sensitivity and accuracy for the detection of muscle invasion in bladder cancer.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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