Head-to-Head Comparison between High-Resolution Microultrasound Imaging and Multiparametric MRI in Detecting and Local Staging of Bladder Cancer: The BUS-MISS Protocol

IF 1 4区医学 Q4 ONCOLOGY Bladder Cancer Pub Date : 2022-01-25 DOI:10.3233/blc-211611

Pietro Diana, Giovanni Lughezzani, Alberto Saita, Alessandro Uleri, Nicola Frego, Roberto Contieri, Nicolomaria Buffi, Luca Balzarini, Federico D’Orazio, Colombo Piergiuseppe, Maria Grazia Elefante, Massimo Lazzeri, Giorgio Guazzoni, Paolo Casale, Rodolfo Hurle

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Abstract

BACKGROUND:

MRI has been proposed as a new staging tool for bladder cancer (BC), but use is limited by its high costs and low availability. 29-MHz high-resolution micro-ultrasound (mUS) technology has been suggested as an alternative to detect BC and distinguish between muscle-invasive and non-muscle invasive BC.

OBJECTIVE:

The aim was to compare the diagnostic accuracy of mUS vs. magnetic resonance imaging (MRI) in differentiating NMIBC and MIBC at definitive pathological examination.

METHODS:

This is a prospective study of patients with a primary diagnosis of BC with either positive urine cytology (UC) or negative UC and a tumor size > 25 mm from a tertiary care high volume center. mUS, with the ExactVu system with an EV29L 29 MHz side-fire transducer, and a 3-Tesla MRI were performed before transurethral resection of bladder tumor (TURBT) in every patient before undergoing TURBT. We compared the imaging results with pathological reports.

RESULTS:

The analyzed population consisted of 58 individuals. The reported mUS and MRI sensitivity, specificity, positive, and negative predictive values were 85.0%, 76.3%, 65.4%, and 90.6%, versus 85.0%, 50.0%, 47.2%, and 86.4%, respectively. In accuracy analysis, the AUC for mUS and MRI were respectively 0.807 and 0.675.

CONCLUSIONS:

In our population mUS seems to have a better performance in distinguishing NMIBC from MIBC. The main limitation of mUS is the probe shape that makes its use problematic in cases with a large prostate and inadequate rectal preparation. Further studies with a larger population are ongoing to compare and validate these techniques in this setting.

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高分辨率微超声成像和多参数MRI在膀胱癌检测和局部分期中的头对头比较:BUS-MISS协议

摘要背景:MRI已被提出作为膀胱癌(BC)的一种新的分期工具，但其高成本和低可用性限制了其使用。29 mhz高分辨率微超声(mUS)技术被认为是检测BC和区分肌肉浸润性和非肌肉浸润性BC的替代方法。目的:目的是比较mUS与磁共振成像(MRI)在确诊病理检查中鉴别NMIBC和MIBC的诊断准确性。方法:这是一项前瞻性研究，患者的原发性诊断为BC或阳性尿细胞学(UC)或阴性UC和肿瘤大小>距离三级保健高容量中心25毫米。在经尿道膀胱肿瘤切除术(turt)前，使用带有EV29L 29 MHz侧火换能器的ExactVu系统和3-Tesla MRI。我们将影像学结果与病理报告进行比较。结果:分析的种群包括58只个体。报告的mUS和MRI敏感性、特异性、阳性和阴性预测值分别为85.0%、76.3%、65.4%和90.6%，而阴性预测值分别为85.0%、50.0%、47.2%和86.4%。在准确性分析中，mUS和MRI的AUC分别为0.807和0.675。结论:在我们的人群中，mUS似乎在区分NMIBC和MIBC方面有更好的表现。mUS的主要限制是探针形状，使其在前列腺大和直肠准备不足的情况下使用问题。目前正在对更大的人群进行进一步的研究，以在这种情况下比较和验证这些技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bladder Cancer Medicine-Urology

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.