Role of Multi Parametric MRI and its Correlation with Histopathology Assumed as Gold Standard for Local Staging of Urinary Bladder Cancer

Background: A cross sectional prospective study done to compare sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of different sequences of multi-parametric MRI with histopathological findings assumed as gold standard. Material and methods: sixty patients suspected with bladder cancer either clinically, through urine cytology or using other radiologic investigations including Ultrasonography by using hitachi aloka F 37 and Arietta 50 USG Machine or computed tomography were prospectively included and multi-parametric MRI data was interpreted by using philips ingenia 3 Tesla MRI Machine. Multi-parametric MRI techniques included role of high resolution T2 weighted images (HR T2WI), diffusion weighted MRI (DW-MRI) and dynamic contrast enhanced MRI (DCE-MRI). Accuracy of these techniques was measured separately and in conjunction using histopathological findings as reference gold standard. Results and discussion: Histopathological confirmation for local T staging was performed in 50 patients (83 %) from cystoscopy and biopsy or from transurethral resection of bladder tumors (TURT) and from radical cystectomy in 10 patients (16.6 %).T2W-MRI correctly diagnosed local T stage of UB cancer in 30/60 patients (50 %) while diagnosed 45/60 patients (75 %) with DCE-MRI and 48/60 patients (80 %) with DW-MRI. MP-MRI correctly diagnosed the local T stage in 51/60 patients (85 %). Overall diagnostic accuracy increased from 50 % in T2W to 75 % in DCE-MRI to 80 % in the DW-MRI and to 85 % in the multi -parametric MRI Conclusion: Multi-parametric MRI is a broad and more effective tool for the local T staging of urinary bladder cancers.