• Shichao Li, Ping Liang, Yanchun Wang, Cui Feng, Yaqi Shen, Xuemei Hu, Daoyu Hu, Xiaoyan Meng, and Zhen Li.
• Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave., Wuhan, 430030, Hubei, China.
• Abdom Radiol (NY). 2021 Sep 1; 46 (9): 4301-4310.

ObjectiveThe objective of this study was to explore whether volumetric apparent diffusion coefficient (ADC) histogram analysis can provide additional value to Vesical Imaging Reporting and Data System (VI-RADS) in differentiating muscle-invasive bladder cancer (MIBC) from non-muscle-invasive bladder cancer (NMIBC).Materials And Methods80 patients were retrospectively reviewed with pathologically proven NMIBC (n = 53) or MIBC (n = 27). All patients underwent MRI including diffusion-weighted imaging (DWI) (b = 0, 800 s/mm2), and the VI-RADS score was evaluated based on DWI. Volumetric ADC histogram parameters were calculated from the volumetric of interest (VOI) on DWI, including the min ADC, mean ADC, median ADC, max ADC, 10th, 25th, 75th, 90th percentiles ADC, skewness, kurtosis, and entropy. The Mann-Whitney U-test was used to compare histogram parameters between NMIBC and MIBC. Receiver operating characteristic analysis was used to evaluate the diagnostic value of each significant parameter.ResultsAmong all parameters, the VI-RADS yield the highest Area Under the Curve (AUC, 0.88; sensitivity, 88.89%; specificity, 83.61%). MIBC had significantly lower min ADC, mean ADC, median ADC, 10th, 25th, 75th, and 90th percentiles ADC than NMIBC (p = 0.002, p < 0.001, p < 0.001, p = 0.003, p = 0.004, p < 0.001, p < 0.001). Skewness and kurtosis of MIBC were significantly higher than those of NMIBC (p < 0.001, p < 0.001). The combination of VI-RADS and skewness showed significantly higher AUC (AUC 0.923; 95% CI 0.847-0.969) than only with VI-RADS (AUC 0.880; 95% CI 0.793-0.940).ConclusionVolumetric ADC histogram analysis and VI-RADS are both useful methods in differentiating MIBC from NMIBC, and the volumetric ADC histogram analysis can provide additional value to VI-RADS.© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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