PD42-08 REAL-WORLD PERFORMANCE OF MRI AFTER TURBT IN PREDICTING FINAL PATHOLOGIC OUTCOMES IN BLADDER CANCER

Abstract

You have accessJournal of UrologyCME1 May 2022PD42-08 REAL-WORLD PERFORMANCE OF MRI AFTER TURBT IN PREDICTING FINAL PATHOLOGIC OUTCOMES IN BLADDER CANCER Michael Chandra, Thomas Gerald, Suzanne Cole, Liwei Jia, Jeffrey Howard, Aditya Bagrodia, Xiaosong Meng, Vitaly Margulis, Yair Lotan, Alberto Diaz de Leon, and Solomon Woldu Michael ChandraMichael Chandra More articles by this author , Thomas GeraldThomas Gerald More articles by this author , Suzanne ColeSuzanne Cole More articles by this author , Liwei JiaLiwei Jia More articles by this author , Jeffrey HowardJeffrey Howard More articles by this author , Aditya BagrodiaAditya Bagrodia More articles by this author , Xiaosong MengXiaosong Meng More articles by this author , Vitaly MargulisVitaly Margulis More articles by this author , Yair LotanYair Lotan More articles by this author , Alberto Diaz de LeonAlberto Diaz de Leon More articles by this author , and Solomon WolduSolomon Woldu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002603.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder cancer staging by transurethral resection of a bladder tumor (TURBT) is often inaccurate due to limited sampling. For higher risk non-muscle invasive bladder cancer, the current standard is to repeat TURBT, an invasive procedure with associated risk and cost. Additionally, interest in bladder preservation following systemic therapy is limited by concerns regarding the accuracy of cystoscopic assessment of response. Bladder MRI has emerged as a potential non-invasive and accurate means of bladder cancer staging. We sought to examine the ability of MRI after TURBT to predict residual tumor and muscle-invasive bladder cancer (MIBC) in a real-world cohort of patients subsequently undergoing re-TURBT or cystectomy. METHODS: This prospectively maintained cohort evaluated 70 patients with bladder cancer who received a multiparametric pelvic MRI from 2019-2021 after TURBT. The MRI was protocoled for bladder cancer evaluation and included T2-, diffusion, and T1-weighed images with and without IV contrast. MRIs were evaluated for restricted diffusion, enhancement and signal intensity features indicative of residual tumor and MIBC. These results were then compared to final pathology at subsequent re-TURBT (n=42) or cystectomy (n=28). RESULTS: Among re-TURBT cases, 24 (57.1%) and 3 (7.1%) had residual tumor and MIBC, respectively. Among cystectomy cases, 22 (78.6%) and 18 (64.3%) demonstrated residual tumor and MIBC, respectively. In detecting residual tumor among patients undergoing cystectomy, MRI showed a sensitivity, specificity, AUC, and positive post-test probability (PTP) of 90.9%, 66.7%, 0.788 (p=0.033), and 91%, respectively. In detecting MIBC among patients undergoing re-TURBT, MRI had a sensitivity, specificity, AUC, and negative PTP of 100%, 82.1%, 0.910 (p=0.019), and 0%, respectively. CONCLUSIONS: In this real-world setting, MRI showed high performance in ruling out MIBC in patients undergoing re-TURBT and in predicting the presence of residual disease prior to cystectomy. Performance characteristics in other settings were less accurate. These findings support the continued refinement of MRI in bladder cancer and as a potentially important adjunct in specific scenarios. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e698 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Chandra More articles by this author Thomas Gerald More articles by this author Suzanne Cole More articles by this author Liwei Jia More articles by this author Jeffrey Howard More articles by this author Aditya Bagrodia More articles by this author Xiaosong Meng More articles by this author Vitaly Margulis More articles by this author Yair Lotan More articles by this author Alberto Diaz de Leon More articles by this author Solomon Woldu More articles by this author Expand All Advertisement PDF DownloadLoading ...