Prediction of muscle invasion of bladder cancer: A comparison between DKI and conventional DWI.

Abstract Objectives To prospectively compare the diagnostic efficacy of conventional diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in differentiating between muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Methods Multiple b value DWIs were performed using a 3-T magnetic resonance (MR) imaging unit in fifty-one patients with bladder cancer including MIBC and NMIBC confirmed by histopathological findings. DWI data were postprocessed using mono-exponential and DKI models to calculate the apparent diffusion coefficient (ADC), apparent diffusional kurtosis (Kapp), and kurtosis-corrected diffusion coefficient (Dapp). Receiver-operating characteristic (ROC) analysis was performed to compare the diagnostic efficacy of all diffusion parameters. Results All parameters differed significantly between MIBC and NIMBC including increased Kapp, decreased Dapp and ADC (all p  Conclusions Both conventional DWI and DKI models are beneficial in differentiating between MIBC and NMIBC, whilst the combination of Dapp and Kapp can produce a more robust value than conventional ADC value in evaluating aggressiveness of bladder cancer.