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• W2324629151 abstract "You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II1 Apr 2016MP27-07 APPARENT DIFFUSION COEFFICIENT AS A PROGNOSTIC BIOMARKER OF UPPER URINARY TRACT CANCER soichiro yoshida, Yusuke Uchida, Shuichiro Kobayashi, Fumitaka Kobayashiga, Hiroshi Tanaka, Minato Yokoyama, Junichiro Ishioka, Yoh Matsuoka, Noboru Numao, Kazutaka Saito, Yasuhisa Fujii, and Kazunori Kihara soichiro yoshidasoichiro yoshida More articles by this author , Yusuke UchidaYusuke Uchida More articles by this author , Shuichiro KobayashiShuichiro Kobayashi More articles by this author , Fumitaka KobayashigaFumitaka Kobayashiga More articles by this author , Hiroshi TanakaHiroshi Tanaka More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Junichiro IshiokaJunichiro Ishioka More articles by this author , Yoh MatsuokaYoh Matsuoka More articles by this author , Noboru NumaoNoboru Numao More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , Yasuhisa FujiiYasuhisa Fujii More articles by this author , and Kazunori KiharaKazunori Kihara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1038AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Diffusion-weighted MRI (DWI) is a functional imaging technique that derives image contrast from differences in the motion of water molecules in tissues. The extent of the water molecule diffusion within the tissue can be quantitatively calculated as an apparent diffusion coefficient (ADC) value from DWI. We investigate the role of ADC value as an imaging biomarker for preoperative risk stratification of upper tract urothelial carcinoma (UTUC) patients. METHODS Of the localized UTUC (cT1-3N0M0) patients treated with nephroureterectomy between 2007 and 2014, 83 patients who underwent MRI examination including DWI (b-values of 0, 400 and 800 sec/mm2) at diagnosis were retrospectively evaluated. Two urologists independently measured the ADC value of each tumor. The relationship of the ADC value with clinicopathological variables and cancer-specific survival (CSS) after nephroureterectomy was evaluated. RESULTS Twelve patients who received neoadjuvant treatment, six patients whose UTUC was negative on DWI, and one patient whose DWI was of poor quality were excluded, and 64 patients were eligible for the analysis. Thirteen patients (20.3%) died of UTUC during the follow-up. The overall 5-year CSS rate was 72.4% (median follow-up, 43 months). Both ADC1 measured by reader 1 and ADC2 measured by reader 2 were significantly lower in grade 3 disease than in grade 1-2 disease (median ADC1 value, 0.98 x 10-3 vs 1.28 x 10-3 mm2/sec; P = 0.010; ADC2 value, 0.96 x 10-3 vs 1.27 x 10-3 mm2/sec; P = 0.013). Martingale residual analysis revealed that the prognostic effect of the ADC on CSS fitted a linear model, and there was no abrupt increase in the hazard ratio for CSS. With the cut-off ADC determined at 1.10 x 10-3 mm2/sec, 40 (62.5%) and 24 patients (37.5%) were classified into the low and high ADC1 groups, respectively, and 38 (59.4%) and 26 patients (40.6%) were classified into the low and high ADC2 groups, respectively. Interobserver agreement between the readers was good (κ = 0.71) for this ADC stratification. Low ADCs were significantly associated with shorter CSS regardless of the ADC reader (5-y CSS rate: ADC1 low vs. high, 70% vs. 90%; P = 0.024, ADC2 low vs. high, 70% vs. 89%; P = 0.036). Multivariate analysis revealed that ADC can serve as an independent pre-operative indicator of shorter CSS among age, gender, tumor location, clinical T stage, and ADC. CONCLUSIONS ADC value reflects the clinical aggressiveness of UTUC and predicts survival after the operation, regardless of the ADC reader. ADC value might be a useful imaging biomarker for a preoperative prognostic stratification. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e364-e365 Advertisement Copyright & Permissions© 2016MetricsAuthor Information soichiro yoshida More articles by this author Yusuke Uchida More articles by this author Shuichiro Kobayashi More articles by this author Fumitaka Kobayashiga More articles by this author Hiroshi Tanaka More articles by this author Minato Yokoyama More articles by this author Junichiro Ishioka More articles by this author Yoh Matsuoka More articles by this author Noboru Numao More articles by this author Kazutaka Saito More articles by this author Yasuhisa Fujii More articles by this author Kazunori Kihara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2324629151 title "MP27-07 APPARENT DIFFUSION COEFFICIENT AS A PROGNOSTIC BIOMARKER OF UPPER URINARY TRACT CANCER" @default.
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