MR staging of bladder carcinoma: correlation with pathologic findings

Abstract

Forty patients with bladder carcinoma were examined preoperatively by means of magnetic resonance (MR) imaging. In all patients, total cystectomy with enterocystoplasty and pelvic node dissection was performed. The surgical and pathologic findings were correlated with the MR findings. Extension through the deep muscle of the bladder wall was present in 20 of the 40 patients and was diagnosed with a sensitivity of 95% and a specificity of 95%. Extension to perivesical fat was present in 18 of 40 patients and was diagnosed with a sensitivity of 66% and a specificity of 100%. Invasion of the adjacent organs was present in nine of 40 patients and was diagnosed with a sensitivity of 44% and a specificity of 96%. On the basis of the MR findings, the tumor was correctly staged, according to the TNM classification, in 24 of 40 (60%) patients, tumor extension was overestimated in three of 40 (7.5%) patients, and tumor extension was underestimated in 13 of 40 (32.5%) patients. MR imaging has been shown to be accurate in identification of macroscopic lymph node involvement and deep muscle involvement. It appears to be at least as useful as computed tomography (CT) in the evaluation of perivesical fat involvement and to be superior to CT in the detection of invasion of adjacent organs. One limitation of MR imaging is in the evaluation of tumor extension into the periurethral glands.