Computed tomography and magnetic resonance imaging evaluation of pelvic lymph node metastasis in bladder cancer

Cancer Communications

Feiyu Diao¹  Siya Shi²  Wangshu Zhu²  Yong Li²  Tianxin Lin³  Kaiwen Li³  Shaoxu Wu³ 

[1]Department of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China

[2]Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China

[3]Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China

关键词: Bladder cancer;    Lymph node metastasis;    Computed tomography;    Magnetic resonance imaging;   

DOI  :  10.1186/s40880-018-0269-0

学科分类：肿瘤学

来源: Springer

【 摘 要 】

Accurate evaluation of lymph node metastasis in bladder cancer (BCa) is important for disease staging, treatment selection, and prognosis prediction. In this study, we aimed to evaluate the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for metastatic lymph nodes in BCa and establish criteria of imaging diagnosis. We retrospectively assessed the imaging characteristics of 191 BCa patients who underwent radical cystectomy. The data regarding size, shape, density, and diffusion of the lymph nodes on CT and/or MRI were obtained and analyzed using Kruskal–Wallis test and χ2 test. The optimal cutoff value for the size of metastatic node was determined using the receiver operating characteristic (ROC) curve analysis. A total of 184 out of 3317 resected lymph nodes were diagnosed as metastatic lymph nodes. Among 82 imaging-detectable lymph nodes, 51 were confirmed to be positive for metastasis. The detection rate of metastatic nodes increased along with more advanced tumor stage (P < 0.001). Once the ratio of short- to long-axis diameter ≤ 0.4 or fatty hilum was observed in lymph nodes on imaging, it indicated non-metastases. Besides, lymph nodes with spiculate or obscure margin or necrosis indicated metastases. Furthermore, the short diameter of 6.8 mm was the optimal threshold to diagnose metastatic lymph node, with the area under ROC curve of 0.815. The probability of metastatic nodes significantly increased with more advanced T stages. Once lymph nodes are detected on imaging, the characteristic signs should be paid attention to. The short diameter > 6.8 mm may indicate metastatic lymph nodes in BCa.

【 授权许可】

CC BY