Correlative Study between ADC Value and Grading of Bladder Carcinoma

Abstract Background: Studying urinary bladder carcinoma is of great importance as it is one of the most common urological malignancies. Accurate pre-operative assessment of disease characteristics and prognosis would be of great help in the diagnosis and treatment planning of bladder cancer. Aim of Study: The aim of this study is to evaluate the role of the Apparent Diffusion Coefficient (ADC) value in detecting the grading of urinary bladder cancer prior to management. Patients and Methods: Prospective study of 108 patients with mean age of 60.81±12.24, diagnosed with proven bladder carcinoma. Two radiologists prospectively assessed the mor-phological and qualitative descriptors of the included carci-nomas (restricted diffusion) and quantitative analysis of the ADC maps. The mean ADC value of the bladder lesions was calculated and correlated with the pathological grade according which was established by means of an open or a core needle biopsy (considered as the standard reference). Results: There was significant difference between the mean ADC value of tumors of grade I and III (p=0.000); and between grade I and II (p=0.00) with slight less significant difference between grade II and III (p=0.022). High ADC values were associated with low grade tumors. Conclusion: DWI is a contrast-free modality that allows for both morphological and quantitative analysis. ADC value is a good discriminator between low and high grade tumors and hence predictor of the histological grade of bladder tumors and prognosis.