Clinical Applications of Magnetic Resonance Imaging in Genitourinary Cancers

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (15 November 2021) | Viewed by 11667

Special Issue Editor

Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy
Interests: oncologic imaging; genitourinary radiology; radiomics

Special Issue Information

Dear Colleagues,

Magnetic resonance imaging (MRI) is highly regarded as one of the most accurate imaging modalities for the assessment of neoplasms occurring in the genitourinary system. Current guidelines recommend MRI for a plethora of applications, including but not limited to bladder cancer staging, prostate cancer detection, endometrial cancer staging, and the differential diagnosis of renal and adrenal incidentally discovered masses. Recent evidence suggests that MRI could also be employed for assessing responses to treatment in genitourinary malignancies. Furthermore, MR images have been turned into mineable data by the introduction of radiomics, and there is a great interest in potential novel imaging biomarkers in genitourinary oncology.

In this Special Issue, we invite submissions exploring clinical applications of MRI in genitourinary cancers. Contributions can focus on different organs (e.g., prostate, kidney, bladder, uterus, adrenal glands) and different scopes (e.g., lesion characterization, staging, treatment response). Survey papers and reviews are also welcome.

Dr. Arnaldo Stanzione
Guest Editor

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Keywords

  • magnetic resonance imaging
  • diagnosis
  • staging
  • treatment response
  • renal neoplasms
  • bladder cancer
  • prostate cancer
  • gynecologic malignancies
  • adrenal tumors
  • radiomics

Published Papers (6 papers)

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Editorial

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2 pages, 163 KiB  
Editorial
Special Issue on Clinical Applications of Magnetic Resonance Imaging in Genitourinary Cancers
by Arnaldo Stanzione
Appl. Sci. 2022, 12(15), 7528; https://0-doi-org.brum.beds.ac.uk/10.3390/app12157528 - 27 Jul 2022
Viewed by 751
Abstract
In the field of oncologic imaging, MRI represents one of the most powerful diagnostic tools at physicians’ disposal, with its superb contrast resolution and its capability to assess both the morphological and functional features of neoplasms [...] Full article

Research

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7 pages, 24871 KiB  
Article
The Fusion of MRI and CT in the Planning of Brachytherapy for Cancer of the Uterine Cervix
by Roland Merten, Mirko Fischer, Hans Christiansen, Kristina I. Ringe, Rüdiger Klapdor and Jörn Wichmann
Appl. Sci. 2022, 12(2), 634; https://0-doi-org.brum.beds.ac.uk/10.3390/app12020634 - 10 Jan 2022
Cited by 1 | Viewed by 3104
Abstract
Introduction: tumors of the uterine cervix are among the most common carcinomas in women. Intracervical brachytherapy is an indispensable part of curative treatment. Although the tumor is significantly more recognizable in MRI than in CT, the practical application of MRI in brachytherapy planning [...] Read more.
Introduction: tumors of the uterine cervix are among the most common carcinomas in women. Intracervical brachytherapy is an indispensable part of curative treatment. Although the tumor is significantly more recognizable in MRI than in CT, the practical application of MRI in brachytherapy planning is still difficult. The present study examines the technical possibilities of merging CT and MRI. Materials and Methods: the treatment files and imaging of all 53 patients who had been irradiated by image-guided adaptive brachytherapy (IGABT) between January 2019 and August 2021 at the Department of Radiotherapy of the Hannover Medical School were evaluated, retrospectively. Patients were treated first with an external beam radiotherapy (EBRT) combined with simultaneous chemotherapy. After an average of 4.2 weeks, the preparation for IGABT began. The clinical target volume (CTV) for brachytherapy was contoured first in an MRI acquired before starting EBRT (MRI 1) and once more in a second MRI just before starting IGABT (MRI 2). Then, after inserting the intravaginal applicator, a CT-scan was acquired, and the CTV was contoured in the CT. Finally, the recordings of MRI 1, MRI 2, and the CT were merged, and the congruence of CTVs was quantitatively evaluated. Results: the CTV delineated in MRI 2 was, on average, 28% smaller than that in MRI 1 after an average applied radiation dose of 42 Gy. The CTV delineated in the CT covered an average of no more than 80.8% of the CTV delineated in MRI 2. The congruence of CTVs was not superior in patients with a smit sleeve in the cervical channel, with a 3D-volumetric MRI or with a contrast-enhanced sequence for MRI. Conclusion: the anatomical shape and position of the uterus is significantly changed by introducing a vaginal applicator. Despite the superior delimitability of the tumor in MRI, brachytherapy cannot be reliably planned by the image fusion of an MRI without a vaginal applicator. Full article
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11 pages, 1754 KiB  
Article
Characterization of Atypical Pheochromocytomas with Correlative MRI and Planar/Hybrid Radionuclide Imaging: A Preliminary Study
by Roberta Galatola, Ludovica Attanasio, Valeria Romeo, Ciro Mainolfi, Michele Klain, Chiara Simeoli, Roberta Modica, Elia Guadagno, Giovanni Aprea, Luca Basso, Emanuele Nicolai, Marco Salvatore and Simone Maurea
Appl. Sci. 2021, 11(20), 9666; https://0-doi-org.brum.beds.ac.uk/10.3390/app11209666 - 16 Oct 2021
Cited by 4 | Viewed by 1705
Abstract
Pheochromocytomas may show atypical imaging findings leading to diagnostic pitfalls. We correlated the results of magnetic resonance imaging (MRI) with those of radionuclide studies in patients with pheochromocytomas. T2-weighted (-w), T1-w chemical-shift and T1-w dynamic contrast enhanced (DCE) MRI sequences were evaluated to [...] Read more.
Pheochromocytomas may show atypical imaging findings leading to diagnostic pitfalls. We correlated the results of magnetic resonance imaging (MRI) with those of radionuclide studies in patients with pheochromocytomas. T2-weighted (-w), T1-w chemical-shift and T1-w dynamic contrast enhanced (DCE) MRI sequences were evaluated to assess tumor structure. 131Iodine metaiodobenzylguanidine (MIBG) scintigraphy, 18fluoro (F) deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) or FDG PET/MRI were evaluated for direct comparison. Of a total of 80 adrenal lesions in 73 patients, 20 in 18 patients were pheochromocytomas. More than half (55%) of the pheochromocytomas (n = 11) had the typical increased signal intensity on T2-w and T1-w DCE, while the remaining (n = 9) lesions showed atypical findings; of these nine latter atypical lesions, seven (35%) were cystic (two totally, three predominantly and two partially) and two (10%) were hemorrhagic on MRI. In these atypical lesions, MIBG scintigraphy (n = 5), FDG PET/CT (n = 6) or FDG PET/MRI (n = 2) showed inhomogeneous tracer uptake in the residual viable tissue providing tumor characterization; however, one predominantly cystic pheochromocytoma showed false negative MIBG scan. Our preliminary results show that cystic degeneration may be frequent in pheochromocytoma being so marked that only a thin rim of viable cells may residue to disclose the true nature of the tumor. MRI findings together with those of correlative planar/hybrid radionuclide images are helpful to characterize these atypical pheochromocytomas. In particular, tumor accumulation of MIBG and/or FDG is able to classify these lesions as not simple cysts; in detail, the presence of partial MIBG uptake allows the diagnosis of pheochromocytomas, while the presence of partial FDG uptake generically reflects the presence of viable solid tissue of such cystic tumors. Full article
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Review

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11 pages, 1023 KiB  
Review
Apparent Diffusion Coefficient Value as a Biomarker for Detecting Muscle-Invasive and High-Grade Bladder Cancer: A Systematic Review
by Shuichiro Kobayashi, Kosuke Takemura and Fumitaka Koga
Appl. Sci. 2022, 12(3), 1278; https://0-doi-org.brum.beds.ac.uk/10.3390/app12031278 - 25 Jan 2022
Cited by 2 | Viewed by 1948
Abstract
Background: Several studies have investigated the potential role of the apparent diffusion coefficient (ADC) value of diffusion-weighted magnetic resonance imaging as a biomarker of high-grade and invasive bladder cancer. Methods: PubMed and the Cochrane Library were systematically searched in September 2021 to extract [...] Read more.
Background: Several studies have investigated the potential role of the apparent diffusion coefficient (ADC) value of diffusion-weighted magnetic resonance imaging as a biomarker of high-grade and invasive bladder cancer. Methods: PubMed and the Cochrane Library were systematically searched in September 2021 to extract studies that evaluated the associations between ADC values, pathological T stage, and histological grade bladder cancers. The diagnostic performance of ADC values in detecting muscle-invasive bladder cancer (MIBC) and high-grade disease was systematically reviewed. Results: Six studies were included in this systematic review. MIBC showed significantly lower ADC values than non-muscle-invasive bladder cancer (NMIBC) in all six studies. The median (range) sensitivity, specificity, and area under the curve (AUC) of ADC values to detect MIBC among the four eligible studies were 73.5% (68.8–90.0%), 79.9% (66.7–84.4%), and 0.762 (0.730–0.884), respectively. Similarly, high-grade disease showed significantly lower ADC values than did low-grade disease in all four eligible studies. The median (range) sensitivity, specificity, and AUC of ADC values for detecting high-grade disease among the three eligible studies were 75.0% (73.0–76.5%), 95.8% (76.2–100%), and 0.902 (0.804–0.906), respectively. Conclusions: The ADC value is a non-invasive diagnostic biomarker for discriminating muscle-invasive and high-grade bladder cancer. Full article
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12 pages, 1379 KiB  
Review
Current Imaging Evaluation of Tumor Response to Advanced Medical Treatment in Metastatic Renal-Cell Carcinoma: Clinical Implications
by Martina Caruso, Valeria Romeo, Arnaldo Stanzione, Carlo Buonerba, Giuseppe Di Lorenzo and Simone Maurea
Appl. Sci. 2021, 11(15), 6930; https://0-doi-org.brum.beds.ac.uk/10.3390/app11156930 - 28 Jul 2021
Cited by 3 | Viewed by 1555
Abstract
The present review is focused on the role of diagnostic tomographic imaging such as computed tomography and magnetic resonance imaging to assess and predict tumor response to advanced medical treatments in metastatic renal cell carcinoma (RCC) patients. In this regard, antiangiogenic agents and [...] Read more.
The present review is focused on the role of diagnostic tomographic imaging such as computed tomography and magnetic resonance imaging to assess and predict tumor response to advanced medical treatments in metastatic renal cell carcinoma (RCC) patients. In this regard, antiangiogenic agents and immune checkpoint inhibitors (ICIs) have developed as advanced treatment options replacing the conventional therapy based on interferon-alpha and interleuchin-2 which had unfavorable toxicity profile and low response rates. In clinical practice, the imaging evaluation of treatment response in cancer patients is based on dimensional changes of tumor lesions in sequential scans; in particular, Response Evaluation Criteria in Solid Tumors (RECIST) have been defined for this purpose and also applied in patients with metastatic RCC. However, these new drugs with predominant cytostatic effect make RECIST insufficient to realize an adequate response imaging evaluation. Therefore, new imaging criteria (mCHOI and iRECIST) have been proposed to assess tumor response to advanced medical treatments of metastatic RCC, they correlate better than RECIST with the progression-free survival and overall survival. Finally, a potential role of radiomics and machine learning models has been suggested to predict tumor response. Full article
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Other

8 pages, 1642 KiB  
Systematic Review
Diagnostic Performance of Magnetic Resonance Imaging for Preoperative Local Staging of Penile Cancer: A Systematic Review and Meta-Analysis
by Rocco Simone Flammia, Antonio Tufano, Luca Antonelli, Arianna Bernardotto, Alberto A. Castro Bigalli, Zhen Tian, Marc C. Smaldone, Pierre I. Karakiewicz, Valeria Panebianco and Costantino Leonardo
Appl. Sci. 2021, 11(15), 7090; https://0-doi-org.brum.beds.ac.uk/10.3390/app11157090 - 31 Jul 2021
Cited by 4 | Viewed by 1532
Abstract
Invasion of the tunica albuginea (TA) and/or urethra are key factors in determining the feasibility of organ-preserving surgery in penile cancer (PC). Magnetic resonance imaging (MRI) appeared to be a promising technique for preoperative local staging. We performed a systematic review (SR) and [...] Read more.
Invasion of the tunica albuginea (TA) and/or urethra are key factors in determining the feasibility of organ-preserving surgery in penile cancer (PC). Magnetic resonance imaging (MRI) appeared to be a promising technique for preoperative local staging. We performed a systematic review (SR) and pooled meta-analysis to investigate the diagnostic performance of MRI in preoperative local staging of primary PC. An SR up to May 2021 was performed according to the PRISMA statement. The diagnostic performance of MRI was evaluated according to TA invasion, urethra invasion, and pT-stage ≥ 2. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) from eligible studies were pooled and summary receiver operating characteristic (SROC) curves were constructed. Overall, seven qualified studies were deemed suitable. Diagnostic performance of MRI showed an accuracy of 0.89 for TA invasion (sensitivity 0.78, PPV 0.79, specificity 0.91, and NPV 0.90); an accuracy of 0.88 for urethra invasion (sensitivity 0.65, PPV 0.46, specificity 0.86, and NPV 0.93); an accuracy of 0.90 for pT ≥ 2 (sensitivity 0.86, PPV 0.84, specificity 0.70, and NPV 0.73).Currently available evidence indicates that MRI might be a one-stop shop for local staging of primary PC and play a central role with regard to conservative surgical management. Full article
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