• Qing Li, Bohong Cao, Qinxuan Tan, Kai Liu, Shuai Jiang, and Jianjun Zhou.
• Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China. Electronic address: liqing_0413@163.com.
• Eur J Radiol. 2021 Mar 1; 136: 109522.

ObjectivesTo prospectively compare the diagnostic efficacy of conventional diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in differentiating between muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC).MethodsMultiple b value DWIs were performed using a 3-T magnetic resonance (MR) imaging unit in fifty-one patients with bladder cancer including MIBC and NMIBC confirmed by histopathological findings. DWI data were postprocessed using mono-exponential and DKI models to calculate the apparent diffusion coefficient (ADC), apparent diffusional kurtosis (Kapp), and kurtosis-corrected diffusion coefficient (Dapp). Receiver-operating characteristic (ROC) analysis was performed to compare the diagnostic efficacy of all diffusion parameters.ResultsAll parameters differed significantly between MIBC and NIMBC including increased Kapp, decreased Dapp and ADC (all p < 0.001). Only the combination of Dapp and Kapp was significantly higher than ADC (p < 0.05), whilst Dapp and Kapp were not statistically different from ADC.ConclusionsBoth conventional DWI and DKI models are beneficial in differentiating between MIBC and NMIBC, whilst the combination of Dapp and Kapp can produce a more robust value than conventional ADC value in evaluating aggressiveness of bladder cancer.Copyright © 2021 Elsevier B.V. All rights reserved.

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