Early Prediction of Neoadjuvant Chemotherapy Response in Bladder Cancer Using Quantitative Multiparametric MRI

Summary

Bladder cancer is a prevalent malignancy globally, with muscle-invasive disease having a five-year survival rate below 50%. Neoadjuvant chemotherapy (NAC) before radical cystectomy has shown efficacy for resectable muscle-invasive bladder cancer (MIBC). However, non-response to NAC can lead to delayed surgery and unnecessary toxicity. Magnetic resonance imaging (MRI), particularly multiparametric MRI (mpMRI) with dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI), offers functional and quantitative biomarkers that may predict NAC response early in treatment.

Eligibility

Inclusion Criteria:

* Patients diagnosed with cT2-T4 urothelial carcinoma of the urinary bladder, according to the TNM classification (8), who give informed, written consent on participation in the study and approve all its requirements.
* Planned to receive cisplatin-based NAC followed by radical cystectomy.
* Willing to undergo three mpMRI scans (baseline, 24h post-initial cisplatin, and post-NAC).

Exclusion Criteria:

* Patients who have received pelvic radiotherapy.
* Severe renal impairment
* Previous open or laparoscopic pelvic surgery.
* Presence of distant metastases at diagnosis.
* Patients with contraindications to MRI.
* Ineligibility to cisplatin

Conditions4

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