Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer

Objectives:To assess the role of multiparametric magnetic resonance imaging(mp-MRI)in the diagnosis and staging of urinary bladder cancer(BC).Materials and methods:Fifty patients diagnosed with bladder masses underwent mp-MRI study.The results of 3 image sets were analyzed and compared with the histopathological results as a reference standard:T2-weighted image(T2WI)plus dynamic contrast-enhanced(DCE),T2WI plus diffusion-weighted images(DWI),and mp-MRI,including T2WI plus DWI and DCE.The diagnostic accuracy of mp-MRI was evaluated using receiver operating characteristic curve analysis.Results:The accuracy of T2WI plus DCE for detecting muscle invasion of BC was 79.5%with a fair agreement with histopathological examination(κ=0.59);this percentage increased up to 88.6%using T2WI plus DWI,with good agreement with histopathological examination(κ=0.74),whereas mp-MRI had the highest overall accuracy(95.4%)and excellent agreement with histopathological data(κ=0.83).Multiparametric MRI can differentiate between low-and high-grade bladder tumors with a high sensitivity and specificity of 93.3%and 98.3%,respectively.Conclusions:Multiparametric MRI is an acceptable method for the preoperative detection and accurate staging of BC,with reasonable accuracy in differentiating between low-and high-grade BC.

One-stage versus staged ureteroscopy and percutaneous nephrolithotomy for simultaneous ureteral and renal stones

Objectives:This study is aimed to investigate the outcome of one-stage ureteroscopy(URS)and percutaneous nephrolithot(PCNL)for simultaneous ureteral and renal stones over 10years at a tertiary urology institute.Materials and methods:We retrospectively analyzed the data of patients who were operated on for simultaneous ureteral and renal stones from January 2011 to December 2020.Patients were divided into 2 groups:group A,who underwent one-stage URS and prone PCNL,and group B,who underwent staged procedures.The overall success,complications,operative time,and hospital stays were compared between the 2 groups.Results:Data for 190 patients were reviewed;mean age was 50±13 years old,and 146(77%)were male.The one-stage(A)and staged(B)groups included 102 and 88 patients,respectively.Group A included older patients,with a high The American Society of Anesthesiologists score,while group B included more patients with multiple or staghorn stones.The one-stage group recorded shorter operative time(120±12min vs.140±16min,p=0.02)and shorter hospital stays(3 days[2-6]vs.4 days[3-9],p=0.06).Otherwise,both groups had equal outcomes in terms of success rates and complications.Conclusions:PCNL and URS can be performed in one-session for simultaneous ureteral and renal stones,except for multiple renal and staghorn stones.The results are comparable to those of the staged procedure in terms of success rate and complications,with the advantage of a shorter operative time and hospital stay.