Optimizing the diagnosis of pelvic lymph node metastasis in bladder cancer using computed tomography and magnetic resonance imaging

摘要

Bladder cancer (BCa) is one of the most common malig-nant urogenital tumors in the world, and is especially common in China [1]. An important component of BCa staging is the determination of pelvic lymph node sta-tus, which provides valuable prognostic information and inf uences treatment decisions [2]. Cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) have proven to be useful for detecting malignant involvement of the pelvic lymph nodes. Both methods rely on morphologi-cal criteria, specif cally, size and shape, as a predictor of lymph node metastasis [3]. Over the past decade, tre-mendous advances in CT and MRI technology, including the introduction of dif usion-weighted and ultra-small, superparamagnetic-particle, iron-oxide-enhanced MRI techniques, have greatly improved imaging resolution, thus readily revealing lymph nodes with diameters as small as 3.0.mm. In addition, the small intestine can be examined without inf ation and small veins can be easily distinguished from lymph nodes [4, 5]. However, a clear consensus regarding the new criteria for imaging-based lymph node evaluation is lacking, and the two modali-ties must once again be assessed for their ability to detect metastatic lymph nodes. In a study recently published in the Chinese Journal of Cancer, titled "Computed tomog-raphy and magnetic resonance imaging evaluation of pel-vic lymph node metastasis in bladder cancer," Li et.al. [6] analyzed the diagnostic accuracy of CT and MRI. Using pelvic lymph node dissection and histopathology as the reference standard, they were able to establish optimal diagnostic criteria.