Relationship of MRI and clinical staging to outcome in invasive bladder cancer treated by radiotherapy

AIM: To compare MRI and clinical staging of invasive bladder cancer prospec tively and identify additional prognostic features on MRI before radiothera py. METHODS AND MATERIALS: 143 patients with a pathological diagnosis of transi tional cell carcinoma underwent MRI (1.0 T) of the abdomen and pelvis befor e radical radiotherapy. Tumour size, site, degree of infiltration, presence of adenopathy and hydronephrosis were assessed and an appropriate radiolog ical stage assigned. Following radiotherapy all patients received regular c ystoscopic follow-up. Date of first relapse and date of death were recorded . RESULTS: The median follow-up was 2.8 years for survivors, Those patients u pstaged from T2a clinically to T3b on MRI had a significantly worse outcome (P = 0.0078). In univariate analysis a number of MRI features were signifi cantly associated with adverse outcome: tumour size, circumferential tumour extent, and presence of hydronephrosis tall P < 0.05). After adjustment fo r clinical T stage and histological grade, all these MRI features and the M RI T stage were found to confer additional prognostic information in predic ting early disease relapse and death (P < 0.05). CONCLUSION: This study demonstrates that MRI before radiotherapy provides v aluable additional prognostic information compared to clinical staging, (C) 2000 The Royal College of Radiologists.