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lüll Clinicopathologic significance of high signal intensity on diffusion-weighted MR imaging in the ureter, urethra, prostate and bone of patients with bladder cancer Takeuchi M; Suzuki T; Sasaki S; Ito M; Hamamoto S; Kawai N; Kohri K; Hara M; Shibamoto YAcad Radiol 2012[Jul]; 19 (7): 827-33RATIONALE AND OBJECTIVES: The aim of this study was to determine the clinicopathologic significance of high-intensity areas in the ureter, urethra, prostate, and bone incidentally found on diffusion-weighted magnetic resonance imaging (DWI) for the staging of bladder cancer. MATERIALS AND METHODS: Axial and sagittal DWI and T2-weighted imaging of the pelvis were evaluated in 157 patients with bladder cancer. Two observers assessed T2-weighted imaging with DWI independently. The observers pointed out 67 areas showing abnormal high signal intensity on DWI in the ureter (n = 17), urethra (n = 8), prostate (n = 20), and bone (n = 22). Of the 67 high-intensity areas, 33 lesions were confirmed histopathologically (ureter, n = 10; urethra, n = 7; prostate, n = 16), and 22 bone lesions were diagnosed using T1-weighted imaging and follow-up computed tomography. Thus, 55 lesions were evaluable for correlation with DWI findings. RESULTS: Of the 55 high-intensity areas, 28 (53%) were synchronous or metastatic urothelial cancer or invasion of urothelial cancer. The remaining 27 (47%) were a ureteral clot in one, a ureteral stone granuloma in one, prostatic cancer in six, granulomatous prostatitis in three, and normal red bone marrow in 16. CONCLUSIONS: DWI is useful to comprehend the extent of bladder cancer and to detect incidentally coexisting diseases. Other imaging, endoscopic, and clinical findings would be useful to reduce false positivity.|*Diffusion Magnetic Resonance Imaging[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Bone Neoplasms/pathology/secondary[MESH]|False Positive Reactions[MESH]|Female[MESH]|Humans[MESH]|Ilium/*pathology[MESH]|Incidental Findings[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Invasiveness[MESH]|Neoplasms, Multiple Primary/pathology[MESH]|Prostate/*pathology[MESH]|Prostatic Neoplasms/pathology/*secondary[MESH]|Sacrum/*pathology[MESH]|Ureter/*pathology[MESH]|Ureteral Neoplasms/pathology/secondary[MESH]|Urethra/*pathology[MESH]|Urethral Neoplasms/pathology/secondary[MESH]|Urinary Bladder Neoplasms/*pathology[MESH] |