Early Prediction of Neoadjuvant Chemotherapy Response in Bladder Cancer Using Quantitative Multiparametric MRI
Assiut University
39 participants
Aug 29, 2025
OBSERVATIONAL
Conditions
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 Criteria3
- 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 Criteria6
- 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
Interventions
Multiparametric MRI (mpMRI) performed at three defined timepoints: prior to neoadjuvant chemotherapy (baseline), 24 hours after first cisplatin dose in the first NAC cycle, and after completing NAC but before radical cystectomy. Imaging protocols include T2-weighted imaging, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE-MRI). Quantitative imaging biomarkers such as K\^trans\^, Ve, and ADC index are extracted and analyzed to evaluate early treatment response and predict pathological outcomes following chemotherapy.
Locations(1)
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NCT07202845