The Value of Amide Proton Transfer <scp>MRI</scp> in the Diagnosis of Malignant and Benign Urinary Bladder Lesions: Comparison With Diffusion‐Weighted Imaging
Bibliographic record
Abstract
Background Conventional magnetic resonance imaging ( MRI ) has certain limitations in distinguishing between malignant and benign urinary bladder ( UB ) lesions. Amide proton transfer ( APT ) imaging may provide more diagnostic information than diffusion‐weighted imaging ( DWI ) to distinguish between malignant and benign UB . Purpose To investigate the potential of APT imaging in the diagnosis of malignant and benign UB lesions and to compare its diagnostic efficacy with that of conventional DWI. Study Type Prospective. Subjects Eighty patients with UB lesions. Field Strength/Sequence A 3.0 T/turbo spin echo (TSE) T1‐weighted and T2‐weighted imaging, single‐shot echo planar DWI, and three‐dimensional TSE APT imaging. Assessment Patients underwent radical cystectomy or transurethral resection of the bladder lesions within 2 weeks after CT urography and MRI examination. APT signal intensity in UB lesions was quantified by the asymmetric magnetization transfer ratio (MTR asym ). MTR asym and apparent diffusion coefficient (ADC) values were measured and compared between malignant and benign UB lesions. Statistical Tests Kolmogorov–Smirnov test, Student's t test or Mann–Whitney U test, Spearman rank correlation coefficient, area under the receiver operating characteristic (ROC) curve (AUC), Delong test, and intraclass correlation coefficient (ICC). The significance threshold was set at P < 0.05. Results Thirty‐two patients had pathologically confirmed benign UB lesions, including 2 bladder leiomyomas, 1 submucosal amyloidosis, 1 inflammatory myofibroblastic tumor, and 28 inflammatory lesions, and 48 patients had pathologically confirmed urothelial carcinoma. Urothelial carcinomas showed significantly higher MTR asym values (1.53% [0.74%] vs. 0.85% [0.23%]) and significantly lower ADC values (1.24 ± 0.34 × 10 −3 mm 2 /s vs. 1.43 ± 0.22 × 10 −3 mm 2 /s) than benign UB lesions. The MTR asym value (AUC = 0.928) was significantly better in differentiating urothelial carcinoma from benign UB lesions than the ADC value (AUC = 0.722). Data Conclusion APT imaging may have value in discriminating malignant from benign UB lesions and has better diagnostic performance than DWI. Level of Evidence 3 Technical Efficacy Stage 2
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".