Quiz: Kidneys & Bladder 4

Objectives: This course is a comprehensive review of the most important aspects of Genito-Urinary MRI, covering multiple organs and diagnoses. The knowledge required for general competence in interpreting GU MRI exams is delivered in 15 lectures by international experts on each topic.

1. What are the important needs in bladder cancer imaging? Select all that apply.*

Detection of upper tract involvement.
Critical stage differentiation between superficial (T2) lesions
Differentiation of transitional from squamous cell carcinoma.
Predict complete pathologic response to neo-adjuvant chemotherapy

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2. Which are the most important MRI pitfalls in local staging of bladder cancer? Select all that apply.*

Inability to differentiate squamous from transitional cell carcinoma
Overstaging
Similar appearance of post-procedure inflammation and malignancy
Inability to differentiate stage T2 tumors from T3

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3. Which is true regarding various MRI sequences for T-staging of bladder cancer?*

A non-contrast study with T2- and diffusion-weighted (DWI) images has higher accuracy than a contrast-enhanced study without DWI.
Dynamic Contrast Enhancement (DCE) definitely increases staging accuracy when added to T2 + DWI sequences.
Contrast enhanced sequences are required to differentiate inflammation from malignancy.
Quantitative ADC values from DWI can be used to differentiate low from high grade tumours.
Diffusion Kurtosis Imaging (DKI) parameters are superior to ADC for differentiation of tumour from normal bladder wall.

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4. Which statement(s) is/are true regarding pathologic response to neo-adjuvant chemo-radiation therapy (CRT) in bladder cancer? Select all that apply.*

Both DWI and DCE can be used to predict response to CRT.
Currently patient with complete pathologic response undergo non-surgical management and surveillance.
Neo-adjuvant CRT has shown survival advantage.
Higher ADC values identify CRT resistant patients.

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