1. Potential and Limitations of Diffusion-Weighted Magnetic Resonance Imaging in Kidney, Prostate, and Bladder Cancer Including Pelvic Lymph Node Staging: A Critical Analysis of the Literature 
Gianluca Giannarini, Giuseppe Petralia, Harriet C. Thoeny 
European Urology 
Volume 61, Issue 2, Pages (February 2012)
DOI: /j.eururo
Copyright © 2011 European Association of Urology Terms and Conditions

2. Fig. 1
Magnetic resonance imaging (MRI) of an 82-yr-old man with flank pain and chronic renal failure performed on a 1.5-T MRI unit. (A) Axial high-resolution T2-weighted MRI shows a focal mass at the midlevel of left kidney (arrows) with hypointense signal intensity and multiple bilateral hyperintense focal lesions (asterisks), corresponding to renal cysts. (B) On axial diffusion-weighted MRI at a b-value of 900s/mm2, the focal mass (arrows) is hyperintense compared with the simple cysts (asterisks). (C) On the corresponding apparent diffusion coefficient map, the focal mass (arrows) is visualised as a hypointense lesion with impeded diffusion compared with the simple cysts, which appear bright (asterisks). Histology after left partial nephrectomy revealed a Fuhrman grade II clear cell renal cell carcinoma.
European Urology  , DOI: ( /j.eururo )
Copyright © 2011 European Association of Urology Terms and Conditions

3. Fig. 2
Magnetic resonance imaging (MRI) of a 63-yr-old man with known prostate cancer performed on a 3-T MRI unit. (A) Axial high-resolution T2-weighted MRI shows low signal intensity areas in the whole prostate, predominantly in the left lobe; exact delineation of the tumour is not possible. (B) Axial diffusion-weighted MRI at the same level acquired at a b-value of 1000s/mm2 shows a hyperintense lesion (arrows) in the peripheral zone of the left prostate lobe with extension into the ipsilateral transition zone at the midlevel. Asterisk identifies bladder. (C) On the corresponding apparent diffusion coefficient (ADC) map, the tumour is visualised as a hypointense lesion (arrows) with an ADC value of 0.66×10−3mm2/s. Histology after radical prostatectomy confirmed unilateral prostate cancer with a Gleason score of 8. Asterisk identifies bladder.
European Urology  , DOI: ( /j.eururo )
Copyright © 2011 European Association of Urology Terms and Conditions

4. Fig. 3
Magnetic resonance imaging (MRI) of a 65-yr-old woman with known bladder cancer performed on a 3-T MRI unit. (A) Axial high-resolution T2-weighted MRI shows large hypointense thickening of the left bladder wall and a small circumscribed focal thickening of the right bladder wall (arrow). Asterisk identifies bladder. (B) Axial diffusion-weighted MRI at a b-value of 1000s/mm2 shows hyperintense thickening of the bladder wall on both sides with extension into the perivesical fat only on the left side (arrows). Asterisk identifies bladder. (C) On the corresponding apparent diffusion coefficient (ADC) map, both tumours are visualised as hypointense lesions (arrows) with an ADC value of 0.90×10−3mm2/s. Histology after radical cystectomy confirmed a pT3a urothelial carcinoma of the bladder. Asterisk identifies bladder.
European Urology  , DOI: ( /j.eururo )
Copyright © 2011 European Association of Urology Terms and Conditions

5. Fig. 4
Magnetic resonance imaging (MRI) of a 63-yr-old man with known bladder cancer performed on a 3-T MRI unit. (A) Axial T2-weighted MRI shows extensive hypointense semicircumferential bladder wall thickening, with suspicious invasion into the perivesical fat (arrows). Asterisk identifies bladder. (B) Axial diffusion-weighted MRI at a b-value of 1000s/mm2 shows hyperintense thickened bladder wall without signs of infiltration into the perivesical fat. Asterisk identifies bladder. (C) On the corresponding apparent diffusion coefficient (ADC) map, the bladder wall has an ADC value of 0.96×10−3mm2/s. Asterisk identifies bladder. (D) Axial T2-weighted MRI at the level of fossa Marcille shows a dilated left-sided ureter (white arrow) with a small (3mm) adjacent lymph node (red arrow). (E) Axial diffusion-weighted MRI at a b-value of 1000s/mm2 at the same level as in (D) shows the lymph node as a small hyperintense lesion (red arrow), whereas the dilated ureter (white arrow) is not visible. (F) On the corresponding ADC map, the lymph node (red arrow) shows impeded diffusion with an ADC value of 0.94×10−3mm2/s, whereas the dilated ureter (white arrow) reveals a bright signal with a high ADC value due to increased diffusion. Histology after radical cystectomy and extended template pelvic lymph node dissection confirmed a pT2 urothelial carcinoma of the bladder with a single lymph node metastasis of 1mm in a 3-mm node.
European Urology  , DOI: ( /j.eururo )
Copyright © 2011 European Association of Urology Terms and Conditions