{
  "abstract": "Accurate assessment of muscle layer invasion in bladder cancer is required to distinguish muscle-invasive bladder cancer (MIBC) from non-MIBC (NMIBC). The present prospective study evaluated continuous-time random-walk (CTRW) and stretched-exponential model (SEM) diffusion parameters against conventional apparent diffusion coefficient (ADC) and vesical imaging-reporting and data system (VI-RADS) scores. A total of 106 patients (62 MIBC and 44 NMIBC) who underwent 3.0T multiparametric magnetic resonance imaging, including multi-b-value diffusion-weighted imaging, at The Second Affiliated Hospital of Kunming Medical University (Kunming, China) were analyzed. CTRW and SEM parameters were extracted, and VI-RADS scores were assigned. Significant differences were found between groups for VI-RADS ≥4, SEM-ADC, CTRW-α and CTRW-β (P<0.05). Multivariate logistic regression identified VI-RADS ≥4 and CTRW-β as independent predictors of muscle invasion. While VI-RADS alone achieved an area under the curve (AUC) of 0.85, the combined model incorporating SEM-ADC, CTRW-α and VI-RADS achieved the highest overall performance (AUC=0.91; 95% CI: 0.86-0.96), significantly outperforming VI-RADS alone (raw P=0.002, Bonferroni-corrected P=0.004). Additionally, diffusion kurtosis was positively correlated with invasion depth (r=0.62). These findings indicate that advanced diffusion parameters, particularly CTRW-α and SEM-ADC, effectively differentiate MIBC from NMIBC. When integrated with VI-RADS, they significantly enhance diagnostic accuracy compared with VI-RADS alone (AUC: 0.91 vs. 0.85; P=0.030). Decision curve analysis confirmed clinical utility, with the combined model providing a mean net benefit gain of 0.10 (95% CI: 0.06-0.14) across the clinically relevant threshold range, corresponding with 10 additional correct diagnoses per 100 patients. These quantitative diffusion metrics represent promising non-invasive biomarkers for guiding therapeutic decisions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, P.R. China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yangying Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaofang Zhu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaolong Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Canli Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Li Guo"
    },
    {
      "affs": [
        0
      ],
      "name": "Jingang Hao"
    },
    {
      "affs": [
        0
      ],
      "name": "Yunyun Shang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b89fs8dpfp64v.bib",
  "cited_by": 0,
  "doi": "10.3892/etm.2026.13316",
  "fulltext_url": "https://europepmc.org/articles/PMC13688612",
  "id": "b89fs8dpfp64v",
  "issns": [
    "1792-0981",
    "1792-1015"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923499",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2741|MRI in cancer diagnosis"
    ]
  ],
  "openalex": "W7214711991",
  "pdf_url": "https://europepmc.org/articles/PMC13688612?pdf=render",
  "pmcid": "PMC13688612",
  "pmid": "42923499",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/b89fs8dpfp64v.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42923499",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923499"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2741|MRI in cancer diagnosis",
      "subfield": "imaging"
    }
  ],
  "title": "Assessment of muscularis propria invasion in urothelial bladder carcinoma using continuous-time random walk and stretched-exponential models: Comparison with VI-RADS and apparent diffusion coefficient.",
  "title_text": "Assessment of muscularis propria invasion in urothelial bladder carcinoma using continuous-time random walk and stretched-exponential models: Comparison with VI-RADS and apparent diffusion coefficient.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/b89fs8dpfp64v",
  "venue": "Experimental and therapeutic medicine",
  "versions": []
}