Diffusion-weighted magnetic resonance imaging in management of bladder cancer, particularly with multimodal bladder-sparing strategy

Figure 1 Magnetic resonance images of a 79-year-old man with non-muscle invasive bladder cancer (urothelial cancer, stage pTa, grade 2 > 3). A: T2WI shows a hypointense tumor at the trigone; B: The signal intensity of diffusion-weighted magnetic resonance imaging depends on both water diffusion and the T2 relaxation time; C: Due to the very long T2 relaxation time of urine, the signal of the urine in the bladder remains high on the diffusion-weighted magnetic resonance imaging with a b-value of 500 s/mm². This is known as the “T2 shine-through effect”; D: Using a b-value of 1000 s/mm² decreases the signal of the urine, as well as those of the seminal vesicles, while the bladder cancer (arrow head) shows little signal attenuation with the increased b-value.