# CT and MRI findings of small cell neuroendocrine carcinoma of the urinary bladder: comparison with urothelial carcinoma

## TL;DR

This study compares CT and MRI features of small cell bladder cancer with urothelial bladder cancer to help distinguish between the two.

## Contribution

The study identifies specific CT and MRI features that can differentiate small cell neuroendocrine carcinoma from urothelial carcinoma of the bladder.

## Key findings

- Bladder SCNEC tumors were larger and had higher CT attenuation compared to UC tumors.
- SCNEC tumors showed lower ADC values and less frequent pedunculated configuration and irregular margins compared to UC.
- These imaging features can help distinguish SCNEC from UC in clinical practice.

## Abstract

This study aimed to evaluate the efficacy of CT and MRI findings to differentiate small cell neuroendocrine carcinoma (SCNEC) from urothelial carcinoma (UC) of the urinary bladder.

This study included 90 patients with histopathologically confirmed bladder cancer (10 SCNECs and 80 UCs). Eight patients with bladder SCNEC and 80 with UC underwent CT and MRI, whereas the remaining two patients with SCNEC underwent CT alone before treatment. CT and MRI findings were retrospectively evaluated and compared between the two pathologies.

The maximum diameter (36.5 mm vs. 19.0 mm, p < 0.01) and height (22.0 mm vs. 14.0 mm, p < 0.01) of the tumor in bladder SCNEC were higher than in UC. The pedunculated configuration (20% vs. 61%, p < 0.05) and irregular tumor margins (20% vs. 76%, p < 0.01) in bladder SCNEC were less common than in UC. The CT attenuation of the solid component in unenhanced CT images was higher in bladder SCNEC than in UC (37 Hounsfield unit [HU] vs. 34 HU, p < 0.01). The apparent diffusion coefficient (ADC) of the solid component in bladder SCNEC was lower than in UC (0.49 × 10−3 mm2/s vs. 1.02 × 10−3 mm2/s, p < 0.01).

In comparison with UC, bladder SCNEC was larger, had higher unenhanced CT attenuation, and had a lower ADC value. The pedunculated configuration and irregular tumor margins were typical of bladder UC.