Abdominal Radiology

, Volume 44, Issue 12, pp 3858–3873 | Cite as

Advanced urothelial cancer: a radiology update

  • Francesco AlessandrinoEmail author
  • Ola Ghaith
  • Kristin Williams
  • Guru P. Sonpavde
  • Stuart G. Silverman
  • Atul B. Shinagare
Special Section: Urothelial Disease


The recent genomic characterization of urothelial carcinoma by the Cancer Genome Atlas Project, made possible by the introduction of high throughput, reduced cost, and sequence analysis, has shed new insights on the biology of advanced disease. In addition, studies on imaging of advanced urothelial carcinoma have widened the knowledge on disease presentation and on pattern of metastatic spread and their correlation with the underlying biology of urothelial carcinoma. The wide range of treatments for advanced urothelial cancer, including combined chemotherapy regimens and immune checkpoint inhibitors, each result in treatment class-specific patterns of response and adverse events. Results of studies point to the need for a reliable biomarker, perhaps with imaging, that predicts prognosis and treatment response to systemic treatment, and can be used to select the most effective treatment while minimizing toxicity. This review of advanced urothelial cancer introduces the latest advances in genetic profiling, the current role of imaging, the radiographic appearance of treatment response and their toxicities, and details potential future areas of imaging research.


Urothelial carcinoma Transitional cell Urinary bladder neoplasms Computed tomography X-ray Programmed cell death-1 receptor Neoplasm Metastasis 


Compliance with ethical standards

Conflict of interest

Guru P. Sonpavde, MD: Consultant for BMS, Exelixis, Bayer, Sanofi, Pfizer, Novartis, Eisai, Janssen, Amgen, Astrazeneca, Merck, Genentech, EMD Serono, Astellas/Agensys; Research support to institution from Astrazeneca, Bayer, Amgen, Boehringer-Ingelheim, Janssen, Merck, Sanofi, Pfizer; Author for Uptodate; Steering committee for Astrazeneca, BMS, Bavarian Nordic; Speaker for Onclive; Research to Practice; Physician Education Resource (PER). Atul B. Shinagare, MD: Relevant: none; unrelated: Consultant, Arog Pharmaceuticals, Virtualscopics. All other authors have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Statement of informed consent is not applicable since the manuscript does not contain any patient data.


  1. 1.
    Rouprêt M, Babjuk M, Compérat E, et al (2015) European Association of Urology guidelines on upper urinary tract urothelial cell carcinoma: 2015 update. Eur Urol 68:868–879PubMedGoogle Scholar
  2. 2.
    Leow JJ, Chong KT, Chang SL, et al (2016) Upper tract urothelial carcinoma: a different disease entity in terms of management ESMO Open. PubMedPubMedCentralGoogle Scholar
  3. 3.
    Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69(1):7-34PubMedGoogle Scholar
  4. 4.
    Lalani AA, Sonpavde GP (2019) Systemic treatments for metastatic urothelial carcinoma. Expert Opin Pharmacother 20(2):201-208PubMedGoogle Scholar
  5. 5.
    Robertson AG, Kim J, Al-Ahmadie H, et al (2017) Comprehensive molecular characterization of muscle-invasive bladder cancer. Cell 171: 540-556PubMedPubMedCentralGoogle Scholar
  6. 6.
    Shinagare AB, Ramaiya NH, Jagannathan JP, Fennessy FM, Taplin ME, Van den Abbeele AD (2011) Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am J Roentgenol 196(1):117-122PubMedGoogle Scholar
  7. 7.
    Spiess PE, Agarwal N, Bangs R, et al (2017) Bladder Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 15(10):1240-1267Google Scholar
  8. 8.
    Choe J, Braschi-Amirfarzan M, Tirumani SH, et al (2017) Updates for the radiologist in non-muscle-invasive, muscle-invasive, and metastatic bladder cancer. Abdom Radiol (NY) 42(11):2710-2724Google Scholar
  9. 9.
    Moss TJ, Qi Y, Xi L, et al (2017) Comprehensive Genomic Characterization of Upper Tract Urothelial Carcinoma. Eur Urol 72(4):641-649PubMedGoogle Scholar
  10. 10.
    Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE (2016) The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumours. Eur Urol 70(1):106-119PubMedGoogle Scholar
  11. 11.
    Sanli O, Dobruch J, Knowles MA, et al (2017) Bladder cancer. Nat Rev Dis Primers 3:17022PubMedGoogle Scholar
  12. 12.
    Audenet F, Attalla K, Sfakianos JP (2018) The evolution of bladder cancer genomics: What have we learned and how can we use it? Urol Oncol 36(7):313-320PubMedGoogle Scholar
  13. 13.
    Vogelstein B, Papadopoulos N, Velculescu VE, Zhou S, Diaz LA, Kinzler KW (2013) Cancer genome landscapes. Science 339(6127):1546–1558PubMedPubMedCentralGoogle Scholar
  14. 14.
    Pietzak EJ, Bagrodia A, Cha EK, et al (2017) Next-generation sequencing of nonmuscle invasive bladder cancer reveals potential biomarkers and rational therapeutic targets. Eur Urol DOI: PubMedPubMedCentralGoogle Scholar
  15. 15.
    Lawrence MS, Stojanov P, Polak P, et al (2013) Mutational heterogeneity in cancer and the search for new cancer-associated genes. Nature 499:214-218PubMedPubMedCentralGoogle Scholar
  16. 16.
    Damrauer JS, Hoadley KA, Chism DD, et al (2014) Intrinsic subtypes of high- grade bladder cancer reflect the hallmarks of breast cancer biology. Proc Natl Acad Sci USA 111:3110–3115PubMedGoogle Scholar
  17. 17.
    Rebouissou S, Bernard-Pierrot I, deReyniès A,et al (2014) EGFR as a potential therapeutic target for a subset of muscle-invasive bladder cancers presenting a basal-like phenotype Sci Transl Med 244ra91–1Google Scholar
  18. 18.
    Choi W, Porten S, Kim S, et al (2014) Identification of distinct basal and luminal subtypes of muscle-invasive bladder cancer with different sensitivities to frontline chemotherapy. Cancer Cell 25:152–65PubMedPubMedCentralGoogle Scholar
  19. 19.
    Eriksson P, Sjödahl G, Chebil G, Liedberg F, Höglund M (2017) HER2 and EGFR amplification and expression in urothelial carcinoma occurs in distinct biological and molecular contexts. Oncotarget 8(30):48905-48914PubMedPubMedCentralGoogle Scholar
  20. 20.
    Seiler R, Ashab HA, Erho N, et al (2017) Impact of Molecular Subtypes in Muscle-invasive Bladder Cancer on Predicting Response and Survival after Neoadjuvant Chemotherapy. Eur Urol 72(4):544-554PubMedGoogle Scholar
  21. 21.
    Rosenberg JE, Hoffman-Censits J, Powles T, et al (2016) Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum based chemotherapy: A single-arm, multicentre, phase 2 trial. Lancet 387:1909–1920PubMedPubMedCentralGoogle Scholar
  22. 22.
    Mak MP, Tong P, Diao L, et al (2015) A Patient-Derived, Pan-Cancer EMT Signature Identifies Global Molecular Alterations and Immune Target Enrichment Following Epithelial-to-Mesenchymal Transition. Clin Cancer Res 22(3):609-620PubMedPubMedCentralGoogle Scholar
  23. 23.
    Karkera JD, Martinez Cardona G, Bell K, et al (2017) Oncogenic characterization and pharmacologic sensitivity of activating fibroblast growth factor receptor (FGFR) genetic alterations to the selective FGFR inhibitor erdafitinib. Mol Cancer Ther 16:1717–1726PubMedGoogle Scholar
  24. 24.
    Kiss B, Wyatt AW, Douglas J, et al (2017) Her2 alterations in muscle-invasive bladder cancer: Patient selection beyond protein expression for targeted therapy. Sci Rep7:42713PubMedPubMedCentralGoogle Scholar
  25. 25.
    Groenendijk FH, de Jong J, Fransen van de Putte EE, et al (2016) ERBB2 Mutations Characterize a Subgroup of Muscle-invasive Bladder Cancers with Excellent Response to Neoadjuvant Chemotherapy. Eur Urol 69(3):384-488PubMedGoogle Scholar
  26. 26.
    Tan TZ, Rouanne M, Tan KT, Huang RY, Thiery JP (2018) Molecular Subtypes of Urothelial Bladder Cancer: Results from a Meta-cohort Analysis of 2411 Tumors. Eur Urol 75(3):423-432PubMedGoogle Scholar
  27. 27.
    Kim J, Kwiatkowski D, McConkey DJ, et al (2019) The Cancer Genome Atlas Expression Subtypes Stratify Response to Checkpoint Inhibition in Advanced Urothelial Cancer and Identify a Subset of Patients with High Survival Probability. Eur Urol PubMedGoogle Scholar
  28. 28.
    Wang L, Saci A, Szabo PM, et al (2018) EMT- and stroma-related gene expression and resistance to PD-1 blockade in urothelial cancer. Nat Commun 9:3503PubMedPubMedCentralGoogle Scholar
  29. 29.
    Mariathasan S, Turley SJ, Nickles D, et al (2018) TGFbeta attenuates tumour response to PD-L1 blockade by contributing to exclusion of T cells. Nature 554:544-548PubMedPubMedCentralGoogle Scholar
  30. 30.
    Nassar AH, Umeton R, Kim J, et al (2018) Mutational analysis of 472 urothelial carcinoma across grades and anatomic sites. Clin Cancer Res PubMedGoogle Scholar
  31. 31.
    National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Version 1.2019 – December 20, 2018. Accessed February 1, 2019.
  32. 32.
    Royal College of Radiologists (2014) Bladder cancer and other urothelial tumours, in: Recommendations for cross-sectional imaging in cancer management. 2nd edn, pp 3-8Google Scholar
  33. 33.
    Ghafoori M, Shakiba M, Ghiasi A, Asvadi N, Hosseini K, Alavi M (2013) Value of MRI in local staging of bladder cancer. Urol J 10:866–872PubMedGoogle Scholar
  34. 34.
    Lee CH, Tan CH, Faria SC, Kundra V (2017) Role of Imaging in the Local Staging of Urothelial Carcinoma of the Bladder. AJR Am J Roentgenol 208(6):1193-1205PubMedGoogle Scholar
  35. 35.
    Shinagare AB, Sadow CA, Silverman SG (2013) Surveillance of patients with bladder cancer following cystectomy: yield of CT urography. Abdom Imaging 38(6):1415-1421PubMedGoogle Scholar
  36. 36.
    Anderson TS, Regine WF, Kryscio R, Patchell RA (2003) Neurologic complications of bladder carcinoma: a review of 359 cases. Cancer;97(9):2267-2272PubMedGoogle Scholar
  37. 37.
    Alfred Witjes J, Lebret T, Compérat EM, et al (2017) Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. Eur Urol 71(3):462-475PubMedGoogle Scholar
  38. 38.
    Zattoni F, Incerti E, Colicchia M, et al (2018) Comparison between the diagnostic accuracies of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and conventional imaging in recurrent urothelial carcinomas: a retrospective, multicenter study. Abdom Radiol (NY) 43(9):2391-2399Google Scholar
  39. 39.
    Zattoni F, Incerti E, Dal Moro F, et al (2019) 18F-FDG PET/CT and Urothelial Carcinoma: Impact on Management and Prognosis-A Multicenter Retrospective Study. Cancers (Basel) 11(5):700Google Scholar
  40. 40.
    Wallmeroth A, Wagner U, Moch H, Gasser TC, Sauter G, Mihatsch MJ (1999) Patterns of metastasis in muscle-invasive bladder cancer (pT2–4): an autopsy study on 367 patients. Urol Int 62:69–75PubMedGoogle Scholar
  41. 41.
    Sengeløv L, Kamby C, von der Maase H (1996) Pattern of metastases in relation to characteristics of primary tumor and treatment in patients with disseminated urothelial carcinoma. J Urol 155:111–114PubMedGoogle Scholar
  42. 42.
    Shinagare AB, Fennessy FM, Ramaiya NH, Jagannathan JP, Taplin ME, Van den Abbeele AD (2011) Urothelial cancers of the upper urinary tract: metastatic pattern and its correlation with tumor histopathology and location. J Comput Assist Tomogr 35(2):217-222PubMedGoogle Scholar
  43. 43.
    Vind-Kezunovic S, Bouchelouche K, Ipsen P, Høyer S, Bell C, Bjerggaard Jensen J (2019) Detection of Lymph Node Metastasis in Patients with Bladder Cancer using Maximum Standardised Uptake Value and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Results from a High-volume Centre Including Long-term Follow-up. Eur Urol Focus 5(1):90-96PubMedGoogle Scholar
  44. 44.
    Galsky MD, Hahn NM, Rosenberg J, et al (2011) A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy. Lancet Oncol 12:211-214PubMedGoogle Scholar
  45. 45.
    Sharma P, Callahan MK, Bono P, et al (2016) Nivolumab monotherapy in recurrent metastatic urothelial carcinoma (CheckMate 032): a multicentre, open-label, two-stage, multi-arm, phase 1/2 trial. Lancet Oncol 17(11):1590-1598PubMedPubMedCentralGoogle Scholar
  46. 46.
    Massard C, Gordon MS, Sharma S, et al (2016) Safety and Efficacy of Durvalumab (MEDI4736), an Anti-Programmed Cell Death Ligand-1 Immune Checkpoint Inhibitor, in Patients With Advanced Urothelial Bladder Cancer. J Clin Oncol 34:3119-3125PubMedPubMedCentralGoogle Scholar
  47. 47.
    Bellmunt J, de Wit R, Vaughn DJ, et al (2017) Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma. N Engl J Med 376:1015-1026PubMedPubMedCentralGoogle Scholar
  48. 48.
    Patel MR, Ellerton J, Infante JR, et al (2018) Avelumab in metastatic urothelial carcinoma after platinum failure (JAVELIN Solid Tumor): pooled results from two expansion cohorts of an open-label, phase 1 trial. Lancet Oncol 19:51-64PubMedGoogle Scholar
  49. 49.
    Balar AV, Galsky MD, Rosenberg JE, et al (2017) Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: a single-arm, multicentre, phase 2 trial. Lancet 389:67-76PubMedGoogle Scholar
  50. 50.
    Powles T, Duran I, van der Heijden MS, et al (2018) Atezolizumab versus chemotherapy in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (IMvigor211): a multicentre, open-label, phase 3 randomised controlled trial. Lancet 391:748-757PubMedGoogle Scholar
  51. 51.
    Balar AV, Castellano D, O’Donnell PH, et al (2017) First-line pembrolizumab in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer (KEYNOTE-052): a multicentre, single-arm, phase 2 study. Lancet Oncol 18(11):1483-1492PubMedGoogle Scholar
  52. 52.
    Petrylak DP PR, Zhang J, et al (2017) A Phase I Study of Enfortumab Vedotin: Updated Analysis of Patients with Metastatic Urothelial Cancer. J Clin Oncol 35 (suppl; abstr 106)Google Scholar
  53. 53.
    Tagawa ST, Faltas BM, Lam ET, et al (2019) Sacituzumab govitecan (IMMU-132) in patients with previously treated metastatic urothelial cancer (mUC): Results from a phase I/II study. J Clin Oncol 37:354-354Google Scholar
  54. 54.
    Siefker-Radtke AO, Necchi A, Park SH, et al (2018) First results from the primary analysis population of the phase 2 study of erdafitinib (ERDA; JNJ-42756493) in patients (pts) with metastatic or unresectable urothelial carcinoma (mUC) and FGFR alterations (FGFRalt). J Clin Oncol 36:4503-4503Google Scholar
  55. 55.
    Dasari S, Tchounwou PB (2014) Cisplatin in cancer therapy: molecular mechanisms of action. Eur J Pharmacol 740:364–378Google Scholar
  56. 56.
    Rosenberg B, Camp LV, Krigas T (1965) Inhibition of cell division in escherichia coli by electrolysis products from a platinum electrode. Nature 205(4972):698–699PubMedGoogle Scholar
  57. 57.
    Tian H, Cronstein BN (2007) Understanding the mechanisms of action of methotrexate: implications for the treatment of rheumatoid arthritis. Bull NYU Hosp Jt Dis 65(3):168-173PubMedGoogle Scholar
  58. 58.
    Hagner N, Joerger M (2010) Cancer chemotherapy: targeting folic acid synthesis. Cancer Manag Res 2:293-301PubMedPubMedCentralGoogle Scholar
  59. 59.
    Moudi M, Go R, Yien CY, Nazre M (2013) Vinca alkaloids. Int J Prev Med 4(11):1231–1235Google Scholar
  60. 60.
    Thorn CF, Oshiro C, Marsh S, et al (2011) Doxorubicin pathways: pharmacodynamics and adverse effects. Pharmacogenet Genomics 21(7):440-446PubMedPubMedCentralGoogle Scholar
  61. 61.
    Tascilar M, Loos WJ, Seynaeve C, Verweij J, Sleijfer S. The pharmacologic basis of ifosfamide use in adult patients with advanced soft tissue sarcomas. Oncologist. 2007;12(11):1351-1360PubMedGoogle Scholar
  62. 62.
    Fife BT, Pauken KE, Eagar TN, et al. Interactions between programmed death-1 and programmed death ligand-1 promote tolerance by blocking the T cell receptor-induced stop signal. Nat immunol 2009;10(11):1185-1192PubMedPubMedCentralGoogle Scholar
  63. 63.
    Dong H, Strome SE, Salomao DR, et al. Tumor-associated B7-H1 promotes T-cell apoptosis: a potential mechanism of immune evasion. Nat Med 2002;8(8):793-800PubMedPubMedCentralGoogle Scholar
  64. 64.
    Dermani FK, Samadi P, Rahmani G, Kohlan AK, Najafi R. PD-1/PD-L1 immune checkpoint: Potential target for cancer therapy. J Cell Physiol 2019 234(2):1313-1325.PubMedGoogle Scholar
  65. 65.
    Tang PA, Bentzen SM, Chen EX, Siu LL (2007) Surrogate end points for median overall survival in metastatic colorectal cancer: literature-based analysis from 39 randomized controlled trials of first-line chemotherapy. J Clin Oncol 25(29):4562-4568PubMedGoogle Scholar
  66. 66.
    Eisenhauer EA, Therasse P, Bogaerts J, et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228-247.PubMedGoogle Scholar
  67. 67.
    Nishino M (2018) Tumor Response Assessment for Precision Cancer Therapy: Response Evaluation Criteria in Solid Tumors and Beyond. American Society of Clinical Oncology Educational Book 38:1019-1029PubMedGoogle Scholar
  68. 68.
    Nishino M, Hatabu H, Johnson BE, McLoud TC (2014) State of the art: Response assessment in lung cancer in the era of genomic medicine. Radiology 271(1):6-27PubMedPubMedCentralGoogle Scholar
  69. 69.
    Wolchok JD, Hoos A, O’Day S, et al (2009) Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria. Clin Cancer Res 15(23):7412-7420PubMedGoogle Scholar
  70. 70.
    Thomas R, Somarouthu B, Alessandrino F, Kurra V, Shinagare AB (2019) Atypical Response Patterns in Patients Treated With Nivolumab. AJR Am J Roentgenol 1-5Google Scholar
  71. 71.
    Nishino M, Giobbie-Hurder A, Gargano M, Suda M, Ramaiya NH, Hodi FS (2013) Developing a common language for tumor response to immunotherapy: immune-related response criteria using unidimensional measurements. Clin Cancer Res 19(14):3936–3943PubMedPubMedCentralGoogle Scholar
  72. 72.
    Seymour L, Bogaerts J, Perrone A, et al (2017) iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics. Lancet Oncol 18(3):e143–e152PubMedPubMedCentralGoogle Scholar
  73. 73.
    Torrisi JM, Schwartz LH, Gollub MJ, et al. (2011) CT findings of chemotherapy-induced toxicity: what radiologists need to know about the clinical and radiologic manifestations of chemotherapy toxicity. Radiology 258(1):41–56PubMedGoogle Scholar
  74. 74.
    Lokich J, Anderson N (1998) Carboplatin versus cisplatin in solid tumors: an analysis of the literature. Ann Oncol 9(1):13-21PubMedGoogle Scholar
  75. 75.
    De Santis M, Bellmunt J, Mead G, et al (2011) Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986. J Clin Oncol 30(2):191-199PubMedPubMedCentralGoogle Scholar
  76. 76.
    Chi D-C, Brogan F, Turenne I, et al. (2012) Gemcitabine-induced pulmonary toxicity. Anticancer Res 32(9):4147–4149PubMedGoogle Scholar
  77. 77.
    Rohatgi S, Jagannathan JP, Rosenthal MH, et al. (2014) Vascular toxicity associated with chemotherapy and molecular targeted therapy: what should a radiologist know? AJR 203(6):1353–1362PubMedGoogle Scholar
  78. 78.
    King PD, Perry MC (2001) Hepatotoxicity of chemotherapy. Oncologist 6(2):162–176PubMedGoogle Scholar
  79. 79.
    Trivedi CD, Pitchumoni CS (2005) Drug-induced pancreatitis: an update. J Clin Gastroenterol 39(8):709–716PubMedGoogle Scholar
  80. 80.
    Arakawa H, Yamasaki M, Kurihara Y, Yamada H, Nakajima Y (2003) Methotrexate-induced pulmonary injury: serial CT findings. J Thorac Imaging 18(4):231-236PubMedGoogle Scholar
  81. 81.
    Adjei AA (2000). Pemetrexed: a multitargeted antifolate agent with promising activity in solid tumors. Ann Oncol 11(10):1335-1341PubMedGoogle Scholar
  82. 82.
    Kim KH, Song SY, Lim KH, et al (2013) Interstitial Pneumonitis after Treatment with Pemetrexed for Non-small Cell Lung Cancer. Cancer Res Treat 45(1):74-77PubMedPubMedCentralGoogle Scholar
  83. 83.
    Rha SE, Ha HK, Lee SH, et al (2000) CT and MR imaging findings of bowel ischemia from various primary causes. Radiographics 20(1):29-42PubMedGoogle Scholar
  84. 84.
    Longstreth GF, Yao JF (2010) Diseases and drugs that increase risk of acute large bowel ischemia. Clin Gastroenterol Hepatol 8(1):49-54PubMedGoogle Scholar
  85. 85.
    Hendel RC, Patel MR, Kramer CM, et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 48(7):1475-1497Google Scholar
  86. 86.
    Wong-you-cheong JJ, Woodward PJ, Manning MA et al (2006) From the archives of the AFIP: Inflammatory and nonneoplastic bladder masses: radiologic-pathologic correlation. Radiographics. 26 (6): 1847-1868PubMedGoogle Scholar
  87. 87.
    Nishino M, Ramaiya NH, Awad MM, et al (2016) PD-1 Inhibitor-Related Pneumonitis in Advanced Cancer Patients: Radiographic Patterns and Clinical Course. Clin Cancer Res 22(24):6051-6060PubMedPubMedCentralGoogle Scholar
  88. 88.
    Mekki A, Dercle L, Lichtenstein P, et al (2018) Detection of immune-related adverse events by medical imaging in patients treated with anti-programmed cell death 1. Eur J Cancer 96:91-104PubMedGoogle Scholar
  89. 89.
    Alessandrino F, Sahu S, Nishino M, et al (2019) Frequency and imaging features of abdominal immune-related adverse events in metastatic lung cancer patients treated with PD-1 inhibitor. Abdom Radiol (NY). PubMedGoogle Scholar
  90. 90.
    Alessandrino F, Shah HJ, Ramaiya NH (2018) Multimodality imaging of endocrine immune related adverse events: a primer for radiologists. Clin Imaging 50:96-103PubMedGoogle Scholar
  91. 91.
    Cheshire SC, Board RE, Lewis AR, Gudur LD, Dobson MJ (2018) Pembrolizumab-induced Sarcoid-like Reactions during Treatment of Metastatic Melanoma. Radiology 14:180572Google Scholar
  92. 92.
    Wezel F, Vallo S, Roghmann F, Young Academic Urologist Urothelial Carcinoma Group of the European Association of Urology (2017) Do we have biomarkers to predict response to neoadjuvant and adjuvant chemotherapy and immunotherapy in bladder cancer?. Transl Androl Urol 6(6):1067-1080Google Scholar
  93. 93.
    Zhu J, Armstrong AJ, Friedlander TW, et al (2018) Biomarkers of immunotherapy in urothelial and renal cell carcinoma: PD-L1, tumor mutational burden, and beyond. J Immunother Cancer 6(1):4PubMedPubMedCentralGoogle Scholar
  94. 94.
    Cha KH, Hadjiiski L, Chan H-P, et al. (2017) Bladder Cancer Treatment Response Assessment in CT using Radiomics with Deep-Learning. Sci Rep 7:8738PubMedPubMedCentralGoogle Scholar
  95. 95.
    Alessandrino F, Gujrathi R, Nassar AH, et al (2019) Predictive Role of Computed Tomography Texture Analysis in Patients with Metastatic Urothelial Cancer Treated with Programmed Death-1 and Programmed Death-ligand 1 Inhibitors. Eur Urol Oncol
  96. 96.
    Ganeshan B, Miles KA (2013) Quantifying tumour heterogeneity with CT. Cancer Imaging 13:140-149PubMedPubMedCentralGoogle Scholar
  97. 97.
    Thomas R, Qin L, Alessandrino F, et al (2018) A review of the principles of texture analysis and its role in imaging of genitourinary neoplasms. Abdom Radiol (NY) Google Scholar
  98. 98.
    Lubner MG, Smith AD, Sandrasegaran K, Sahani DV, Pickhardt P (2017) CT Texture Analysis: Definitions, Applications, Biologic Correlates, and Challenges. RadioGraphics 37:5:1483-503PubMedGoogle Scholar
  99. 99.
    Xu X, Wang H, Du P, et al (2019) A predictive nomogram for individualized recurrence stratification of bladder cancer using multiparametric MRI and clinical risk factors. J Magn Reson Imaging PubMedGoogle Scholar
  100. 100.
    Wu S, Zheng J, Li Y, et al (2017) A Radiomics Nomogram for the Preoperative Prediction of Lymph Node Metastasis in Bladder Cancer. Clin Cancer Res 23(22):6904-6911PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Imaging, Dana Farber Cancer InstituteHarvard Medical SchoolBostonUSA
  2. 2.Department of Radiology, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  3. 3.Lank Center for Genitourinary Oncology, Dana Farber Cancer InstituteHarvard Medical SchoolBostonUSA

Personalised recommendations