Significant results

• Normal tissue perfusion in the bladder is altered by neo-adjuvant chemotherapy.
• Changes in perfusion observed in the rectum correlated with reported adverse effects.

Chemotherapy effects

Chemotherapy leads to cell death and reduces tumour neovascularisation. This affects normal tissues as well as tumour leading to tissue toxicity and resulting in short- and long-term inflammatory effects on the bladder and bowel, such as haemorrhagic cystitis, urinary retention, haematuria, dysuria, diarrhoea and constipation [4,5].

Comparisons with other studies

• Few studies have investigated relationships between DCE-MRI parameters in normal tissues and treatment effects.
• Some studies have shown increases in dynamic signal enhancement following treatment with both chemotherapy and radiotherapy [6].

Study limitations

• Patients did not undergo a LENT-SOMA test to formally record adverse effects.
• The number of patients included was small – we hope to investigate this result in a larger population.
• No motion correction or correction for the bladder filling with contrast agent were applied over dynamic time course.
• The accuracy of AIFs acquired in DCE-MRI is known to be subject to inflow [7] and partial volume effects when scans are acquired in the transverse plane.

Conclusions

• DCE-MRI parameters obtained in normal bladder wall and rectum are altered following neo-adjuvant chemotherapy.
• An increase in perfusion was associated with early toxicity.
• This should be confirmed in larger studies.