Comparative sensitivity and specificity of imaging modalities in staging bladder cancer prior to radical cystectomy: a systematic review and meta-analysis

Crozier, Jack; Papa, Nathan; Perera, Marlon; Ngo, Brian; Bolton, Damien; Sengupta, Shamik; Lawrentschuk, Nathan

doi:10.1007/s00345-018-2439-8

Cited by 56 publications

(45 citation statements)

References 48 publications

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“…In a combined meta-analysis and single-institution study of patients with bladder cancer scheduled to undergo radical cystectomy and pelvic lymph node dissection, the authors determined that the pooled sensitivity and specificity for detection of lymph node metastases were 57% and 95%, respectively [52]. These findings were also confirmed in two subsequent meta-analyses, which demonstrated a pooled sensitivity of 56-57% and a pooled specificity of 92% for the detection of lymph node metastases on FDG-PET/CT [53,54]. A small (n = 15) study evaluating the use of FDG-PET/CT for the preoperative lymph node staging of MIBC demonstrated minimal benefit of FDG-PET/CT compared with CT alone, thought to potentially be due to overlap in standardized uptake values (SUVs) between inflammatory and malignant lesions [55].…”

Section: Fdg-pet/ct For Bladder Cancer Stagingmentioning

confidence: 86%

The Role of Imaging in Bladder Cancer Diagnosis and Staging

et al. 2020

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Bladder cancer (BC) is the most common cancer of the urinary tract in the United States. Imaging plays a significant role in the management of patients with BC, including the locoregional staging and evaluation for distant metastatic disease, which cannot be assessed at the time of cystoscopy and biopsy/resection. We aim to review the current role of cross-sectional and molecular imaging modalities for the staging and restaging of BC and the potential advantages and limitations of each imaging modality. CT is the most widely available and frequently utilized imaging modality for BC and demonstrates good performance for the detection of nodal and visceral metastatic disease. MRI offers potential value for the locoregional staging and evaluation of muscular invasion of BC, which is critically important for prognostication and treatment decision-making. FDG-PET/MRI is a novel hybrid imaging modality combining the advantages of both MRI and FDG-PET/CT in a single-setting comprehensive staging examination and may represent the future of BC imaging evaluation.

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Section: Fdg-pet/ct For Bladder Cancer Stagingmentioning

confidence: 86%

The Role of Imaging in Bladder Cancer Diagnosis and Staging

et al. 2020

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“…Finally, the accuracy of mpMRI in nodal staging was not assessed in the present study, limiting its applicability as a comprehensive staging tool. However, a recent metaanalysis showed that MRI and PET/CT have a comparable performance in nodal staging [24].…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center

Simone²,

et al. 2019

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Objectives To evaluate accuracy and inter-observer variability using Vesical Imaging-Reporting and Data System (VI-RADS) for discrimination between non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Methods Between September 2017 and July 2018, 78 patients referred for suspected bladder cancer underwent multiparametric MRI of the bladder (mpMRI) prior to transurethral resection of bladder tumor (TURBT). All mpMRI were reviewed by two radiologists, who scored each lesion according to VI-RADS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each VI-RADS cutoff. Receiver operating characteristics curves were used to evaluate the performance of mpMRI. The Ƙ statistics was used to estimate inter-reader agreement.Results Seventy-five patients were included in the final analysis, 53 with NMIBC and 22 with MIBC. Sensitivity and specificity were 91% and 89% for reader 1 and 82% and 85% for reader 2 respectively when the cutoff VI-RADS > 2 was used to define MIBC. At the same cutoff, PPV and NPV were 77% and 96% for reader 1 and 69% and 92% for reader 2. When the cutoff VI-RADS > 3 was used, sensitivity and specificity were 82% and 94% for reader 1 and 77% and 89% for reader 2. Corresponding PPVand NPV were 86% and 93% for reader 1 and 74% and 91% for reader 2. Area under curve was 0.926 and 0.873 for reader 1 and 2 respectively. Inter-reader agreement was good for the overall score (Ƙ = 0.731).Conclusions VI-RADS is accurate in differentiating MIBC from NMIBC. Inter-reader agreement is overall good. Key Points • Traditionally, the local staging of bladder cancer relies on transurethral resection of bladder tumor. • However, transurethral resection of bladder tumor carries a significant risk of understaging a cancer; therefore, more accurate, faster, and non-invasive staging techniques are needed to improve outcomes. • Multiparametric MRI has proved to be the best imaging modality for local staging; therefore, its use in suitable patients has the potential to expedite radical treatment when necessary and non-invasive diagnosis in patients with poor fitness.

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“…MRI and (PET/CT) provides superior sensitivity compared to CT for the detection of positive LN in BC before cystectomy. There is variability in the accuracy that current imaging modalities achieve across different studies [ 10 ]. Combining metabolical and morphological features using 18F-FDG PET/CT improves the detection of malignant LN in patients with BC [ 11 ].…”

Section: Discussionmentioning

confidence: 99%