Diagnostic accuracy of retrospective application of the Vesical Imaging-Reporting and Data System: preliminary results

Abstract

Objective: To evaluate the retrospective accuracy of the Vesical Imaging-Reporting and Data System (VI-RADS) in detecting muscle invasion in bladder cancer. Materials and Methods: We investigated patients who underwent pelvic magnetic resonance imaging and were submitted to transurethral resection of a bladder tumor between 2015 and 2018. Thirty cases were reviewed by radiologists blinded to the final clinical stage. The VI-RADS score was applied and compared with the histopathological findings in the surgical specimen. Results: Of the 30 patients with suspicious bladder lesions, 5 (16.6%) had benign histopathological findings, 17 (56.6%) had non-muscle-invasive bladder cancer, and 8 (26.6%) had muscle-invasive bladder cancer. The optimal criterion to detect muscle-invasive bladder cancer was a final VI-RADS score > 3, for which the sensitivity and specificity were 100% (95% CI: 56.0-100%) and 90.9% (95% CI: 69.3-98.4%), respectively. Conclusion: The VI-RADS appears to estimate correctly the degree of muscle invasion in suspicious bladder lesions. However, prospective studies evaluating larger samples are needed in order to validate the method.

Role of Vesical Imaging–Reporting and Data System in predicting muscle‐invasive bladder cancer: A diagnostic meta‐analysis

“…After 161 duplicates were removed and the titles and abstracts of the 38 remaining articles were screened, 26 potential articles were obtained. Full‐text reviews were considered, and 20 studies met the inclusion criteria, 14–33 whereas the other six studies were excluded for the following reasons: original study involving VI‐RADS ( n = 2), non‐English language ( n = 1) and insufficient information provided ( n = 3). Ultimately, the 20 included studies that reported on 2725 patients with more than 2861 lesions provided the raw data of this meta‐analysis, as shown in Figure 1.…”

“…A total of 12 studies used scanners that provided a magnet strength of 3 T, whereas eight used scanners with a magnet strength of 1.5 T or the combination of 1.5 and 3 T. The bladder was distended in all 20 studies using multiple methods, such as holding back urine, oral hydration, saline injection using a catheter or drugs that inhibit bladder contraction. MpMRI was carried out before TURBT in all cases except for one study, 26 in which 26.6% of patients underwent MRI after bladder biopsy or TURBT. Parameters differed among the included studies, and all studies met the requirement to obtain sufficient information that followed the recommendations of the VI‐RADS guideline 10 .…”

Multiparametric magnetic resonance imaging for bladder cancer: a comprehensive systematic review of the Vesical Imaging-Reporting and Data System (VI-RADS) performance and potential clinical applications

“…Retrospective studies From our review, 12 retrospective studies performed between 2019 and 2020 were retrieved (Table 1). [15][16][17][18][19][20][21][22][23][24][25][26] These studies covered a total of 1676 patients. Authors of those studies investigated various thresholds to discriminate MIBC from NMIBC.…”

“…The sensitivity ranged from 78% to 100%, specificity from 44% to 100%. [15][16][17][18][19][20][21][22][23][24] For a VI-RADS 4 threshold, sensitivity ranged from 63 to 100%, specificity from 76% to 96% (including 7 studies with 88 patients). 15,16,19,[21][22][23] Finally, for a VI-RADS 5 threshold, the sensitivity ranged from 68% to 86%, and the specificity from 95% to Figure 3.…”

“…99%. 15,17,[20][21][22][23]26 As outlined here, the number of patients used to assess the VI-RADS score performance for each given threshold is limited. There is an unmet need for larger studies.…”