Multiparametric MRI Evaluation of VI-RADS for Bladder Tumors Located                     at the Ureteral Orifice

Cai, Qian; Ling, Jian; Kong, Lingmin; Huang, Yiping; Lin, Yingyu; Wen, Zhihua; Li, Meiqin; Guo, Yan; Wang, Huanjun J.

doi:10.1148/radiol.220028

Cited by 9 publications

(4 citation statements)

References 19 publications

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“…Our results revealed that tumors scored as VI-RADS 4 and 5 had muscle invasion risks of 55–70% and 92–100%, respectively. In contrast, prior studies evaluating muscle invasion in pre-treatment bladder cancer reported that VI-RADS 4 tumors achieved an accuracy of 90–100% in evaluating muscle infiltration [ 20 , 24 , 30 ], surpassing our findings. This discrepancy may be attributed to the inflammatory response in the bladder wall after NAC, complicating the assessment of muscle layer continuity.…”

Section: Discussioncontrasting

confidence: 99%

MRI evaluation of vesical imaging reporting and data system for bladder cancer after neoadjuvant chemotherapy

Zhang,

Wang,

Wang

et al. 2024

Cancer Imaging

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Background The Vesical Imaging-Reporting and Data System (VI-RADS) has demonstrated effectiveness in predicting muscle invasion in bladder cancer before treatment. The urgent need currently is to evaluate the muscle invasion status after neoadjuvant chemotherapy (NAC) for bladder cancer. This study aims to ascertain the accuracy of VI-RADS in detecting muscle invasion post-NAC treatment and assess its diagnostic performance across readers with varying experience levels. Methods In this retrospective study, patients with muscle-invasive bladder cancer who underwent magnetic resonance imaging (MRI) after NAC from September 2015 to September 2018 were included. VI-RADS scores were independently assessed by five radiologists, consisting of three experienced in bladder MRI and two inexperienced radiologists. Comparison of VI-RADS scores was made with postoperative histopathological diagnosis. Receiver operating characteristic curve analysis (ROC) was used for evaluating diagnostic performance, calculating sensitivity, specificity, and area under ROC (AUC)). Interobserver agreement was assessed using the weighted kappa statistic. Results The final analysis included 46 patients (mean age: 61 years ± 9 [standard deviation]; age range: 39–70 years; 42 men). The pooled AUC for predicting muscle invasion was 0.945 (95% confidence interval (CI): 0.893–0.977) for experienced readers, and 0.910 (95% CI: 0.831–0.959) for inexperienced readers, and 0.932 (95% CI: 0.892–0.961) for all readers. At an optimal cut-off value ≥ 4, pooled sensitivity and specificity were 74.1% (range: 66.0–80.9%) and 94.1% (range: 88.6–97.7%) for experienced readers, and 63.9% (range: 59.6–68.1%) and 86.4% (range: 84.1–88.6%) for inexperienced readers. Interobserver agreement ranged from substantial to excellent between all readers (k = 0.79–0.92). Conclusions VI-RADS accurately assesses muscle invasion in bladder cancer patients after NAC and exhibits good diagnostic performance across readers with different experience levels.

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Section: Discussioncontrasting

confidence: 99%

MRI evaluation of vesical imaging reporting and data system for bladder cancer after neoadjuvant chemotherapy

Zhang,

Wang,

Wang

et al. 2024

Cancer Imaging

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“…Thus far, few studies have focused on the effect of macroscopic image characteristics on the accuracy of VI-RADS. Several studies ( 24 , 32 , 33 ) have revealed the effect of tumor location on the accuracy of the VI-RADS, especially at the ureteral orifice and bladder diverticuli. Meng et al ( 34 ) reported that discrepancies between T2WI and DWI affected the application of VI-RADS.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance radiographic features which might lead to misdiagnosis of muscle-invasive bladder cancer based on vesical imaging reporting and data system: the application experience of a single center

Li,

et al. 2023

Quant Imaging Med Surg

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Background The Vesical Imaging Reporting and Data System (VI-RADS) has been widely used for diagnosing muscle-invasive bladder cancer (MIBC), yet instances of misdiagnosis persist. However, limited research discusses the factors affecting its accuracy. This study aimed to evaluate the diagnostic efficacy of the VI-RADS in our center and to preliminarily identify possible magnetic resonance imaging (MRI) characteristics of misdiagnosis. Methods From January 2018 to February 2023, a consecutive series of 211 participants pathologically diagnosed with bladder cancer (BC) who underwent an MRI exam were retrospectively enrolled. MRI was interpreted by 2 radiologists with different levels of experience, the diagnostic performance was validated using the receiver operating characteristic (ROC) curve, and VI-RADS ≥4 was considered to indicate MIBC-positive status. The clinical and radiographic characteristics of the true-positive (TP), true-negative (TN), false-positive (FP), and false-negative (FN) groups were analyzed using Kruskal-Wallis test or Fisher exact test. Results With VI-RADS ≥4 as the cutoff value, the area under the ROC curves (AUCs) were 0.951 (0.912–0.976) and 0.847 (0.791–0.893) for the more-experienced reader and less-experienced reader, respectively, with good interobserver agreement (κ=0.74105). The median tumor size in the TP (more experienced: 57 cases; less experienced: 44 cases) and FP (more experienced: 8 cases; less experienced: 9 cases) groups was larger than that in the TN (more experienced: 141 cases; less experienced: 139 cases) group for the more-experienced reader (TP: 28 mm; FP: 31 mm; TN: 19 mm; P<0.001 and P=0.031, respectively) and the less-experienced reader (TP: 31 mm; FP: 28 mm; TN: 19 mm; P<0.001 and P=0.042, respectively). The tumor base in the TP and FP groups was larger than that in the TN group for the more-experienced reader (TP: 37 mm; FP: 48 mm; TN: 15 mm; both P<0.001) and for the less-experienced reader (FP: 42 mm; FP: 36 mm; TN: 15 mm; P<0.001 and P=0.022, respectively). The median tumor base in the TP group was larger than that in the FN group for the less-experienced reader (TP: 42 mm; FN: 17 mm; P=0.004). Conclusions We observed good to excellent AUCs with good interobserver agreement among radiologists with different levels of expertise using VI-RADS. Large tumor size and wide tumor base affected the accuracy of VI-RADS in MIBC diagnosis.

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“…Low spatial resolution and signal-to-noise ratio of diffusion-weighted imaging limit its applicability for the assessment of small tumors or thin bladder wall with overdistension and make it susceptible to numerous artifacts. Moreover, transurethral resection biopsy is required for tumor grading and cannot be replaced by MRI [33,34].…”

Section: Multiparametric-mrimentioning

confidence: 99%

Role of Multiparametric-MRI in Bladder Cancer

Eusebi¹,

Masino

Gifuni

et al. 2023

Curr Radiol Rep

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Purpose of Review This narrative review article aims to show the actual role of imaging, in particular MRI, and the role of VI-RADS Score, in recognition and follow-up of the tumor. Recent Findings A team of professionals created VI-RADS with the goal of standardizing the acquisition and interpretation of multiparametric-MRI in bladder cancer. Summary Bladder cancer is the most common cancer involving the urinary system. It is the fourth most common urological cancer in men and the second most frequent cancer affecting the urinary tract. Main risks factors are advanced age, male sex, and cigarette smoking. Bladder cancer ranges from unaggressive and usually non-invasive tumors that recur and commit patients to long-term invasive surveillance, to aggressive and invasive tumors with high disease-specific mortality. At the time of diagnosis, 70% of patients are experiencing non-muscle-invasive bladder cancer. Vesical imaging-reporting and data system score (VI-RADS) is a scoring system useful to standardize the approach to multiparametric-MRI interpretation, and reporting for bladder cancer.

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Multiparametric MRI Evaluation of VI-RADS for Bladder Tumors Located at the Ureteral Orifice

Cited by 9 publications

References 19 publications

MRI evaluation of vesical imaging reporting and data system for bladder cancer after neoadjuvant chemotherapy

MRI evaluation of vesical imaging reporting and data system for bladder cancer after neoadjuvant chemotherapy

Magnetic resonance radiographic features which might lead to misdiagnosis of muscle-invasive bladder cancer based on vesical imaging reporting and data system: the application experience of a single center

Role of Multiparametric-MRI in Bladder Cancer

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