Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results

Abstract

We aimed to investigate the accuracy of Vesical Imaging -Reporting and Data System (VI-RADS) in the detection of muscle-invasive bladder cancer (MIBC) and to determine which factors affect the results of this scoring system. METHODSA prospective data analysis of 80 patients who were detected to have bladder tumor was performed between March 2019 and October 2020. VI-RADS scoring was used to determine the probability of muscle invasion. The scores were compared with pathological results to evaluate the accuracy of the VI-RADS scoring system. Interobserver agreement was assessed by VI-RADS scoring of 20 randomly chosen patients by a different experienced radiologist. RESULTSUsing the VI-RADS scoring system, the sensitivity, specificity, positive predictive value, and negative predictive value of multiparametric magnetic resonance imaging (mpMRI) were 87.5%, 87.5%, 63.6%, and 96.6%, respectively. The interobserver agreement expressed as the interclass correlation coefficient (ICC) was 0.72 (95% CI: 0.44-0.84, P < .001). In addition, the flat appearance of the tumor was an important factor affecting the accuracy of the VI-RADS score (odds ratio: 5.3 [95% CI: 1.1-27.0] and relative risk: 1.87 [95% CI: 1.24-2.82]). CONCLUSIONThe mpMRI, used in conjunction with VI-RADS, has proven to be an effective imaging method for detecting muscle invasion in cases of bladder cancer. VI-RADS scoring system can distinguish whether there is a muscle-invasive and non-muscle invasive bladder cancer with acceptable accuracy. In addition, the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system.

Role of multiparametric MRI in predicting muscle invasiveness in urinary bladder neoplasms with pathological correlations

“…With a sensitivity of 92.31%, a specificity of 72.72%, a positive predictive value of 66.67%, and a negative predictive value of 94.11%, the current study indicated that the diagnostic accuracy of mp-MRI (VIRADS score >3) in diagnosing bladder tumour muscle invasiveness is 77.14%. Our findings are superior to those made public by Makboul et al, and nearly identical findings were discovered between our research and those of Marchioni et al and Liu et al 10–13 The agreement between HPE staging for muscle invasiveness and mp-MRI using the VI-RADS score is good (kappa = 0.61–0.80).…”

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

“…Moreover, all VI-RADS 3 tumors were sessile/broad-based without a thickened inner layer, which may also be the cause of false negative results. A previous study showed that the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system [ 31 ]. Improving the evaluation of myometrial infiltration of bladder tumor with flat appearance is worth further exploring in the future.…”

Letter to the Editor: “Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results”

“…Therefore, the authors need to indicate the VI-RADS scores of the 20 patients they evaluated. 1 Finally, the authors noted that patients without muscle tissue in the transurethral resection of bladder tumor (TUR-BT) sample underwent a second TUR-BT after the first resection but did not specify the number or proportion of these patients. Akcay et al 5 reported that 10 of 83 patients (12%) had insufficient TUR-BT.…”

“…First, it is noteworthy that the number of cases accepted on the Vesical Imaging Reporting and Data System (VI-RADS) 3, according to the MRI evaluation in this study, was considerably higher than the studies in the current literature. 2 , 3 , 4 , 5 , 6 The proportion of patients with a VI-RADS score of 3 in Oğuz et al’s 1 study was 38.75%. However, in prospective studies in the current literature, the proportion of patients with a VI-RADS score of 3 was 13.4% in Del Giudice et al’s 2 study, 18.2% in Erkoc et al’s 3 study, 6.9% in Metwally et al’s 4 study, 19.2%–20.5% in Akcay et al’s 5 study, and 8.8%–18.7% in Ueno et al’s 6 study.…”

“…We read the article titled “Prospective assessment of VI-RADS score in multiparametric MRI in bladder cancer: accuracy and the factors affecting the results” by Oğuz et al 1 , published online in Diagnostic and Interventional Radiology. We congratulate the authors on this prospective magnetic resonance imaging (MRI) study in patients with bladder cancer.…”