Quantitation of bladder cancer for the prediction of muscle layer invasion as a complement to the vesical imaging-reporting and data system

Ahn, Hyo Hyun; Hwang, Sung Il; Lee, Hak Jong; Choe, Gheeyoung; Oh, Jong Jin; Jeong, Seong Jin; Byun, Seok Soo; Kim, Jung Kwon

doi:10.1007/s00330-020-07224-7

Cited by 33 publications

(41 citation statements)

References 33 publications

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“…Lastly, this study did not supplement or improve the VI‐RADS scoring rules. The study of Ahn et al showed that the tumor‐wall interface could be a potential complement to VI‐RADS 25 and it is possible that the VI‐RADS scoring rules for post‐treatment patients could be improved. Some changes in bladder wall imaging have been seen in post‐treatment patients, the post‐treatment version of VI‐RADS may be worth considering.…”

Section: Limitationsmentioning

confidence: 99%

Preliminary Exploration of the Application of Vesical Imaging‐Reporting and Data System (VI‐RADS) in Post‐treatment Patients With Bladder Cancer: A Prospective Single‐Center Study

Cao

et al. 2021

Magnetic Resonance Imaging

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Background Vesical Imaging‐Reporting and Data System (VI‐RADS) has been shown to be effective in diagnosing muscle invasion of bladder cancer (BC) in primary patients. Purpose To evaluate the diagnostic efficacy of VI‐RADS in a BC target population which included post‐treatment patients, and to determine the repeatability. Study Type Prospective. Population Seventy‐three patients (42 with primary BC, 31 with post‐treatment BC). Field Strength/Sequence 3.0 T MRI with propeller fast spin‐echo T2WI, echo planer imaging diffusion‐weighted imaging (DWI), and dynamic contrast‐enhanced imaging (DCEI). Assessment VI‐RADS scores were independently assessed by five radiologists with different levels of experience. The diagnostic efficiency in each group (primary and post‐treatment) and of each radiologist was assessed. Statistical Tests Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), and area under the curve (AUC) in receiver operating characteristic curve analysis were calculated to evaluate VI‐RADS diagnostic performance. Interobserver agreement was assessed using weighted Kappa statistics. A P value <0.05 was considered statistically significant. Results At the corresponding cut‐off, AUC values of three groups range from 0.936 to 0.947 and AUC values of five observers range from 0.901 to 0.963. There was no significant difference between the AUCs in the primary and post‐treatment groups (P = 0.870). The cut‐off of the whole group and the post‐treatment group was ≥4, and the cut‐off of the primary group was ≥3. The Kappa values of interobserver agreements range from 0.709 to 0.923. Conclusions After expanding the target population to include post‐treatment patients, VI‐RADS still has good diagnostic efficacy and repeatability. VI‐RADS could potentially be a preoperative staging tool for post‐treatment patients. Level of Evidence 1 Technical Efficacy Stage 2

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Section: Limitationsmentioning

confidence: 99%

Preliminary Exploration of the Application of Vesical Imaging‐Reporting and Data System (VI‐RADS) in Post‐treatment Patients With Bladder Cancer: A Prospective Single‐Center Study

Cao

et al. 2021

Magnetic Resonance Imaging

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“…Previous study revealed that the TCL was associated with MIBC ( P ≤ 0.05), with an AUC of 0.90 and accuracy of 0.88 with a cutoff value of 3 cm 27 . However, the authors did not provide any strategy to implemented TCL with VI‐RADS in clinical practice.…”

Section: Discussionmentioning

confidence: 94%

“…According to previous studies, we set a VI‐RADS score of 3 as the optimal threshold for predicting muscle layer invasion 15,27,30 . In our study cohort, 22.8% (26/114) of the NMIBC lesions were scored as VI‐RADS 3, and less than 5.3% of NMIBC lesions were scored as VI‐RADS 4 or 5.…”

Section: Discussionmentioning

confidence: 99%

Detecting Muscle Invasion of Bladder Cancer Using a Proposed Magnetic Resonance Imaging Strategy

Wang

Sun

et al. 2021

Magnetic Resonance Imaging

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Background Accurate evaluation of the invasion depth of tumors with a Vesical Imaging‐Reporting and Data System (VI‐RADS) score of 3 is difficult. Purpose To evaluate the diagnostic performance of a new magnetic resonance imaging (MRI) strategy based on the integration of the VI‐RADS and tumor contact length (TCL) for the diagnosis of muscle‐invasive bladder cancer (MIBC). Study type Single center, retrospective. Subjects A group of 179 patients with a mean age of 67 years (range, 24.0–96.0) underwent multiparametric MRI (mpMRI) before surgery, including 147 (82.1%) males and 32 (17.9%) females. Twenty‐four (13.4%), 90 (50.3%), 43 (24.0%), 15 (8.4%), and 7 (3.9%) cases were Ta, T1, T2, T3, and T4, respectively. Field Strength/Sequence A 1.5 T and 3.0 T, T2‐weighted turbo spin‐echo (TSE), single‐shot echo‐planar (SS‐EPI), diffusion‐weighted imaging (DWI), and T1‐weighted volumetric interpolated breath‐hold examination (T1‐VIBE). Assessment Three radiologists independently graded the VI‐RADS score and measured the TCL on index lesion images. A proposed MRI strategy called VI‐RADS_TCL was introduced by modifying the VI‐RADS score, which was downgraded to VI‐RADS 3F (equal to a VI‐RADS score of 2) if VI‐RADS = 3 and TCL < 3 cm. Statistical Tests Intraclass correlation coefficients (ICCs), Mann–Whitney U test, chi‐square tests, receiver operating characteristic (ROC) curves, and 2 × 2 contingency tables were applied. Results Inter‐reader agreement values were 0.941 (95% CI, 0.924–0.955) and 0.934 (95% CI, 0.916–0.948) for the TCL and VI‐RADS score. The TCL was significantly increased in the MIBC group (6.40–6.85 cm) compared with the NMIBC group (1.98–2.45 cm) (P < 0.05). The specificity and positive predictive values (PPV) of VI‐RADS_TCL were 82.46%–87.72% and 90.91%–91.59%, which were significantly greater than VI‐RADS score (P < 0.05). Additionally, 52.17%–55.88% NMIBC lesions with VI‐RADS 3 were downgraded to 3F by using VI‐RADS_TCL. Data Conclusion The proposed MRI strategy could reduce the false‐positive rate of lesions with a VI‐RADS score of 3 while retaining sensitivity. Evidence Level 4 Technical Efficacy 2

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2021

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The objective of this study is to systematically evaluate the diagnostic performance of the Vesical Imaging–Reporting and Data System for predicting muscle‐invasive bladder cancer. Embase, PubMed and Web of Science were systematically searched from 1 September 2018 to 30 July 2021 to include proper studies. We included studies that included data on Vesical Imaging–Reporting and Data System and their associated pathological findings, and we assessed their quality using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. The pooled sensitivity and specificity were calculated and plotted using hierarchical summary receiver operating characterisijutic modeling. Meta‐regression analysis was carried out to detect heterogeneity. A total of 20 studies with 2725 patients were included. When the cut‐off point was 3, the pooled sensitivity and specificity were 0.92 (0.89–0.94) and 0.85 (0.78–0.90), respectively, and 0.82 (0.75–0.88) and 0.95 (0.91–0.97), respectively, when the cut‐off point was 4. The area under the curve was 0.95 and 0.95, respectively. Heterogeneity was substantially considerable in sensitivity and specificity. All subgroup variables, including patient number, study design, magnetic resonance imaging field strength, number of radiologists, surgery pattern, diffusion‐weighted imaging, and dynamic contrast‐enhanced magnetic resonance imaging, contributed to sensitivity heterogeneity when the cut‐off point was 3 and specificity heterogeneity when the cut‐off point was 4. Multiple image acquisition plane of diffusion‐weighted imaging achieved a higher sensitivity than single image acquisition plane of diffusion‐weighted imaging in both the Vesical Imaging–Reporting and Data System 3 and 4 groups, and higher specificity in the Vesical Imaging–Reporting and Data System 4 group. Another significant source of heterogeneity was the cut‐off point. The diagnostic performance of the Vesical Imaging–Reporting and Data System for predicting muscle‐invasive bladder cancer was excellent in both cut‐off points of the Vesical Imaging–Reporting and Data System 3 and 4. Multiple image acquisition planes of diffusion‐weighted imaging should be given more attention in the Vesical Imaging–Reporting and Data System.

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Quantitation of bladder cancer for the prediction of muscle layer invasion as a complement to the vesical imaging-reporting and data system

Cited by 33 publications

References 33 publications

Preliminary Exploration of the Application of Vesical Imaging‐Reporting and Data System (VI‐RADS) in Post‐treatment Patients With Bladder Cancer: A Prospective Single‐Center Study

Preliminary Exploration of the Application of Vesical Imaging‐Reporting and Data System (VI‐RADS) in Post‐treatment Patients With Bladder Cancer: A Prospective Single‐Center Study

Detecting Muscle Invasion of Bladder Cancer Using a Proposed Magnetic Resonance Imaging Strategy

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

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