Diagnostic Performance of Multiparametric MRI Based Vesical Imaging-Reporting and Data System (VI-RADS) Scoring in Discriminating Between Non-muscle Invasive and Muscle Invasive Bladder Cancer

Overview

Journal Pol J Radiol

Publisher Termedia

Specialty Radiology

Date 2023 Sep 13

PMID 37701172

Authors

Naseer Ul Islam

Majid Jehangir

Arshed Hussain Parry

Syed Sajjad Nazir

Sheikh Bilal

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of the present study was to assess the diagnostic accuracy of the Vesical Imaging-Reporting and Data System (VI-RADS) scoring system in predicting muscle infiltration of bladder cancer (BC) on a pre-operative multiparametric magnetic resonance imaging (mpMRI).

Methods: The prospective study enrolled patients with bladder lesions detected on a preliminary ultrasonography or cystoscopy. The patients underwent mpMRI on a 3T MRI scanner followed by surgery within 2 weeks. The tumours were assigned a VI-RADS score by 2 experienced abdominal radiologists. The VI-RADS score was compared with postoperative histopathological findings to confirm detrusor muscle infiltration. The diagnostic performance of VI-RADS for predicting muscle invasion was assessed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy.

Results: A total of 60 patients were included in the study with a male: female ratio of 4.4 : 1. Transurethral resection of bladder tumour (TURBT) was performed in 47 (78.4%) and radical cystectomy in 13 (21.6%) patients. 19 (31.7%) had non-muscle invasive invasive BC (NMIBCa) and 41 (68.3%) had muscle invasive BC (MIBCa) on histopathology. There was a significant association between VI-RADS score and its components with muscle invasion ( < 0.05). A VI-RADS score of ≥ 3 had a sensitivity of 97.56% (95% CI: 0.87-0.99%), specificity of 73.68% (95% CI: 0.49-0.91), positive predictive value of 88.9% (95% CI: 0.79-0.94), negative predictive value of 93.33% (95% CI: 0.66-0.99), and diagnostic accuracy of 90% (95% CI: 0.80-0.96) for prediction of muscle invasion.

Conclusion: VI-RADS scoring system pre-operatively predicts the likelihood of muscle invasion in BC with a satisfactory diagnostic performance, and it should be incorporated in the diagnostic work-up of BC patients.

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