Evaluation of the value of the VI-RADS scoring system in assessing muscle infiltration by bladder cancer

Abstract

Background: The Vesical Imaging-Reporting and Data System (VI-RADS) was created in 2018, and a 5-point VI-RADS scoring system was proposed to determine whether the muscularis of the bladder has been infiltrated by tumor tissues. Purpose: To verify the accuracy of the VI-RADS scoring system in predicting muscle-invasive bladder cancer and to explore its value in clinical application. Materials and methods: A total of 220 patients with bladder cancer who underwent multiparameter magnetic resonance imaging from January 2017 to June 2019 were selected. Then, two radiologists with equivalent qualifications gave their diagnoses of bladder tumors on T2-weighted imaging, diffusion-weighted imaging and dynamic contrast enhanced imaging. Meanwhile, the bladder tumor was also scored on the basis of the VI-RADS system; for multifocal tumors, the highest tumor load was selected for scoring. Furthermore, the final pathological results of the patients were unknown during the imaging diagnosis and scoring. Next, the VI-RADS score was compared with the pathological results after surgery, and the ability of the VI-RADS score to assess the degree of muscularis infiltration was finally analyzed. Results: A total of 220 patients were included in our study, including 194 males and 26 females. Among them, the pathological results were 113 cases of muscle-invasive bladder cancer and 107 cases of non-muscle-invasive bladder cancer. The results showed that there was a positive correlation between the pathological results and VI-RADS score (r = 0.821, P < 0.05). The area under the receiver operating characteristic curve of the VI-RADS score was 0.960 (95% CI: 0.937, 0.983). When the VI-RADS score was above 3, the sensitivity, specificity and accuracy of predicting muscle-invasive bladder cancer were 82.3, 95.3 and 88.64%, respectively. Conclusion: The VI-RADS scoring system has good diagnostic value in predicting the degree of tumor invasion and can be used to guide clinical decision-making and management.

The efficacy and reliability of VI‐RADS in determining candidates for repeated transurethral resection in patients with high‐risk non‐muscle invasive bladder cancer

“…The authors have demonstrated that the VI-RADS scoring system can play an important role in determining muscle invasion in BC and managing the disease. 19 Luo C et al examined six different studies and a total of 1064 patients in their metaanalysis and concluded that VI-RADS scoring had high sensitivity and specificity in identifying muscle invasion. 20 The authors further reported that the results of VI-RADS cut-off value of 3 and VI-RADS cut-off value of 4 were similar.…”

“…The AUC in the ROC analysis of the VI‐RADS score was reported to be 0.960 (95% CI: 0.937, 0.983). The authors have demonstrated that the VI‐RADS scoring system can play an important role in determining muscle invasion in BC and managing the disease 19 . Luo C et al examined six different studies and a total of 1064 patients in their meta‐analysis and concluded that VI‐RADS scoring had high sensitivity and specificity in identifying muscle invasion 20 .…”

Vesical Imaging Reporting and Data System (VI-RADS): Are the individual MRI sequences equivalent in diagnostic performance of high grade NMIBC and MIBC?

“…All perfomed mp-MRI examinations of the bladder were independently assessed by two radiologists (xy., a board certified radiologist specialized in urogenital imaging with > 10 years of experience, and xx., a fifth-year resident having undergone dedicated urogenital imaging training) according to the VI-RADS score, blinded to histological findings. Both readers assigned a VI-RADs score (1)(2)(3)(4)(5) to each lesion. If there were several tumors, only the one with the highest VI-RADS score was considered for each patient.…”

“…As with each new reporting system, VI-RADS requires independent validation regarding its accuracy and the necessity of all multiparametric data to provide evidence based information for clinical decision making. The predictive ability of each single image sequence of the VI-RADS score to diagnose muscle invasion has been mentioned in a few studies [4], but none of the prior studies assessed VI-RADS performance in differentiating between low and high grade non-muscle invasive bladder cancer. In addition, it is yet not clear whether the different VI-RADS parameters contain information independent from each other.…”

Combining Multiparametric MRI Radiomics Signature With the Vesical Imaging-Reporting and Data System (VI-RADS) Score to Preoperatively Differentiate Muscle Invasion of Bladder Cancer

“…VI-RADS provides five-point scores that predict the possibility of muscle invasiveness by BCa. The reported accuracy of VI-RADS in predicting MIBC has exceeded 85% in recent validation studies (13)(14)(15)(16)(17) with a great inter-reader agreement and reviewer acceptance (17,18), so VI-RADS has obtained novel interest and acceptance and has been adopted by many radiologists and institutions in clinical routine. Recent studies reported that VI-RADS also had the potential to differentiate BCa patients with extravesical extension (19) and select high risk NMIBC patients who are a candidate for repeated transurethral Resection (16).…”