Is high accuracy of Vesical Imaging-Reporting and Data System (VI-RADS) sufficient for its implementation in the urological practice?

Abstract

Aims. Currently, the only method used to differentiate between MIBC and NMIBC is transurethral resection of the bladder tumour (TURBT). Magnetic resonance and Vesical Imaging-Reporting and Data System (VI-RADS) would allow for discrimination between NMIBC and MIBC. We evaluate the sensitivity and specificity of VI-RADS in the diagnosis of muscle-invasive bladder cancer and discuss its value in everyday urological practice. Methods. 64 patients with bladder cancer (BC) were enrolled into this prospective study. Multiparametric magnetic resonance imaging (mpMRI) was performed before transurethral resection of the bladder tumour (TURBT) and evaluated using the VI-RADS score. Score were compared to histopathology results. We evaluated the sensitivity, specificity, positive and negative predictive value of this system using both cut-off VI-RADS ≥ 3 and ≥ 4.

Diagnostic Protocol, Outcomes and Future Perspectives of the Vesical Imaging-Reporting and Data Systems (VI-RADS), a Narrative Review

“…In view of its versatility, the reporting system could potentially support disease management at every disease stage. One major line of research is represented by the possibility of mpMRI to revisit the role of extensive TURBT in clearly muscle-invasive BC [49], with preliminary reports confirming the feasibility of such a strategy [20]. Patients with a VI-RADS score 5 disease might potentially avoid the morbidity of extensive primary resections in favour of sampling-TURBT for histology [50].…”