Systematic Review and Meta-Analysis of Vesical Imaging-Reporting and Data System (VI-RADS) Inter-Observer Reliability: An Added Value for Muscle Invasive Bladder Cancer Detection

Abstract

The Vesical Imaging-Reporting and Data System (VI-RADS) has been introduced to provide preoperative bladder cancer staging and has proved to be reliable in assessing the presence of muscle invasion in the pre-TURBT (trans-urethral resection of bladder tumor). We aimed to assess through a systematic review and meta-analysis the inter-reader variability of VI-RADS criteria for discriminating non-muscle vs. muscle invasive bladder cancer (NMIBC, MIBC). PubMed, Web of Science, Cochrane, and Embase were searched up until 30 July 2020. The Quality Appraisal of Diagnostic Reliability (QAREL) checklist was utilized to assess the quality of included studies and a pooled measure of inter-rater reliability (Cohen’s Kappa [κ] and/or Intraclass correlation coefficients (ICCs)) was calculated. Further sensitivity analysis, subgroup analysis, and meta-regression were conducted to investigate the contribution of moderators to heterogeneity. In total, eight studies between 2018 and 2020, which evaluated a total of 1016 patients via 21 interpreting genitourinary (GU) radiologists, met inclusion criteria and were critically examined. No study was considered to be significantly flawed with publication bias. The pooled weighted mean κ estimate was 0.83 (95%CI: 0.78–0.88). Heterogeneity was present among the studies (Q = 185.92, d.f. = 7, p < 0.001; I2 = 92.7%). Meta-regression analyses showed that the relative % of MIBC diagnosis and cumulative reader’s experience to influence the estimated outcome (Coeff: 0.019, SE: 0.007; p= 0.003 and 0.036, SE: 0.009; p = 0.001). In the present study, we confirm excellent pooled inter-reader agreement of VI-RADS to discriminate NMIBC from MIBC underlying the importance that standardization and reproducibility of VI-RADS may confer to multiparametric magnetic resonance (mpMRI) for preoperative BCa staging.

Detection of Degenerative Changes on MR Images of the Lumbar Spine with a Convolutional Neural Network: A Feasibility Study

“…Although attempts have been made to standardize the nomenclature in the reporting of lumbar spine disease, such as the nomenclature of lumbar discs [ 25 ] and the grading of spinal canal stenosis [ 27 ], a general reporting and data system for spine MRI is still lacking. In other organ systems, such as the genitourinary tract, the recently established Vesical Imaging Reporting and Data System (VI-RADS) [ 42 , 43 , 44 ] demonstrated near-perfect interrater agreement in the evaluation of non-muscle-invasive vs. muscle-invasive bladder cancer. However, only moderate intra- and interrater agreement was observed for degenerative conditions of the lumbar spine across different readers, even after adjustment to standardized evaluation criteria [ 45 ].…”

Prognostic Value of the Systemic Inflammatory Response Index in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Population-Based Study

“…Multiparametric magnetic resonance imaging (mpMRI) for BCa is able to accurately provide a high tissue contrast resolution, and can finely differentiate bladder wall layers (26). The Vesical Imaging-Reporting and Data System (VI-RADS) scoring system has been validated to reproducible imaging and reporting by a consensus-driven approach (27). Many recent evidences suggest that VI-RADS was a novel imaging tool that can accurately discriminate between NMIBC and MIBC patients before transurethral resection of bladder tumor (TURBT) (28).…”

Prognostic Role of Programmed Death Ligand-1 on Tumor-Infiltrating Immune Cells in “High-Risk” Patients Following Radical Cystectomy: A Retrospective Cohort Study

“…For further application of the novel biomarker in future research, it is important to integrate with other available clinical predictors. The Vesical Imaging-Reporting and Data System (VI-RADS) using multiparametric MRI has been demonstrated to effectively differentiate among non-muscle invasive bladder cancer (NMIBC), MIBC and extravesical BCa (≥pT3) preoperatively (26)(27)(28)(29). In addition, the VI-RADS scoring system might stratify patients according to earlier prediction of tumor response to treatment (30).…”