The Diagnostic Value of MR Imaging in Differentiating T Staging of Bladder Cancer: A Meta-Analysis

Huang, Li; Kong, Qingcong; Liu, Zhenzhen; Wang, Jin; Kang, Zhuang; Zhu, Yaqiong

doi:10.1148/radiol.2017171028

Cited by 119 publications

(96 citation statements)

References 31 publications

(31 reference statements)

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“…The utility of the stalk in describing T stage was more recently confirmed by Wang et al [18]; our results are in accordance with those authors, as we found that 81% of NMIBC presented with a stalk. Given the growing interest in evaluating mpMRI performance in BCa local staging, three meta-analyses have recently addressed the issue, finding a pooled sensitivity of 0.87 (95% CI 0.82-0.91), 0.92 (95% CI 0.88-0.95), and 0.90 (95% CI 0.83-0.94) and specificity of 0.79 (95% CI 0.72-0.85), 0.87 (95% CI 0.78-0.93), and 0.88 (95% CI 0.77-0.94), respectively [10,11,19].…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center

Simone²,

et al. 2019

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Objectives To evaluate accuracy and inter-observer variability using Vesical Imaging-Reporting and Data System (VI-RADS) for discrimination between non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Methods Between September 2017 and July 2018, 78 patients referred for suspected bladder cancer underwent multiparametric MRI of the bladder (mpMRI) prior to transurethral resection of bladder tumor (TURBT). All mpMRI were reviewed by two radiologists, who scored each lesion according to VI-RADS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each VI-RADS cutoff. Receiver operating characteristics curves were used to evaluate the performance of mpMRI. The Ƙ statistics was used to estimate inter-reader agreement.Results Seventy-five patients were included in the final analysis, 53 with NMIBC and 22 with MIBC. Sensitivity and specificity were 91% and 89% for reader 1 and 82% and 85% for reader 2 respectively when the cutoff VI-RADS > 2 was used to define MIBC. At the same cutoff, PPV and NPV were 77% and 96% for reader 1 and 69% and 92% for reader 2. When the cutoff VI-RADS > 3 was used, sensitivity and specificity were 82% and 94% for reader 1 and 77% and 89% for reader 2. Corresponding PPVand NPV were 86% and 93% for reader 1 and 74% and 91% for reader 2. Area under curve was 0.926 and 0.873 for reader 1 and 2 respectively. Inter-reader agreement was good for the overall score (Ƙ = 0.731).Conclusions VI-RADS is accurate in differentiating MIBC from NMIBC. Inter-reader agreement is overall good. Key Points • Traditionally, the local staging of bladder cancer relies on transurethral resection of bladder tumor. • However, transurethral resection of bladder tumor carries a significant risk of understaging a cancer; therefore, more accurate, faster, and non-invasive staging techniques are needed to improve outcomes. • Multiparametric MRI has proved to be the best imaging modality for local staging; therefore, its use in suitable patients has the potential to expedite radical treatment when necessary and non-invasive diagnosis in patients with poor fitness.

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Section: Discussionmentioning

confidence: 99%

Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center

Simone²,

et al. 2019

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“…Woo et al performed a recent meta‐analysis, with a pooled sensitivity and specificity of 0.92 and 0.87, respectively, for differentiating <T1 vs. >T2 disease . Huang et al also published a recent meta‐analysis obtaining a pooled sensitivity and specificity of 0.90 and 0.88, respectively, for differentiating <T1 vs. >T2 disease …”

Section: Mri Staging and Accuracymentioning

confidence: 99%

“…20 Huang et al also published a recent meta-analysis obtaining a pooled sensitivity and specificity of 0.90 and 0.88, respectively, for differentiating <T1 vs. >T2 disease. 21 Bladder cancer N stage criteria were modified in the more recent 7 th and 8 th editions of the AJCC Staging Manual. 62,71 N stage is now determined by the number of pathologic lymph nodes, and includes common iliac nodes as regional nodal disease.…”

Section: Mri Staging and Accuracymentioning

confidence: 99%

“…It is anticipated that utilization of mp‐MRI for bladder cancer local staging will increase as awareness of its accuracy in the urology community improves. Several recent meta‐analyses assessing the topic of local staging of bladder cancer with mp‐MRI confirm an increased interest in the genitourinary community …”

mentioning

confidence: 95%

“…Several recent meta-analyses assessing the topic of local staging of bladder cancer with mp-MRI confirm an increased interest in the genitourinary community. [19][20][21] This article reviews urinary bladder anatomy and histology with MRI correlations, MRI techniques including updates on DWI, DCE, and MR urography (MRU), MRI staging and accuracy, bladder cancer variants, and finally discusses the applications of radiomic analysis and machine learning to bladder cancer.…”

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confidence: 99%

See 2 more Smart Citations

Update on multiparametric MRI of urinary bladder cancer

Pol

Chung

Lim

et al. 2018

Magnetic Resonance Imaging

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MRI of Bladder Cancer: Local and Nodal Staging

Caglič

Panebianco

Vargas

et al. 2020

Magnetic Resonance Imaging

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Accurate staging of bladder cancer (BC) is critical, with local tumor staging directly influencing management decisions and affecting prognosis. However, clinical staging based on clinical examination, including cystoscopy and transurethral resection of bladder tumor (TURBT), often understages patients compared to final pathology at radical cystectomy and lymph node (LN) dissection, mainly due to underestimation of the depth of local invasion and the presence of LN metastasis. MRI has now become established as the modality of choice for the local staging of BC and can be additionally utilized for the assessment of regional LN involvement and tumor spread to the pelvic bones and upper urinary tract (UUT). The recent development of the Vesical Imaging‐Reporting and Data System (VI‐RADS) recommendations has led to further improvements in bladder MRI, enabling standardization of image acquisition and reporting. Multiparametric magnetic resonance imaging (mpMRI) incorporating morphological and functional imaging has been proven to further improve the accuracy of primary and recurrent tumor detection and local staging, and has shown promise in predicting tumor aggressiveness and monitoring response to therapy. These sequences can also be utilized to perform radiomics, which has shown encouraging initial results in predicting BC grade and local stage. In this article, the current state of evidence supporting MRI in local, regional, and distant staging in patients with BC is reviewed.Level of Evidence3Technical Efficacy Stage2 J. Magn. Reson. Imaging 2020;52:649–667.

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The Diagnostic Value of MR Imaging in Differentiating T Staging of Bladder Cancer: A Meta-Analysis

Cited by 119 publications

References 31 publications

Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center

Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center

Update on multiparametric MRI of urinary bladder cancer

MRI of Bladder Cancer: Local and Nodal Staging

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