Predicting the risk of muscle-invasive bladder cancer using vesical imaging-reporting and data system

Abstract

Objective To evaluate the accuracy and clinical significance of the vesical imaging-reporting and data system (VI-RADS) in predicting muscle-invasive bladder cancer (MIBC). Methods The data of 59 bladder cancer patients who underwent multiparametric magnetic resonance imaging and surgery between 2014 March and 2019 May were retrospectively analyzed, which includes 51 males and 8 females, aged 36-82 years old, with a median age of 62 years old. According to the scoring methods specified by VI-RADS, radiologists read and scored all mpMRIs including T2-weighted imaging(T2WI), diffusion-weighted imaging(DWI), and dynamic contrast enhancement MRI(DCE-MRI) of all the included patients. And then the VI-RADS were compared with pathological diagnosis. Proportions of MIBC in each score category were calculated, and ROC curve was plotted and the area under the curve(AUC) was estimated to assess the sensitivity and specificity of VI-RADS in diagnosing MIBC. Results The number of patients in VI-RADS score category 1 to 5 were 12, 28, 2, 15 and 2, respectively. And there were 0, 2(7.4%), 1(50.0%), 13(81.3%), 2(100.0%)MIBC patients in each score category, respectively. When VI-RADS ≥3 was used to define MIBC, it came to the largest Youden’s Index(0.7913), with an AUC of 0.924. And the sensitivity and specificity were 88.9% and 90.2%, respectively. Conclusions VI-RADS has high accuracy in predicting MIBC, and it is worthy of application and verification in further clinical practice. The urologists should be highly alert to the existence of MIBC when VI-RADS ≥3. Key words: Vesical imaging-reporting and data system; Muscle invasive bladder cancer; Non-muscle invasive bladder cancer; Multiparametric magnetic resonance imaging