Vesical Imaging-Reporting and Data System (VI-RADS).

Abstract

453 Background: The VI-RADS has been widely used as diagnostic criteria for MRI to predict muscle-invasive of bladder cancer (MIBC). The aim of this study is to evaluate the diagnostic performance of VI-RADS in our hospital and the clinicopathological features of true positive (TP), false positive (FP), true negative (TN), and false negative (FN) cases to identify possible factors for misdiagnosis. Methods: Of the 286 patients who underwent TURBT at our hospital from January 2019 to October 2020, we selected 129 consecutive cases who had performed preoperative enhanced mpMRI and diagnosed as urothelial carcinoma pathologically. We defined VI-RADS score ≥4 as positive for MIBC. The clinicopathological features of TP, FP, TN, and FN groups were retrospectively analyzed and compared. Chi-square test and Mann–Whitney U test were used for the test between the two groups. Results: VI-RADS score in MIBC cases were 2 cases for ≤3 and 22 for ≥4, and in non-MIBC cases 91 cases for ≤3 and 14 for ≥4. The diagnostic performance of VI-RADS for MIBC was 92% for sensitivity, 87% for specificity, 61% for positive predictive value, 98% for negative predictive value, 88% for accuracy and the area under the curve (AUC) was 0.89. There were no statistical differences of age and %male cases between TP (22 cases), FP (14), TN (91) and FN (2) groups. Pathological features of the (TP, FP, TN, FN) groups were shown (table). TP had significantly larger tumor size than the other three groups, and higher %G3, %tumor necrosis and %variant+ than FP and TN. FP group had significantly larger tumor size than the TN. Conclusions: VI-RADS showed high diagnostic performance in predicting MIBC. Our study showed that larger tumor size was a significant factor for overestimation, suggesting the need for improved accuracy in cases with large tumor size.[Table: see text]