Vesical Imaging-Reporting And Data System Research Articles

Prognostic Utility of MRI Features in Intradiverticular Bladder Tumor

Intradiverticular bladder tumors (IDBT) are rare but clinically important, as they are difficult to assess endoscopically due to limited anatomic access and risk of perforation. MRI may be helpful in assessing IDBT and providing relevant staging and prognostic information. To assess MRI findings of IDBT and their relationship with overall survival. This retrospective study included 31 consecutive patients with IDBT undergoing MRI from 2008 to 2018 identified through electronic medical records and PACS database search. Two radiologists independently assessed the following MRI features: size (>3 vs ≤3 cm), diverticular neck involvement, Vesical Imaging-Reporting and Data System (VI-RADS) score (>3 vs ≤3), perivesical fat infiltration, additional tumors and suspicious pelvic lymph nodes. Overall survival was estimated using Kaplan-Meier analysis; and the relationship with clinicopathological and MRI features was determined using the Cox proportional-hazards regression model. Inter-reader agreement was assessed using intraclass correlation coefficients (ICC) and Cohen's kappa (K). Median follow-up was 1044 days (interquartile range, 474-1952 days). Twenty-six (83.9%) patients underwent surgical treatment with or without neoadjuvant chemotherapy. On MRI, greater tumor size (>3 cm), diverticular neck involvement, perivesical extension, and suspicious lymph nodes were associated with lower overall survival (HR = 3.6-8.1 and 4.3-6.3 for the 2 radiologists, p ≤ 0.03). Other clinicopathological or MRI findings were not associated with survival (p = 0.27-0.65). Inter-reader agreement was excellent for tumor size (ICC = 0.991; 95% CI 0.982-0.996), fair for VI-RADS (K = 0.52, 95% CI, 0.22-0.82), and moderate for others (K = 0.61-0.79). In patients with IDBT, several MRI features were significantly associated with overall survival. Utilizing all available clinicopathological and imaging information may improve estimation of prognosis.

Combining Multiparametric MRI Radiomics Signature with the Vesical Imaging-Reporting and Data System (VI-RADS) Score to Preoperatively Differentiate Muscle Invasion of Bladder Cancer

Background: The treatment and prognosis for muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC) are different. We aimed to construct a nomogram based on the multiparametric MRI (mpMRI) radiomics signature and the Vesical Imaging-Reporting and Data System (VI-RADS) score for the preoperative differentiation of MIBC from NMIBC. Methods: The retrospective study involved 185 pathologically confirmed bladder cancer (BCa) patients who received mpMRI before surgery between August 2014 to April 2020. A total of 2,436 radiomics features were quantitatively extracted from the largest lesion located on the axial T2WI and from dynamic contrast-enhancement images. After feature selection, radiomics signatures were developed in the training set (n=129) and validated in the validation set (n=56) . Univariable and multivariable logistic regression were used to develop a nomogram. Findings: The radiomics signature generated by the least absolute shrinkage and selection operator classifier had the best capacity for muscle-invasive status differentiation in both the training (accuracy: 90.7%, area under the curve (AUC): 0.934) and validation sets (accuracy: 87.5%, AUC: 0.906). Incorporating the radiomics signature and VI-RADS score, the nomogram demonstrated better discrimination and calibration both in the training set (accuracy: 93.0%, AUC: 0.970) and validation set (accuracy: 89.3%, AUC: 0.943). Decision curve analysis showed the clinical usefulness of the nomogram. Interpretation: The mpMRI radiomics signature may be useful for the preoperative differentiation of muscle-invasive status in BCa . The proposed nomogram integrating the radiomics signature with the VI-RADS score may further increase the differentiation power and improve clinical decision making. Funding Statement: Shanghai Science Committee Foundation and Shanghai Youth Science and Technology Talents Sailing Program. Declaration of Interests: This study was funded by the Shanghai Science Committee Foundation (grant number 19411967700) and Shanghai Youth Science and Technology Talents Sailing Program (20YF1437200). Ethics Approval Statement: This study was approved by the institutional review board, and informed consent of patients was waived due to its retrospective nature.

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.

Simple SummaryIn our systematic review and meta-analysis of eight observational studies including a total of 1016 patients, we demonstrated excellent pooled inter-observer agreement among Genito-Urinary radiologists when adopting the novel Vesical Imaging-Reporting and Data System (VI-RADS) criteria in the pre-trans-urethral resection of bladder tumor (TURBT) assessment for non-muscle (NMIBC) vs. muscle-invasive bladder cancer (MIBC) detection.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.

Prospective Validation of Vesical Imaging-Reporting and Data System Using a Next-Generation Magnetic Resonance Imaging Scanner-Is Denoising Deep Learning Reconstruction Useful?

The Vesical Imaging Reporting and Data System (VI-RADS) was launched in 2018 to standardize reporting of magnetic resonance imaging for bladder cancer. This study aimed to prospectively validate VI-RADS using a next-generation magnetic resonance imaging scanner and to investigate the usefulness of denoising deep learning reconstruction. We prospectively enrolled 98 patients who underwent bladder multiparametric magnetic resonance imaging using a next-generation magnetic resonance imaging scanner before transurethral resection of bladder tumor. Tumors were categorized according to VI-RADS, and we ultimately analyzed 68 patients with pathologically confirmed urothelial bladder cancer. We used receiving operating characteristic curve analyses to assess the predictive accuracy of VI-RADS for muscle invasion. Sensitivity, specificity, positive/negative predictive value, accuracy and area under the curve were calculated for different VI-RADS score cutoffs. Muscle invasion was detected in the transurethral resection of bladder tumor specimens of 18 patients (26%). The optimal cutoff value of the VI-RADS score was determined as ≥4 based on the receiver operating curve analyses. The accuracy of diagnosing muscle invasion using a cutoff of VI-RADS ≥4 was 94% (AUC 0.92). Additionally, we assessed the utility of denoising deep learning reconstruction. Combination with denoising deep learning reconstruction significantly improved the AUC of category by T2-weighted imaging, and of the 4 patients who were misdiagnosed by the final VI-RADS score 3 were correctly diagnosed by T2-weighted imaging+denoising deep learning reconstruction. In this prospective validation study with a next-generation magnetic resonance imaging scanner, VI-RADS showed high predictive accuracy for muscle invasion in patients with bladder cancer before transurethral resection of bladder tumor. Combining T2-weighted imaging with denoising deep learning reconstruction might further improve the diagnostic accuracy of VI-RADS.

Vesical Imaging-Reporting and Data System (VI-RADS) incorporated into bladder cancer clinical practice: what's the perspectives beyond diagnostic accuracy?

Vesical Imaging-Reporting and Data System (VI-RADS) incorporated into bladder cancer clinical practice: what's the perspectives beyond diagnostic accuracy?

SC274 - Clinical implications of Vesical Imaging-Reporting and Data System (VI-RADS) on the management of high-risk non-muscle invasive bladder cancers (HR-NMIBCs) candidate for repeated transurethral resection (Re-TURBT)

SC274 - Clinical implications of Vesical Imaging-Reporting and Data System (VI-RADS) on the management of high-risk non-muscle invasive bladder cancers (HR-NMIBCs) candidate for repeated transurethral resection (Re-TURBT)

SC310 - Perspective multi-reader comparison between biparametric and multiparametric MRI for muscle-invasiveness assessment in bladder cancer: can we expect a contrast-free Vesical Imaging Reporting and Data System (VI-RADS)?

SC310 - Perspective multi-reader comparison between biparametric and multiparametric MRI for muscle-invasiveness assessment in bladder cancer: can we expect a contrast-free Vesical Imaging Reporting and Data System (VI-RADS)?

VI-RADS for Bladder Cancer: Current Applications and Future Developments.

Bladder cancer (BCa) is among the ten most frequent cancers globally. It is the tumor with the highest lifetime treatment-associated costs, and among the tumors with the heaviest impacts on postoperative quality of life. The purpose of this article is to review the current applications and future perspectives of the Vesical Imaging Reporting and Data System (VI-RADS). VI-RADS is a newly developed scoring system aimed at standardization of MRI acquisition, interpretation, and reporting for BCa. An insight will be given on the BCa natural history, current MRI applications for local BCa staging with assessment of muscle invasiveness, and clinical implications of the score for disease management. Future applications include risk stratification of nonmuscle invasive BCa, surveillance, and prediction and monitoring of therapy response. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.

Quantitation of bladder cancer for the prediction of muscle layer invasion as a complement to the vesical imaging-reporting and data system.

To examine the diagnostic performance of Vesical Imaging-Reporting and Data System (VIRADS) and to find a quantitative indicator for predicting muscle layer invasion of bladder cancer. 3-T MRI of 82 patients performed before transurethral resection of bladder tumors or radical cystectomy between July 2018 and June 2019 were retrospectively analyzed. For one index lesion of each patient, two radiologists independently assigned VIRADS score and measured tumor-wall interface (contact length between tumor and bladder wall) on T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI. Inter-reader agreement was assessed, and logistic regression analysis was performed to find indicators of muscle layer invasion. Comparison of indicators' diagnostic performance was done with receiver operating characteristic (ROC) curve and generalized linear model analyses. Optimal cutoff point was determined by the Youden index J. Inter-reader agreement was at least substantial for VIRADS categorization (κ 0.77-0.81), and almost perfect for tumor-wall interface (intraclass correlation coefficient 0.88-0.90). Tumor-wall interface (odds ratio [OR] 1.90-2.00) and VIRADS score (OR 8.59-8.89) were independently associated with muscle layer invasion (p≤ 0.02). For VIRADS, area under the ROC curve (AUROC) was 0.94, and the accuracy was 0.93 at score 3, the optimal threshold for predicting muscle layer invasion. Depending on the MRI sequence, tumor-wall interface showed AUROCs of 0.90-0.92 and accuracy of 0.84-0.90 at suggested thresholds (3 ± 0.3 cm). Tumor-wall interface showed insignificant differences in accuracy compared with VIRADS (p > 0.10), except as measured on diffusion-weighted images (p = 0.01). VIRADS is a good predictor of muscle layer invasion. As an independent quantitative indicator, tumor-wall interface may complement VIRADS to enhance prediction. • Vesical Imaging-Reporting and Data System (VIRADS) is a promising predictor of muscle invasion of bladder cancer with good reproducibility, as suggested by previous studies. • VIRADS score and the tumor-wall interface (curvilinear contact length between the tumor and the bladder wall) are independent predictors of muscle layer invasion. • As an easy-to-use quantitative indicator, tumor-wall interface is expected to be used as an indicator complementary to VIRADS, a qualitative indicator.

Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions

To investigate the clinical utility of the Vesical Imaging-Reporting and Data System (VI-RADS) by comparing its diagnostic performance for muscle-invasive bladder cancer (MIBC) between radiologists and urologists based on multiparametric MRI, including three-dimensional (3D) fast spin-echo (FSE) T2-weighted acquisitions. This study included 66 treatment-naïve patients (60 men, 6 women; mean age 74.0years) with pathologically proven bladder cancer who underwent multiparametric MRI, including 3D FSE T2-weighted imaging, before transurethral bladder tumour resection between January 2010 and November 2018. The MRI scans were categorised according to the five-point VI-RADS score by four independent readers (two board-certified radiologists and board-certified urologists each), blinded to the histopathological findings. The VI-RADS scores were compared with the postoperative histopathological diagnosis. Interobserver agreement was assessed using weighted kappa coefficients. ROC analysis and generalised estimating equations were used to evaluate the diagnostic performance. Forty-nine (74.2%) and 17 (25.8%) tumours were confirmed to be non-MIBC and MIBC, respectively, based on pathological examination. The interobserver agreement was good-to-excellent between all pairs of readers (range, 0.73-0.91). The urologists' sensitivity/specificity values for DCE-MRI VI-RADS scores were significantly lower than those of radiologists. No significant differences were observed for the overall VI-RADS score. The AUC for the overall VI-RADS score was 0.94, 0.92, 0.89, and 0.87 for radiologists 1 and 2 and urologists 1 and 2, respectively. The VI-RADS score, based on multiparametric MRI including 3D FSE T2-weighted acquisitions, can be useful for radiologists and urologists to determine the bladder cancer muscle invasion status preoperatively. • VI-RADS (using multiparametric MRI including 3D FSE T2-weighted acquisitions) achieves good to excellent interobserver agreement and has similar diagnostic performance for detecting muscle invasion by both radiologists and urologists. • The diagnostic performance of the overall VI-RADS score is high for both radiologists and urologists, particularly due to the dominant effect of diffusion-weighted imaging on the overall VI-RADS score. • The sensitivity and specificity values of the T2WI VI-RADS scores for four readers in our study (using 3D FSE T2-weighted acquisitions) were similar (with slightly higher specificity values) to previously published results (using 2D FSE T2-weighted acquisitions).

Preoperative detection of Vesical Imaging-Reporting and Data System (VI-RADS) score 5 reliably identifies extravesical extension of urothelial carcinoma of the urinary bladder and predicts significant delayed time to cystectomy: time to reconsider the need for primary deep transurethral resection of bladder tumour in cases of locally advanced disease?

(I) To determine Vesical Imaging-Reporting and Data System (VI-RADS) score 5 accuracy in predicting locally advanced bladder cancer (BCa), so as to potentially identify those patients who could avoid the morbidity of deep transurethral resection of bladder tumour (TURBT) in favour of histological sampling-TUR prior to radical cystectomy (RC). (II) To explore the predictive value of VI-RADS score 5 on time-to-cystectomy (TTC) outcomes. We retrospectively reviewed patients' ineligible or refusing cisplatin-based combination neoadjuvant chemotherapy who underwent multiparametric magnetic resonance imaging (mpMRI) of the bladder prior to staging TURBT followed by RC for muscle-invasive BCa. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated for VI-RADS score 5 vs. score 2-4 cases to assess the accuracy of mpMRI for extravesical BCa detection (≥pT3). VI-RADS score performance was assessed by receiver operating characteristics curve analysis. A Κ statistic was calculated to estimate mpMRI and pathological diagnostic agreement. The risk of delayed TTC (i.e. time from initial BCa diagnosis of >3months) was assessed using multivariable logistic regression model. A total of 149 T2-T4a, cN0-M0 patients (VI-RADS score 5, n=39 vs VI-RADS score 2-4, n=110) were examined. VI-RADS score 5 demonstrated sensitivity, specificity, PPV and NPV, in detecting extravesical disease of 90.2% (95% confidence interval [CI] 84-94.3), 98.1% (95% CI 94-99.6), 94.9% (95% CI 89.6-97.6) and 96.4% (95% CI 91.6-98.6), respectively. The area under the curve was 94.2% (95% CI 88.7-99.7) and inter-reader agreement was excellent (Κinter 0.89). The mean (SD) TTC was 4.2(2.3) and 2.8(1.1)months for score 5 vs 2-4, respectively (P<0.001). VI-RADS score 5 was found to independently increase risk of delayed TTC (odds ratio 2.81, 95% CI 1.20-6.62). The VI-RADS is valid and reliable in differentiating patients with extravesical disease from those with muscle-confined BCa before TURBT. Detection of VI-RADS score 5 was found to predict significant delay in TTC independently from other clinicopathological features. In the future, higher VI-RADS scores could potentially avoid the morbidity of extensive primary resections in favour of sampling-TUR for histology. Further prospective, larger, and multi-institutional trials are required to validate clinical applicability of our findings.

VI-RADS: Multiinstitutional Multireader Diagnostic Accuracy and Interobserver Agreement Study

BACKGROUND. The Vesical Imaging Reporting and Data System (VI-RADS), based on multiparametric MRI (mpMRI), was developed to provide accurate information for the diagnosis of muscle-invasive bladder cancer (MIBC). OBJECTIVE. The purpose of our study was to evaluate the interobserver agreement and diagnostic performance of VI-RADS among readers with different levels of experience. METHODS. This retrospective study included 91 consecutive patients who underwent mpMRI before transurethral resection of bladder tumor (TURBT) from July 2010 through August 2018. After attending a training session, seven radiologists (five radiologists experienced in bladder MRI and two inexperienced radiologists) reviewed and scored all MRI examinations according to VI-RADS. The interobserver agreement was assessed by kappa statistics. ROC analysis was used to evaluate the diagnostic performance for MIBC. AUCs were estimated. RESULTS. Among 91 patients (72 men and 19 women; mean age ± SD, 73.2 ± 10.2 years), 48 (52.7%) had MIBC and 43 (47.3%) had non-muscle-invasive bladder cancer. Sixty-eight patients were treated with TURBT, and 23 were treated with radical cystectomy. Interobserver agreement was moderate to substantial (κ = 0.60-0.80) among the experienced readers, substantial (κ = 0.67) between the two inexperienced readers, and moderate to substantial (κ = 0.55-0.75) between the experienced and inexperienced readers. The pooled AUC was 0.88 (range, 0.82-0.91) for experienced readers and 0.84 (range, 0.83-0.85) for inexperienced readers, and 0.87 for all readers. Using a VI-RADS score of 4 or greater as the cutoff value for MIBC, the pooled sensitivity and specificity were 74.1% (range, 66.0-80.9%) and 94.1% (range, 88.6-97.7%) for experienced readers and 63.9% (range, 59.6-68.1%) and 86.4% (range, 84.1-88.6%) for inexperienced readers. Using a VI-RADS score of 3 or greater as the cutoff value, the pooled sensitivity and specificity were 83.4% (range, 80.9-85.1%) and 77.3% (range, 61.4-88.6%) for experienced readers and 82.0% (range, 80.9-83.0%) and 73.9% (range, 72.7-75.0%) for inexperienced readers. CONCLUSION. We observed moderate to substantial interobserver agreement and a pooled AUC of 0.87 among radiologists of different levels of expertise using VI-RADS. CLINICAL IMPACT. VI-RADS could help determine the depth and range of excision in TURBT, decreasing the risk of complications and enhancing the accuracy of pathologic diagnosis.

660 - Clinical implications of vesical imaging-reporting and data system (VI-RADS) on management of high-risk non-muscle invasive bladder cancers (HR-NMIBCs) candidate for repeated transurethral resection (Re-TURBT): A single-center prospective analysis

660 - Clinical implications of vesical imaging-reporting and data system (VI-RADS) on management of high-risk non-muscle invasive bladder cancers (HR-NMIBCs) candidate for repeated transurethral resection (Re-TURBT): A single-center prospective analysis

531 - Prospective validation of vesical imaging-reporting and data system (VI-RADS) for non-muscle invasive (NMI) vs. muscle invasive bladder cancer (MIBC) discrimination in patients candidate for primary transurethral resection of bladder tumors (TURBT)κκκ

531 - Prospective validation of vesical imaging-reporting and data system (VI-RADS) for non-muscle invasive (NMI) vs. muscle invasive bladder cancer (MIBC) discrimination in patients candidate for primary transurethral resection of bladder tumors (TURBT)κκκ

Overview of VI-RADS in Bladder Cancer.

OBJECTIVE. The purpose of this article is to review the natural history and management of bladder cancer, with insight into MRI applications for the assessment of muscle invasiveness of bladder cancer using the newly developed Vesical Imaging Reporting and Data System (VI-RADS) score. CONCLUSION. Multiparametric MRI and the VI-RADS score have been consistently validated across several different institutions as appropriate tools for local staging of bladder cancer and have been proven to contribute to the diagnostic workup and management of urinary bladder cancer.

Evaluation of the value of the VI-RADS scoring system in assessing muscle infiltration by bladder cancer

BackgroundThe Vesical Imaging-Reporting and Data System (VI-RADS) was created in 2018, and a 5-point VI-RADS scoring system was proposed to determine whether the muscularis of the bladder has been infiltrated by tumor tissues.PurposeTo verify the accuracy of the VI-RADS scoring system in predicting muscle-invasive bladder cancer and to explore its value in clinical application.Materials and methodsA total of 220 patients with bladder cancer who underwent multiparameter magnetic resonance imaging from January 2017 to June 2019 were selected. Then, two radiologists with equivalent qualifications gave their diagnoses of bladder tumors on T2-weighted imaging, diffusion-weighted imaging and dynamic contrast enhanced imaging. Meanwhile, the bladder tumor was also scored on the basis of the VI-RADS system; for multifocal tumors, the highest tumor load was selected for scoring. Furthermore, the final pathological results of the patients were unknown during the imaging diagnosis and scoring. Next, the VI-RADS score was compared with the pathological results after surgery, and the ability of the VI-RADS score to assess the degree of muscularis infiltration was finally analyzed.ResultsA total of 220 patients were included in our study, including 194 males and 26 females. Among them, the pathological results were 113 cases of muscle-invasive bladder cancer and 107 cases of non-muscle-invasive bladder cancer. The results showed that there was a positive correlation between the pathological results and VI-RADS score (r = 0.821, P < 0.05). The area under the receiver operating characteristic curve of the VI-RADS score was 0.960 (95% CI: 0.937, 0.983). When the VI-RADS score was above 3, the sensitivity, specificity and accuracy of predicting muscle-invasive bladder cancer were 82.3, 95.3 and 88.64%, respectively.ConclusionThe VI-RADS scoring system has good diagnostic value in predicting the degree of tumor invasion and can be used to guide clinical decision-making and management.

Use of Vesical Imaging-Reporting and Data System (VI-RADS) for detecting the muscle invasion of bladder cancer: a diagnostic meta-analysis.

To comprehensively assess the diagnostic performance of Vesical Imaging-Reporting and Data System (VI-RADS) score for detecting the muscle invasion of bladder cancer. PubMed, Web of Science, and Embase were searched up to November 20, 2019. QUADAS-2 tool assessed the quality of included studies. The diagnostic estimates including sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the area under the curve (AUC) of hierarchical summary receiver operating characteristic (HSROC) were calculated. Further subgroup analysis, meta-regression and sensitivity analysis were conducted. Six studies with 1064 patients were finally included. The pooled sensitivity, specificity, and AUC value were 0.90 (95% CI 0.86-0.94), 0.86 (95% CI 0.71-0.94), and 0.93 (95% CI 0.91-0.95) for VI-RADS 3 as the cutoff value. The corresponding estimates were 0.77 (95% CI 0.65-0.86), 0.97 (95% CI 0.88-0.99), and 0.92 (95% CI 0.89-0.94) for VI-RADS 4 as the cutoff value. Meta-regression analysis revealed that study design (p value 0.01) and surgical pattern of reference standard (p value 0.02) were source of the heterogeneity of pooled sensitivity. No publication bias was observed. The VI-RADS score can provide a good predictive ability for detecting the muscle invasiveness of primary bladder cancer with VI-RADS 3 or VI-RADS 4 as the cutoff value. • VI-RADS score has high sensitivity and specificity for predicting muscle invasion. • The diagnostic efficiencies of VI-RADS 3 and VI-RADS 4 as the cutoff value are similar. • VI-RADS score could be used for detecting muscle invasion of bladder cancer in clinical practice.

MP36-07 EVALUATING THE DIAGNOSTIC ACCURACY OF VESICAL IMAGING-REPORTING AND DATA SYSTEM FOR DETECTING MUSCLE-INVASIVE BLADDER CANCER IN REAL CLINICAL SETTING

You have accessJournal of UrologyImaging/Radiology: Uroradiology I (MP36)1 Apr 2020MP36-07 EVALUATING THE DIAGNOSTIC ACCURACY OF VESICAL IMAGING-REPORTING AND DATA SYSTEM FOR DETECTING MUSCLE-INVASIVE BLADDER CANCER IN REAL CLINICAL SETTING Ryohei Kufukihara*, Eiji Kikuchi, Keisuke Shigeta, Youta Yasumizu, Nobuyuki Tanaka, Toshikazu Takeda, Kazuhiro Matsumoto, Ryuichi Mizuno, Yuki Arita, Hirotaka Akita, Masahiro Jinzaki, and Mototsugu Oya Ryohei Kufukihara*Ryohei Kufukihara* More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Keisuke ShigetaKeisuke Shigeta More articles by this author , Youta YasumizuYouta Yasumizu More articles by this author , Nobuyuki TanakaNobuyuki Tanaka More articles by this author , Toshikazu TakedaToshikazu Takeda More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto More articles by this author , Ryuichi MizunoRyuichi Mizuno More articles by this author , Yuki AritaYuki Arita More articles by this author , Hirotaka AkitaHirotaka Akita More articles by this author , Masahiro JinzakiMasahiro Jinzaki More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000880.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although Vesical Imaging-Reporting and Data System (VI-RADS) has introduced for additional diagnostic modality for bladder cancer (Bca) patients, the diagnostic accuracy in real clinical setting remains uncertain. Our aim is to compare the diagnostic performance of VI-RADS scoring between urologists and radiologists, and to evaluate the accuracy for detecting muscle invasive bladder cancer (MIBC). METHODS: We identified 112 patients who underwent multiparametric- magnetic resonance imaging (mp-MRI) and diagnostic cystoscope preoperatively for Bca detection. VI-RADS was categorized from 1 to 5 (3 or more as suspecting muscle invasive) among two radiologists (R1 and R2) and two urologists (U1 and U2), who were blinded to histopathologic findings. The presence of muscle invasion was also visually evaluated by cystoscopic findings. The MacNemar analysis was used to assess the impact of diagnostic accuracy between VI-RADS and cystoscope. RESULTS: Overall, 61 patients met the criteria and were able to calculate VI-RADS score. Among them, 16 (26.2%) were pathologically diagnosed as MIBC and 45 (73.8%) as non-MIBC. Focusing on muscle invasion diagnostic accuracy, the sensitivity/specificity values in VI-RADS score were 93.8% and 88.9% by R1, 87.5% and 86.7% by R2, 81.3% and 84.4% by U1, and 81.3% and 80.0% by U2, which had no significant differences among radiologists and urologists (p=0.131, p=0.184, respectively). On the other hand, the sensitivity/specificity values in diagnostic cystoscopy were 53.3% and 68.2% by U1, 66.7% and 86.4% by U2, which diagnostic accuracy were marginally significantly lower than VI-RADS score compared to that of R1 (p=0.007 and p=0.062, respectively). Interestingly, VI-RADS scored by R1 and R2 showed overestimations upon 5 and 6 cases, and underestimations upon 1 and 3 cases out of 61 cases (12.3% misdiagnosis as total), which were all localized in lateral wall or nearby ureteral orifice. Limiting in these tumor locations, the diagnostic cystoscopy performed by U1 and U2 tended to have higher diagnostic accuracy than those of VI-RADS (overestimations were 3 and 2 cases, and underestimations were 2 and 0 cases, respectively (5.7% misdiagnosis as total). CONCLUSIONS: VI-RADS shows promise as a comprehensive tool which can be used by both urologists and radiologist. Although VI-RADS comprises the higher diagnostic accuracy for detecting muscle invasion, visual judgement acquired by cystoscope may be crucial upon tumors developed in lateral wall or nearby ureteral orifice. Source of Funding: nothing © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e524-e524 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryohei Kufukihara* More articles by this author Eiji Kikuchi More articles by this author Keisuke Shigeta More articles by this author Youta Yasumizu More articles by this author Nobuyuki Tanaka More articles by this author Toshikazu Takeda More articles by this author Kazuhiro Matsumoto More articles by this author Ryuichi Mizuno More articles by this author Yuki Arita More articles by this author Hirotaka Akita More articles by this author Masahiro Jinzaki More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement PDF downloadLoading ...

MP73-20 DIAGNOSTIC ACCURACY OF THE BI-PARAMETRIC MRI ANALYSIS FOR MUSCLE-INVASIVE BLADDER CANCER PREDICTION

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP73)1 Apr 2020MP73-20 DIAGNOSTIC ACCURACY OF THE BI-PARAMETRIC MRI ANALYSIS FOR MUSCLE-INVASIVE BLADDER CANCER PREDICTION Hyun Jung Jin* Hyun Jung Jin*Hyun Jung Jin* More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000959.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To investigate accuracy of the bi-parametric MRI (bpMRI) analysis using Vesical Imaging-Reporting and Data System (VI-RADS) for the prediction of muscle-invasive bladder cancer (MIBC). METHODS: In this retrospective study, a total of 100 patients who were suspected bladder cancer underwent bpMRI from May 2016 to March 2019. All bpMRI were retrospectively reviewed by one radiologist and scoring using the VI-RADS. Sensitivity, specificity and accuracy were calculated for each VI-RADS cutoff. The performance of bpMRI for the prediction of MIBC was analyzed using receiver operating characteristics (ROC) curves. RESULTS: Among the 100 patients, 81 patients were man and 19 patients were women, with the median age of 66.9 years (interquartile range [IQR], 60.0–76.0 years). Histopathological examination revealed 77 patients with non-muscle invasive bladder cancer (NMIBC) and 23 patients with MIBC. When the cutoff VIRADS ≥ 3 was used, sensitivity and specificity were 83% and 82%, and accuracy was 89%, respectively. The area under curve (AUC) on the ROC curve was 0.892 (95% confidence interval [CI] 0.814, 0.945). CONCLUSIONS: Analysis of bpMRI using the VI-RADS showed good accuracy in distinguishing NMIBC from MIBC. However, prospective and multi-institutional studies are needed to verify the validity of this study. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1129-e1130 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hyun Jung Jin* More articles by this author Expand All Advertisement PDF downloadLoading ...

PD03-03 HOW EFFECTIVE IS MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING VESICAL IMAGING REPORTING AND DATA SYSTEM (VI-RADS) FOR BLADDER CANCER STAGING: CAN IT REPLACE RE STAGING TRANSURETHRAL RESECTION OF BLADDER CANCER IN BLADDER CANCER?

You have accessJournal of UrologyBladder Cancer: Non-invasive I (PD03)1 Apr 2020PD03-03 HOW EFFECTIVE IS MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING VESICAL IMAGING REPORTING AND DATA SYSTEM (VI-RADS) FOR BLADDER CANCER STAGING: CAN IT REPLACE RE STAGING TRANSURETHRAL RESECTION OF BLADDER CANCER IN BLADDER CANCER? Muhammad Abdus Salam*, Sharmin Akther, Faisal Islam, Pranashish Saha, Ibrahim Kaiser, Ghazi Shahinul Islam, Shahed Hossain, and SM Bakhtiar Muhammad Abdus Salam*Muhammad Abdus Salam* More articles by this author , Sharmin AktherSharmin Akther More articles by this author , Faisal IslamFaisal Islam More articles by this author , Pranashish SahaPranashish Saha More articles by this author , Ibrahim KaiserIbrahim Kaiser More articles by this author , Ghazi Shahinul IslamGhazi Shahinul Islam More articles by this author , Shahed HossainShahed Hossain More articles by this author , and SM BakhtiarSM Bakhtiar More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000823.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric MRI (mpMRI) is widely used in the imaging of other types of cancers, though its usefulness in Urothelial cancer of bladder has yet to be fully elucidated. We wanted to determine the efficacy of staging accuracy of routine use of mpMRI and VI-RADS (Vesical Imaging-Reporting And Data System) in staging Urothelial bladder cancer. METHODS: This prospective study was undertaken on 62 patients with mpMRI and VI-RADS in staging high grade Urothelial bladder cancer. Primary Transurethral resection of bladder tumor ( TURBT) mpMRI was performed routinely in all cases, from Jan 2018 to July 2019. Of them 36 patients with High grade Urothelial carcinoma of bladder, the specimen did not contain Muscularis Propria requiring a Restaging TURBT. Radical cystectomy was performed in 18 patients during this time frame. The mpMRI staging was correlated with the final pathologic staging. RESULTS: Analysis of our results revealed a highly significant (P<-0.001) mpMRI accuracy of 88% for muscle invasion, 96% accuracy for perivesical fat invasion and 74% accuracy of MRI detection of lymph node metastases. CONCLUSIONS: A larger prospective study is however, required for determining the exact role of MRI in the staging of bladder carcinoma. Source of Funding: No Sponsor © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e72-e73 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Muhammad Abdus Salam* More articles by this author Sharmin Akther More articles by this author Faisal Islam More articles by this author Pranashish Saha More articles by this author Ibrahim Kaiser More articles by this author Ghazi Shahinul Islam More articles by this author Shahed Hossain More articles by this author SM Bakhtiar More articles by this author Expand All Advertisement PDF downloadLoading ...