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 ...