In the present study, we tested the ability of VI-RADS score to discern MIBC from NMIBC. We found that the VI- RADS score has high accuracy. Thus, its routine use may be appealing. Background: The Vesical Imaging Reporting and Data System (VI-RADS) was recently introduced as a stan- dardized approach to reporting multiparametric magnetic resonance imaging (mpMRI) for bladder cancer. We aimed to prospectively analyze its routine use and its diagnostic performance in discriminating nonemuscle- invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Patients and Methods: A total of 38 patients with diagnosis of suspect bladder cancer at cystoscopy underwent bladder mpMRI before transurethral resection of the bladder (TURB). Bladder tumors were categorized according to the VI-RADS. After TURB, the VI- RADS score was compared with histological report for each lesion separately. Receiving operating characteristic and decision curve analyses were used to assess its accuracy and clinical utility. Results: A total of 68 lesions were included, of which 7 (10.3%) were MIBC. The pooled accuracy was 90.0% (95% confidence interval [CI], 75.4%- 98.7%). The best threshold was estimated as VI-RADS 4, showing a sensitivity of 85.7% (95% CI, 57.1%-100%) and a specificity of 86.9% (95% CI, 78.7%-95.1%). Decision curve analyses showed that using VI-RADS !4 improved the net benefit compared with any default strategy for threshold probabilities of MIBC up to w40%, which is a reasonable clinical threshold for planning further treatments. Conclusions: Our prospective study shows that the use of VI-RADS as a standardized reporting method is appealing and could be considered in clinical practice owing to its high accuracy.

Could Bladder Multiparametric MRI Be Introduced in Routine Clinical Practice? Role of the New VI-RADS Score: Results From a Prospective Study

Marchioni, Michele;Primiceri, Giulia;Delli Pizzi, Andrea;Mincuzzi, Erica;Castellucci, Roberto;Di Nicola, Marta;Schips, Luigi
2020

Abstract

In the present study, we tested the ability of VI-RADS score to discern MIBC from NMIBC. We found that the VI- RADS score has high accuracy. Thus, its routine use may be appealing. Background: The Vesical Imaging Reporting and Data System (VI-RADS) was recently introduced as a stan- dardized approach to reporting multiparametric magnetic resonance imaging (mpMRI) for bladder cancer. We aimed to prospectively analyze its routine use and its diagnostic performance in discriminating nonemuscle- invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Patients and Methods: A total of 38 patients with diagnosis of suspect bladder cancer at cystoscopy underwent bladder mpMRI before transurethral resection of the bladder (TURB). Bladder tumors were categorized according to the VI-RADS. After TURB, the VI- RADS score was compared with histological report for each lesion separately. Receiving operating characteristic and decision curve analyses were used to assess its accuracy and clinical utility. Results: A total of 68 lesions were included, of which 7 (10.3%) were MIBC. The pooled accuracy was 90.0% (95% confidence interval [CI], 75.4%- 98.7%). The best threshold was estimated as VI-RADS 4, showing a sensitivity of 85.7% (95% CI, 57.1%-100%) and a specificity of 86.9% (95% CI, 78.7%-95.1%). Decision curve analyses showed that using VI-RADS !4 improved the net benefit compared with any default strategy for threshold probabilities of MIBC up to w40%, which is a reasonable clinical threshold for planning further treatments. Conclusions: Our prospective study shows that the use of VI-RADS as a standardized reporting method is appealing and could be considered in clinical practice owing to its high accuracy.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11564/718316
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