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; Basilico, Raffaella; Berardinelli, Francesco; Mincuzzi, Erica; Castellucci, Roberto; Sessa, Barbara; Di Nicola, Marta; Schips, Luigi

doi:10.1016/j.clgc.2020.03.002

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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.

Titolo:	Could Bladder Multiparametric MRI Be Introduced in Routine Clinical Practice? Role of the New VI-RADS Score: Results From a Prospective Study
Autori:	MARCHIONI, MICHELE PRIMICERI, GIULIA DELLI PIZZI, ANDREA Basilico, Raffaella Berardinelli, Francesco MINCUZZI, ERICA CASTELLUCCI, ROBERTO Sessa, Barbara DI NICOLA, MARTA SCHIPS, LUIGI mostra contributor esterni nascondi contributor esterni
Data di pubblicazione:	2020
Rivista:	CLINICAL GENITOURINARY CANCER
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.
Handle:	http://hdl.handle.net/11564/718316
Appare nelle tipologie:	1.1 Articolo in rivista

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