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Inicio Actas Urológicas Españolas (English Edition) Diagnostic validity of the vesical imaging-reporting and data system (VI-RADS): ...
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Vol. 47. Issue 10.
Pages 638-644 (December 2023)
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Vol. 47. Issue 10.
Pages 638-644 (December 2023)
Original article
Diagnostic validity of the vesical imaging-reporting and data system (VI-RADS): a real-world study
Validez diagnóstica del sistema vesical imaging-reporting and data system (VI-RADS): estudio con datos de la vida real
O. Kazana,
Corresponding author
ozgurkazan@hotmail.com

Corresponding author.
, N. Gunduzb, B. Bakirc, A. Iplikcia, M. Culpana, B. Ersoyc, A. Yildirima
a Servicio de Urología, Universidad Medeniyet de Estambul, Escuela de Medicina, Estambul, Turkey
b Servicio de Radiología, Universidad Medeniyet de Estambul, Escuela de Medicina, Estambul, Turkey
c Servicio de Radiología, Universidad de Estambul, Escuela de Medicina de Estambul, Estambul, Turkey
Article information
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Figures (2)
Tables (3)
Table 1. Patient features.
Table 2. VI-RADS on predicting muscle invasive bladder cancer.
Table 3. Interobserver agreement between radiologists.
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Additional material (1)
Abstract
Objectives

Preoperative Vesical Imaging-Reporting and Data System (VI-RADS) becomes widespread. We aimed to validate the diagnostic performance of VI-RADS in differentiating muscle-invasive (MIBC) from non-muscle-invasive bladder cancer (NMIBC) in a real-world setting.

Methods

Between December 2019 and February 2022 suspected primary bladder cancer patients were reviewed. Those with proper multiparametric MRI (mpMRI) protocol for VI-RADS before any invasive treatment were included. Patients were locally staged according to transurethral resection, second resection, or radical cystectomy as the reference standard. Two experienced genitourinary radiologists who were blinded to clinical and histopathological data evaluated the mpMRI images independently and retrospectively. The diagnostic performance of both radiologists and the interreader agreement were analyzed.

Results

Among 96 patients, 20 (20.8%) had MIBC, and 76 (79.2%) had NMIBC. Both radiologists had great diagnostic performance in diagnosing MIBC. The first radiologist had an area under curve (AUC) of 0.83 and 0.84, the sensitivity of 85% and 80%, and the specificity of 80.3% and 88.2% for VI-RADS ≥3 and ≥4, respectively. The second radiologist had an area under curve (AUC) of 0.79 and 0.77, the sensitivity of 85% and 65%, and the specificity of 73.7% and 89.5% for VI-RADS ≥3 and ≥4, respectively. The overall VI-RADS score agreement between the two radiologists was moderate (κ = 0.45).

Conclusion

VI-RADS is diagnostically powerful in differentiating MIBC from NMBIC prior to transurethral resection. The agreement between radiologists is moderate.

Keywords:
Bladder cancer
Muscle-invasive bladder cancer
Multiparametric magnetic resonance imaging
VI-RADS
Resumen
Objetivo

Recientemente se ha generalizado el uso del sistema Vesical Imaging-Reporting and Data (VI-RADS). Nos propusimos validar el rendimiento diagnóstico del VI-RADS para diferenciar el cáncer vesical músculo-invasor (CVMI) del cáncer vesical no músculo-invasor (CVNMI) en un contexto de práctica clínica real.

Métodos

Entre diciembre de 2019 y febrero de 2022 se revisaron los pacientes con sospecha de cáncer vesical primario. Se incluyeron los pacientes con un protocolo de RM multiparamétrica (RMmp) adecuado para VI-RADS antes de cualquier tratamiento invasivo. La estadificación local de los pacientes se realizó mediante resección transuretral, segunda resección o cistectomía radical como tratamiento de referencia. Dos expertos en radiología genitourinaria cegados a los datos clínicos e histopatológicos evaluaron las imágenes de RMmp de forma independiente y retrospectiva. Se analizó el rendimiento diagnóstico de ambos radiólogos y la concordancia entre lectores.

Resultados

De los 96 pacientes, 20 (20,8%) tenían CVMI y 76 (79,2%) tenían CVNMI. La exactitud diagnostica del CVMI fue alta para los dos radiólogos. El primer radiólogo tenía un área bajo la curva (ABC) de 0,83 y 0,84, una sensibilidad de 85% y 80% y una especificidad de 80,3% y 88,2% para VI-RADS ≥3 y ≥4, respectivamente. El segundo radiólogo tenía un área bajo la curva (ABC) de 0,79 y 0,77, una sensibilidad del 85 % y el 65 % y una especificidad del 73,7 % y el 89,5 % para VI-RADS ≥3 y ≥4, respectivamente. La concordancia de la puntuación VI-RADS global entre los dos radiólogos fue moderada (κ = 0,45).

Conclusión

El sistema VI-RADS tiene un alto poder diagnóstico para diferenciar el CVMI de CVNMI antes de la resección transuretral. La concordancia entre los radiólogos es moderada.

Palabras clave:
Cáncer de vejiga
Cáncer de vejiga músculo-invasor
Resonancia magnética multiparamétrica
VI-RADS

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