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

• Published in: Cancer imaging Vol. 20; no. 1; p. 26
• Main Authors: Wang, Ziyong, Shang, Yunyun, Luan, Ting, Duan, Yi, Wang, Jiansong, Wang, Haifeng, Hao, Jingang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06-04-2020; BioMed Central; BMC
• Subjects: Bladder; Bladder cancer; Cancer; Cancer patients; Chemotherapy; Decision making; Diagnosis; Diagnostic imaging; Diagnostic systems; Immunotherapy; Infiltration; Magnetic resonance imaging; Males; Medical imaging; Medical research; Multiparameter magnetic resonance imaging; Muscles; Patients; Reporting and data system; Scoring; Staging; Statistical analysis; Surgery; Tumors; Urology; Taiwan; Multiparameter magnetic resonance imaging; Scoring; Reporting and data system; Staging; Bladder cancer
• ISSN: 1470-7330; 1740-5025; 1470-7330
• DOI: 10.1186/s40644-020-00304-3

The 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.
To verify the accuracy of the VI-RADS scoring system in predicting muscle-invasive bladder cancer and to explore its value in clinical application.
A 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.
A 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.
The 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.