Vesical Imaging–Reporting and Data System for Multiparametric MRI to Predict the Presence of Muscle Invasion for Bladder Cancer. Issue 4 (27th March 2020)

• Record Type: Journal Article
• Authors: Hong, Seung Baek; Lee, Nam Kyung; Kim, Suk; Son, Il Wan; Ha, Hong Koo; Ku, Ja Yoon; Kim, Kyung Hwan; Park, Won Young
• Is Part Of: Journal of magnetic resonance imaging. Volume 52:Issue 4(2020)
• Page Start: 1249
• Page End: 1256
• Publication Date: 2020-03-27
• Subjects: urinary bladder -- magnetic resonance imaging -- neoplasm -- tumor staging -- diagnosis; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.27141
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: The Vesical Imaging–Reporting and Data System (VI‐RADS) is a newly developed system of bladder cancer staging with multiparametric MRI (mpMRI), which can be used to predict the presence of muscle invasion for bladder cancer. Purpose: To evaluate the accuracy of three mpMRI series (T2 WI, diffusion‐weighted imaging [DWI], and dynamic contrast‐enhanced image [DCEI]) and VI‐RADS for diagnosing the muscle invasive bladder cancer (MIBC). Study Type: Retrospective. Population: In all, 66 pathologically proven bladder cancers in 32 patients. Field Strength/Sequence: Before the diagnostic MRI with an intramuscular antispasmodic agent, optimal bladder distension was confirmed. 3.0T MRI with T2 WI, DWI, and DCEI. Assessment: Three reviewers independently assessed and scored the bladder cancers in T2 WI, DWI, and DCEI using a five‐point score system. Based on the scores in the three sequences, reviewers scored each bladder cancer with reference to VI‐RADS categories. We evaluated the diagnostic performance of each of three mpMRI sequences and the final VI‐RADS categorization for diagnosing MIBC. Statistical Tests: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the curve (AUC) of each of three sequences separately and VI‐RADS categorization for diagnosing the MIBC. Results: The diagnostic performances of each of the three mpMRI series and VI‐RADS for diagnosing MIBC were excellent. Especially using the optimal cutoff score >3 for predicting MIBC on DWI, DCEI, and VI‐RADS, the sensitivity, specificity, PPV, NPV, and AUC values were 90% (95% confidence interval [CI]: 0.56, 1.00), 100% (95% CI: 0.94, 1.00), 100% (95% CI: 0.66. 1.00), 98.3% (95% CI: 0.91, 1.00), and 0.95, respectively. Data Conclusion: mpMRI based on VI‐RADS can stratify patients with bladder cancer according to the presence of muscle invasion. Level of Evidence: 3. Technical Efficacy Stage: 2. J. Magn. Reson. Imaging 2020;52:1249–1256.