Vesical Imaging Reporting and Data System (VI-RADS): Are the individual MRI sequences equivalent in diagnostic performance of high grade NMIBC and MIBC?. Issue 142 (September 2021)

• Record Type: Journal Article
• Authors: Gmeiner, Jasmin; Garstka, Nathalie; Helbich, Thomas H.; Shariat, Shahrokh F.; Baltzer, Pascal A.
• Is Part Of: European journal of radiology. Issue 142(2021)
• Publication Date: 2021-09
• Subjects: Urinary bladder neoplasms -- Multiparametric magnetic resonance imaging -- Vesical imaging and reporting system; AUC Area Under the Curve -- BC Bladder Cancer -- CE Contrast enhanced -- DCE Dynamic contrast enhanced -- DWI Diffusion weighted image -- IRB Insitutional Review Board -- mp multiparametric -- MRI Magnetic Resonance Imaging -- R1 Reader 1 -- R2 Reader 2 -- T Tesla -- T2w T2 weighted -- TUR-BT Transurethral resection of bladder tumor -- VI-RADS Vesical Imaging and Reporting Data System; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.109829
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: VI-RADS provides high diagnostic accuracy to diagnose high grade and muscle invasive bladder cancer. The T2 weighted sequence appears to have the most robust accuracy when it comes to the definition of a high grade or muscle invasive bladder carcinoma. Considering preparation, efforts and costs, contrast enhanced MRI may be omitted without sacrificing diagnostic accuracy. Abstract: Purpose: To investigate the diagnostic performance of the overall Vesical Imaging Reporting and Data System (VI-RADS) score and its individual magnetic resonance imaging (MRI) parameters in assessing grade and muscle invasiveness of bladder cancer (BC). Methods: This IRB-approved retrospective, single-center, cross-sectional study included patients with BC wo underwent 3 Tesla preoperative multiparametric (mp)-MRI including T2-weighted (T2w), diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) sequences. An independent evaluation according to VI-RADS was performed by two radiologists in separate sessions, blinded to histological findings. Results: The mean age of 59 included patients was 68.2 (±13.6 standard deviation) years. Among bladder cancer patients, 26 (51%) were identified as high grade and 14 (27.5%) as muscle invasive urothelial carcinomas in histological sections. The area under the curve (AUC) for the overall VI-RADS score to predict muscle invasion was 0.986 (R1) and 0.992 (R2). The AUC to diagnose high grade bladder cancer was 0.908 (R1) and 0.905 (R2). There was no significance difference between the AUC of single parameters (T2w, DWI and DCE) compared to the total VI-RADS score (P > 0.05, respectively). Upon multivariate logistic regression, only the T2w VI-RADS score contributed independently to the diagnosis of high grade and muscle invasive bladder cancer (P = 0.001 (R1) and P = 0.0022 (R2) for high grade cancer; P = 0.0007 (R1) and P = 0.0019 (R2) for muscle invasiveness). Conclusion: VI-RADS provides high diagnostic accuracy to diagnose high grade and muscle invasive BC. Our results suggest, that mp-MRI parameters provide overlapping information and for sake of clinical simplicity, a biparametric, contrast free image acquisition may be approached without sacrificing diagnostic accuracy.