Multiparametric magnetic resonance imaging for bladder cancer: a comprehensive systematic review of the Vesical Imaging-Reporting and Data System (VI-RADS) performance and potential clinical applications. (August 2021)

• Record Type: Journal Article
• Authors: Séguier, Denis; Puech, Philippe; Kool, Ronald; Dernis, Léa; Gabert, Héléna; Kassouf, Wassim; Villers, Arnauld; Marcq, Gautier
• Is Part Of: Therapeutic advances in urology. Volume 13(2021)
• Publication Date: 2021-08
• Subjects: magnetic resonance imaging -- multimodal therapy -- multiparametric -- neoadjuvant therapy -- urinary bladder neoplasms -- urinary bladder neoplasms/diagnosis -- urinary bladder neoplasms/diagnostic imaging -- staging; Urology -- Periodicals; Urologic Diseases -- therapy -- Periodicals; Genital Diseases, Male -- therapy -- Periodicals; Urologie -- Périodiques; 616.6005
• DOI: 10.1177/17562872211039583
• Languages: English
• ISSNs: 1756-2872

Abstract

Background: The Vesical Imaging-Reporting and Data System (VI-RADS) score is a novel standardized approach to image and report bladder cancer (BC) with multiparametric MRI (mpMRI). Objectives: To describe and evaluate the performance of the VI-RADS score using mpMRI and assess its potential clinical applications and limitations. Methods: A systematic review was conducted using the MEDLINE and EMBASE electronic bibliographic databases between June 2020 and December 2020. All reports deemed relevant to describe the VI-RADS score and assess its performance and applications were retrieved. Results presentation stands as narrative, purely descriptive synthesis based on aggregate studies data. Results: A total of 20 relevant studies were retrieved: three meta-analyses, five prospective studies, and twelve retrospective studies. The retrospective studies covered 1676 patients, while the prospective studies included a total number of 468 patients. Pooled sensitivity, specificity to differentiate muscle-invasive from non-muscle-invasive bladder cancer, ranged from 74.1% to 97.3%, and 77% to 100%, respectively. The chosen VI-RADS score thresholds for this discrimination varied across studies. The interreader agreement ranged from 0.73 to 0.95. Currently, the potential clinical applications of VI-RADS consist of initial BC risk stratification, assessment of neoadjuvant therapies response, and bladder sparing approaches, although further validation is required. Conclusions: The VI-RADS score helps to discriminate muscle invasive from non-muscle invasive BC with good performance and reproducibility. A simple algorithm based on four basic questions may enhance its popularization. Further studies are required to validate the clinical applications.