Liu Shenghua, Xu Feijia, Xu Tianyuan, Yan Yang, Yao Xudong, Tang Guangyu
Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China.
Department of Radiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China.
Transl Androl Urol. 2020 Apr;9(2):445-451. doi: 10.21037/tau.2020.02.16.
To investigate the accuracy of using the Vesical Imaging-Reporting and Data System (VI-RADS) scoring system in prediction preoperative muscle invasion of bladder cancer.
The study retrospectively reviewed consecutive patients with bladder cancer who received multiparametric magnetic resonance imaging (MRI) between January 2017 and June 2019. Clinical and pathological parameters were collected. Bladder tumors were re-evaluated with 5-point VI-RADS scoring system by two experienced radiologists independently. The VI-RADS score was compared with postoperative pathology for each tumor for determining muscle invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each VI-RADS cutoff.
A total of 126 patients were included in analysis, with 82 patients received transurethral resection of bladder tumor (TURBt) while 44 underwent radical cystectomy. Fifty patients were muscle-invasive bladder cancer and 76 were non-muscle invasive tumor confirmed pathologically. VI-RADS score was only predictive factor to muscle invasion in multivariate analysis. Setting VI-RADS score greater than or equal to 4 reached the best sensitivity and specificity of 94.00% and 92.11%, with PPV and NPV value of 88.68% and 95.89%.
VI-RADS score system is a promising and effective modality in determining detrusor muscle invasion of bladder cancer preoperatively.
探讨使用膀胱影像报告和数据系统（VI-RADS）评分系统预测膀胱癌术前肌肉浸润的准确性。
本研究回顾性分析了2017年1月至2019年6月期间接受多参数磁共振成像（MRI）检查的连续性膀胱癌患者。收集临床和病理参数。由两名经验丰富的放射科医生独立使用5分VI-RADS评分系统对膀胱肿瘤进行重新评估。将每个肿瘤的VI-RADS评分与术后病理结果进行比较，以确定肌肉浸润情况。计算每个VI-RADS临界值的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
共有126例患者纳入分析，其中82例行经尿道膀胱肿瘤切除术（TURBt），44例行根治性膀胱切除术。病理证实50例为肌肉浸润性膀胱癌，76例为非肌肉浸润性肿瘤。多因素分析显示，VI-RADS评分是肌肉浸润的唯一预测因素。将VI-RADS评分设定为大于或等于4时，敏感性和特异性最佳，分别为94.00%和92.11%，PPV和NPV值分别为88.68%和95.89%。
VI-RADS评分系统是术前确定膀胱癌逼尿肌浸润的一种有前景且有效的方法。
