Carando Roberto, Afferi Luca, Marra Giancarlo, Krajewski Wojciech, Pagliarulo Vincenzo, Abufaraj Mohammad, Xylinas Evanguelos, Cathelineau Xavier, Sanchez-Salas Rafael, Moschini Marco
Department of Urology, Clinica Luganese Moncucco, Lugano, Switzerland.
Clinica S. Anna, Swiss Medical Group, Sorengo, Switzerland.
Arab J Urol. 2020 Mar 1;18(2):67-71. doi: 10.1080/2090598X.2020.1733818.
To evaluate the role of the Vesical Imaging-Reporting and Data System (VI-RADS) score in the diagnostic pathway of bladder cancer.
A systemic search of the contemporary literature was performed in December 2019 using the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica dataBASE (EMBASE), and Web of Science databases focussing on all available articles on VI-RADS.
Overall, six of 15 articles were included. All the available articles evaluated the ability of radiologists to use the VI-RADS score for discriminating non-muscle-invasive bladder cancer (NMIBC) from muscle-invasive bladder cancer (MIBC). Considering a cut-off VI-RADS score of >2, the sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were 78-91.9%, 85-91%.1, 69-78%, and 88-97.1%, respectively. Considering a VI-RADS score cut-off of >3, the sensitivity, specificity, PPV and NPV were 77-94.6%, 43.9-96.5%, 51.6-86%, and 63.7-93%, respectively. Good interobserver agreement was demonstrated in the evaluated studies with a κ score of 0.73-0.89. Only one study evaluated the utility of VI-RADS in determining the presence of MIBC in patients treated with transurethral resection of the bladder diagnosed with high-grade T1 before the second transurethral resection using a VI-RADS score cut-off of >2; the sensitivity, specificity, PPV and NPV were 85%, 93.6%, 74.5%, and 96.6%, respectively.
The VI-RADS score, using multiparametric magnetic resonance imaging, showed excellent results in discriminating MIBC from NMIBC. Preliminary results have been reported for its use in patients with high-grade T1 bladder cancer. These results need to be validated in high-quality real-world settings.
DCE: dynamic contrast enhancement; DWI: diffusion-weighted imaging; (N)MIBC: (non-)muscle-invasive bladder cancer; mpMRI: multiparametric MRI; TURBT: transurethral resection of bladder tumour; (N)(P)PV: (negative) (positive) predictive value; SC: structural category; T2W: T2-weighted; VI-RADS: vesical imaging-reporting and data system.
评估膀胱影像报告和数据系统（VI-RADS）评分在膀胱癌诊断流程中的作用。
2019年12月使用医学文献分析和检索系统在线数据库（MEDLINE）、医学文摘数据库（EMBASE）和科学网数据库对当代文献进行系统检索，重点关注所有关于VI-RADS的可用文章。
总体而言，纳入了15篇文章中的6篇。所有可用文章均评估了放射科医生使用VI-RADS评分区分非肌层浸润性膀胱癌（NMIBC）和肌层浸润性膀胱癌（MIBC）的能力。将VI-RADS评分临界值设为>2时，敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为78%-91.9%、85%-91.1%、69%-78%和88%-97.1%。将VI-RADS评分临界值设为>3时，敏感性、特异性、PPV和NPV分别为77%-94.6%、43.9%-96.5%、51.6%-86%和63.7%-93%。在评估研究中观察者间一致性良好，κ值为0.73-0.89。只有一项研究评估了VI-RADS在确定经尿道膀胱肿瘤切除术后接受第二次经尿道膀胱肿瘤切除术的患者中MIBC存在情况的效用，这些患者在首次经尿道膀胱肿瘤切除术前被诊断为高级别T1期，使用的VI-RADS评分临界值为>2；敏感性、特异性、PPV和NPV分别为85%、93.6%、74.5%和96.6%。
使用多参数磁共振成像的VI-RADS评分在区分MIBC和NMIBC方面显示出优异结果。已报道其在高级别T1期膀胱癌患者中的初步应用结果。这些结果需要在高质量的真实世界环境中得到验证。
DCE：动态对比增强；DWI：扩散加权成像；（N）MIBC：（非）肌层浸润性膀胱癌；mpMRI：多参数磁共振成像；TURBT：经尿道膀胱肿瘤切除术；（N）（P）PV：（阴性）（阳性）预测值；SC：结构类别；T2W：T2加权；VI-RADS：膀胱影像报告和数据系统
