Polish Center of Advanced Urology, Department of Urology, St. Anne's Hospital EMC, Piaseczno, Poland.
Department of Diagnostic Imaging - Quadia, Piaseczno, Poland.
World J Urol. 2024 Jul 24;42(1):438. doi: 10.1007/s00345-024-05101-2.
Our purpose was to evaluate the prognostic value of Vesical Imaging Reporting and Data System (VI-RADS) in bladder cancer (BCa) staging and predicting recurrence or progression.
We retrospectively analyzed the prospectively collected data from 96 patients with bladder tumors who underwent VI-RADS-based multiparametric magnetic resonance imaging (mpMRI) before endourological treatment from April 2021 to December 2022. Diagnostic performance was evaluated by comparing mpMRI reports with final pathology, using logistic regression for muscle-invasive bladder cancer (MIBC) predictors. Follow-up until May 2023 included Kaplan-Meier and Cox regression analysis to assess VI-RADS predictive roles for recurrence-free survival (RFS) and progression-free survival (PFS).
A total of 96 patients (19.8% women, 80.2% men; median age 68.0 years) were included, with 71% having primary tumors and 29% recurrent BCa. Multiparametric MRI exhibited high sensitivity (92%) and specificity (79%) in predicting MIBC, showing no significant differences between primary and recurrent cancers (AUC: 0.96 vs. 0.92, P = .565). VI-RADS emerged as a key predictor for MIBC in both univariate (OR: 40.3, P < .001) and multivariate (OR: 54.6, P < .001) analyses. Primary tumors with VI-RADS ≥ 3 demonstrated significantly shorter RFS (P = .02) and PFS (P = .04).
In conclusion, mpMRI with VI-RADS has a high diagnostic value in predicting MIBC in both primary and recurrent BCa. A VI-RADS threshold ≥ 3 is a strong predictor for MIBC, and in primary tumors predicts early recurrence and progression.
我们旨在评估膀胱成像报告和数据系统（VI-RADS）在膀胱癌（BCa）分期和预测复发或进展方面的预后价值。
我们回顾性分析了 2021 年 4 月至 2022 年 12 月期间 96 例接受基于 VI-RADS 的多参数磁共振成像（mpMRI）的膀胱肿瘤患者的前瞻性收集数据。使用逻辑回归分析肌层浸润性膀胱癌（MIBC）预测因子，比较 mpMRI 报告与最终病理结果，评估诊断性能。随访至 2023 年 5 月，包括 Kaplan-Meier 和 Cox 回归分析，以评估 VI-RADS 对无复发生存率（RFS）和无进展生存率（PFS）的预测作用。
共纳入 96 例患者（19.8%为女性，80.2%为男性；中位年龄 68.0 岁），其中 71%为原发性肿瘤，29%为复发性 BCa。多参数 MRI 对 MIBC 的预测具有较高的敏感性（92%）和特异性（79%），原发性和复发性癌症之间无显著差异（AUC：0.96 对 0.92，P = .565）。VI-RADS 是单因素（OR：40.3，P < .001）和多因素（OR：54.6，P < .001）分析中 MIBC 的关键预测因子。VI-RADS≥3 的原发性肿瘤患者 RFS（P = .02）和 PFS（P = .04）显著缩短。
总之，VI-RADS 联合 mpMRI 对原发性和复发性 BCa 中 MIBC 具有较高的诊断价值。VI-RADS 阈值≥3 是 MIBC 的强预测因子，在原发性肿瘤中预测早期复发和进展。
