Details

Autor(en) / Beteiligte

• Bicchetti, Marco
• Simone, Giuseppe
• Giannarini, Gianluca
• Girometti, Rossano
• Briganti, Alberto
• Brunocilla, Eugenio
• Cardone, Gianpiero
• De Cobelli, Francesco
• Gaudiano, Caterina
• Del Giudice, Francesco
• Flammia, Simone
• Leonardo, Costantino
• Pecoraro, Martina
• Schiavina, Riccardo
• Catalano, Carlo
• Panebianco, Valeria

Titel

A novel pathway to detect muscle-invasive bladder cancer based on integrated clinical features and VI-RADS score on MRI: results of a prospective multicenter study

Ist Teil von

• Radiologia medica, 2022-08, Vol.127 (8), p.881-890

Ort / Verlag

Milan: Springer Milan

Erscheinungsjahr

2022

Quelle

Springer Online Journals【Remote access available】

Beschreibungen/Notizen

• Purpose To determine the clinical, pathological, and radiological features, including the Vesical Imaging-Reporting and Data System (VI-RADS) score, independently correlating with muscle-invasive bladder cancer (BCa), in a multicentric national setting. Method and Materials Patients with BCa suspicion were offered magnetic resonance imaging (MRI) before trans-urethral resection of bladder tumor (TURBT). According to VI-RADS, a cutoff of ≥ 3 or ≥ 4 was assumed to define muscle-invasive bladder cancer (MIBC). Trans-urethral resection of the tumor (TURBT) and/or cystectomy reports were compared with preoperative VI-RADS scores to assess accuracy of MRI for discriminating between non-muscle-invasive versus MIBC. Performance was assessed by ROC curve analysis. Two univariable and multivariable logistic regression models were implemented including clinical, pathological, radiological data, and VI-RADS categories to determine the variables with an independent effect on MIBC. Results A final cohort of 139 patients was enrolled (median age 70 [IQR: 64, 76.5]). MRI showed sensitivity, specificity, PPV, NPV, and accuracy for MIBC diagnosis ranging from 83–93%, 80–92%, 67–81%, 93–96%, and 84–89% for the more experienced readers. The area under the curve (AUC) was 0.95 (0.91–0.99). In the multivariable logistic regression model, the VI-RADS score, using both a cutoff of 3 and 4 ( P  < .0001), hematuria ( P  = .007), tumor size ( P  = .013), and concomitant hydronephrosis ( P  = .027) were the variables correlating with a bladder cancer staged as ≥ T2. The inter-reader agreement was substantial ( k  = 0.814). Conclusions VI-RADS assessment scoring proved to be an independent predictor of muscle-invasiveness, which might implicate a shift toward a more aggressive selection approach of patients’ at high risk of MIBC, according to a novel proposed predictive pathway.