Purpose

We herein compared the diagnostic performance of Vesical Imaging-Reporting and Data System (VI-RADS) scoring with diagnostic cystoscopy and evaluated diagnostic accuracies based on tumor locations.

Materials and Methods

Among 112 bladder cancer patients who underwent multiparametric magnetic resonance imaging and diagnostic cystoscopy preoperatively to detect bladder cancer, 61 were analyzed. VI-RADS was categorized into 5 stages by 2 radiologists (R1 and R2). Cut-off values ≥3 indicated muscle-invasive bladder cancer (MIBC). Muscle invasion (MI) was visually evaluated using diagnostic cystoscopy by 2 urologists (U1 and U2). The sensitivity and specificity of VI-RADS scores and diagnostic cystoscopy for diagnosing MI were compared.

Results

16 patients (26.2%) were pathologically diagnosed with MIBC. Regarding MI diagnostic accuracy, the sensitivity/specificity of VI-RADS scores were 93.8/88.9% by R1 and 87.5/86.7% by R2, while those of diagnostic cystoscopy were 56.3/68.9% by U1 and 68.8/84.4% by U2. Therefore, the diagnostic accuracy of VI-RADS was significantly higher than that of cystoscopy, particularly for tumors located on the bladder neck, trigone, dome, and posterior and anterior walls. Over- and under-diagnosis rates were higher with VI-RADS than with diagnostic cystoscopy (25.9% vs. 14.8%) for tumors located on the lateral wall or ureteral orifice.

Conclusion

VI-RADS had superior diagnostic performance for detecting MI, especially in tumors located at the bladder neck/trigone/dome/posterior and anterior wall. However, VI-RADS was inferior to cystoscopy in terms of MI detection for tumors located on the lateral wall or ureteral orifice. Therefore, a combination of diagnostic tools is recommended for the accurate staging of these tumors.

中文翻译：

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膀胱成像报告和数据系统在真实临床环境中检测肌肉浸润性膀胱癌的诊断性能：与诊断性膀胱镜检查的比较

目的

我们在此比较了膀胱成像报告和数据系统 (VI-RADS) 评分与诊断性膀胱镜检查的诊断性能，并根据肿瘤位置评估了诊断准确性。

材料和方法

在术前接受多参数磁共振成像和诊断性膀胱镜检查以检测膀胱癌的 112 名膀胱癌患者中，对 61 名进行了分析。VI-RADS 被 2 位放射科医师（R1 和 R2）分为 5 个阶段。截断值≥3 表示肌肉浸润性膀胱癌 (MIBC)。2 位泌尿科医师（U1 和 U2）使用诊断性膀胱镜检查对肌肉侵犯 (MI) 进行了视觉评估。比较了 VI-RADS 评分和诊断性膀胱镜检查诊断 MI 的敏感性和特异性。

结果

16例（26.2%）病理诊断为MIBC。在 MI 诊断准确性方面，VI-RADS 评分的敏感性/特异性为 R1 的 93.8/88.9% 和 R2 的 87.5/86.7%，而诊断性膀胱镜检查的敏感性/特异性分别为 U1 的 56.3/68.9% 和 U2 的 68.8/84.4%。因此，VI-RADS的诊断准确性明显高于膀胱镜检查，尤其是对位于膀胱颈、三角区、圆顶以及前后壁的肿瘤。对于位于侧壁或输尿管口的肿瘤，VI-RADS 的过度诊断率和诊断不足率高于诊断性膀胱镜检查（25.9% 对 14.8%）。

结论

VI-RADS 在检测 MI 方面具有卓越的诊断性能，尤其是在位于膀胱颈/三角区/圆顶/后壁和前壁的肿瘤中。然而，VI-RADS 在对位于侧壁或输尿管口的肿瘤的 MI 检测方面不如膀胱镜检查。因此，建议结合使用诊断工具对这些肿瘤进行准确分期。