Diagnostic performance of the vesical imaging-reporting and data system for detecting muscle-invasive bladder cancer in real clinical settings: Comparison with diagnostic cystoscopy

Ryohei Kufukihara, Eiji Kikuchi, Keisuke Shigeta, Koichiro Ogihara, Yuki Arita, Hirotaka Akita, Tatsuya Suzuki, Takayuki Abe, Ryuichi Mizuno, Masahiro Jinzaki, Mototsugu Oya

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)61.e1-61.e8
JournalUrologic Oncology: Seminars and Original Investigations
Volume40
Issue number2
DOIs
Publication statusPublished - 2022 Feb

Keywords

  • Diagnostic cystoscopy
  • Muscle invasion
  • Muscle-invasive bladder cancer
  • Tumor locations
  • VI-RADS

ASJC Scopus subject areas

  • Oncology
  • Urology

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