Detection of Muscle-Invasive Bladder Cancer on Biparametric MRI Using Vesical Imaging-Reporting and Data System and Apparent Diffusion Coefficient Values (VI-RADS/ADC)
Detection of Muscle-Invasive Bladder Cancer on Biparametric MRI Using Vesical Imaging-Reporting and Data System and Apparent Diffusion Coefficient Values (VI-RADS/ADC)
复制标题
DOI：
10.3233/blc-190267
复制
发表时间：
2020-01-01
期刊：
影响因子：
1.1
通讯作者：
Koga, Fumitaka
中科院分区：
文献类型：
--
作者：
Sakamoto, Kazumasa;Ito, Masaya;Koga, Fumitaka
背景：膀胱成像报告和数据系统 (VI-RADS) 被提出来检测肌层浸润性膀胱癌 (MIBC)。 目的： 评估 VI-RADS 的性能以及弥散加权磁共振成像 (MRI) 测量的表观弥散系数 (ADC) 值在检测 MIBC 中的附加值。 方法： 总共 176 名患者接受 MRI（多参数 97 例 [55%]，双参数 79 例） [45%])在经尿道膀胱肿瘤电切术前对原发性膀胱癌进行了回顾性鉴定。 MRI 结果根据 VI-RADS 进行评分。计算标准化肿瘤ADC（sT-ADC：肿瘤ADC/臀大肌ADC）并用于解释不同MRI方案之间的不兼容性。使用 ROC 曲线的 AUC 评估 VI-RADS、sT-ADC 及其组合检测 MIBC 的准确性。结果：46 例患者 (26%) 经病理证实 MIBC。 VI-RADS 检测 MIBC 的 AUC 为 0.86。当 VI-RADS 的截止值设置为 >= 3 和 >= 4 时，敏感性/特异性分别为 78%/70% 和 63%/96%。将 sT-ADC（= 3 或 sT-ADC = 4 且 sT-ADC = 4）降低 80%。结论：将 ADC 值纳入 VI-RADS 提高了原发性膀胱癌患者检测 MIBC 的准确性。
BACKGROUND: Vesical Imaging-Reporting And Data System (VI-RADS) was proposed to detect muscle-invasive bladder cancer (MIBC).OBJECTIVE: To evaluate the performance of VI-RADS and additional value of apparent diffusion coefficient (ADC) values measured on diffusion-weighted magnetic resonance imaging (MRI) for detecting MIBC.METHODS: A total of 176 patients undergoing MRI (multiparametric in 97 [55%] and biparametric in 79 [45%]) before transurethral resection of bladder tumor for primary bladder cancer were retrospectively identified. MRI findings were scored according to VI-RADS. The standardized tumorADC(sT-ADC: tumor ADC/gluteus maximus ADC) was calculated and used to account for the incompatibility among different MRI protocols. The accuracy of VI-RADS, sT-ADC and their combination to detect MIBC was assessed using the AUC of the ROC curve.RESULTS: MIBC was pathologically confirmed in 46 patients (26%). AUC of VI-RADS to detect MIBC was 0.86. When cut-off of VI-RADSwas set at >= 3 and >= 4, sensitivity/specificity were 78%/70% and 63%/96%, respectively. Alower sT-ADC (= 3 or sT-ADC = 4 and sT-ADC = 4 by 80%.CONCLUSIONS: Incorporation of ADC values into VI-RADS improves accuracy to detect MIBC in primary bladder cancer patients.