Diagnostic performance of the vesical imaging-reporting and data system for detecting muscle-invasive bladder cancer in real clinical settings: Comparison with diagnostic cystoscopy
Diagnostic performance of the vesical imaging-reporting and data system for detecting muscle-invasive bladder cancer in real clinical settings: Comparison with diagnostic cystoscopy
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DOI：
10.1016/j.urolonc.2021.07.005
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发表时间：
2022-01-29
影响因子：
2.7
通讯作者：
Oya, Mototsugu
中科院分区：
文献类型：
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作者：
Kufukihara, Ryohei;Kikuchi, Eiji;Oya, Mototsugu
目的：在此，我们比较了膀胱成像报告和数据系统（VI-RADS）评分诊断膀胱镜的诊断性能和评估诊断准确性的基础上肿瘤locations.Materials和方法：在112例膀胱癌患者进行多参数磁共振成像和诊断膀胱镜术前检测膀胱癌，61进行了分析。由2名放射科医师（R1和R2）将VI-RADS分为5期。临界值>= 3表示肌层浸润性膀胱癌（MIBC）。由2名泌尿科医生（U1和U2）使用诊断性膀胱镜检查目视评估肌肉浸润（MI）。结果：16例（26.2%）患者经病理确诊为MIBC，其中16例（26.2%）患者经膀胱镜检查确诊为MI。关于MI诊断准确性，R1和R2的VI-RADS评分的敏感性/特异性分别为93.8/88.9%和87.5/86.7%，而U1和U2的诊断性膀胱镜检查的敏感性/特异性分别为56.3/68.9%和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、穹隆、后壁和前壁的肿瘤。结论：VI-RADS对位于膀胱颈、膀胱三角、膀胱穹隆、膀胱后壁和前壁的MI有上级诊断价值，且对位于膀胱侧壁或输尿管口的MI有较高的诊断价值。然而，VI-RADS在检测位于侧壁或输尿管口的肿瘤的MI方面不如膀胱镜。因此，建议结合诊断工具对这些肿瘤进行准确分期。(C)2021爱思唯尔公司All rights reserved.
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. (C) 2021 Elsevier Inc. All rights reserved.