The Value Of VI-RADS Score In Diagnosis Of Muscle Invasive Bladder Cancer

ObjectiveTo investigate the diagnostic value of Vesical Imaging-Reporting and Data System(VI-RADS)score for muscle invasive bladder cancer(BC),and to provide more reference for the clinical application of VI-RADS.Method59 bladder cancer patients(a total of 60 lesions)were admitted to Chuzhou Hospital of Anhui Medical University from May 2018 to July 2022,all of which were urothelial carcinoma.Among these,48 were male and 11 were female,aged 24 to 94 years and median age 69 years.Inclusion criteria were:(1)complete preoperative mp-MRI image data;(2)BC diagnosis after surgical treatment and postoperative pathological examination.Exclusion criteria:(1)mp-MRI image quality was poor and scoring could not be completed;(2)The patient also had other malignancies;(3)received radiotherapy,chemotherapy and other treatments before imaging examination.All patients underwent multiparameter magnetic resonance imaging(mp-MRI)examination,including T1WI(T1 weighted imaging),T2WI(T2 weighted imaging),and DWI(diffusion weighted imaging).In this study,two physicians with more than 5years of experience in bladder disease diagnosis independently scored the images of all patients without knowing the clinical pathological results,and scored the multiple lesions respectively.When the evaluation results were different,an agreement was reached through communication and compared with the pathological results.The SPSS25.0 software analysis was used to assess the rater agreement with the kappa values.If P<0.05,the ROC curve was drawn to analyze the diagnostic efficacy of VI-RADS score on muscle invasion of bladder cancer,and the best cut-off value and corresponding sensitivity and specificity were obtained by the maximum Youden index,and the area under the curve was obtained,P <0.05,a statistically significant difference.ResultForty-five of the 59 patients received TURBT,10 total cystectomy and 4 partial cystectomy.Among the 60 lesions,NMIBC was found in 38 patients,and MIBC in22.The VI-RADS scores were 1 point in 6 cases,2 points in 21 eases,3 points in 17 cases,4 points in 12 cases,and 5 points in 4 cases.The VI-RADS scores of the two radiologists were in good agreement(kappa=0.755,P<0.001).The results of ROC curve analysis showed that VI-RADS score could effectively diagnose muscle invasive bladder cancer[area under the curve(AUC)(95% CI)=0.880(0.790-0.971),P<0.001].The optimal cut-off value was 3.5,with a sensitivity of 63.64% and a specificity of94.74%.ConclusionVI-RADS score has good diagnostic efficacy for muscle invasive bladder cancer,which is worthy of clinical promotion.