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Abstract

Background:

Multiparametric magnetic resonance imaging (mp-MRI) has emerged as a promising technique for evaluating the extent of bladder cancer, particularly for assessing muscle invasion. The Vesical Imaging Reporting and Data System (VI-RADS), introduced in 2018, aims to standardize the interpretation of mp-MRI for staging bladder tumors. This study investigates the diagnostic accuracy of VI-RADS in predicting detrusor muscle involvement preoperatively.

Objective:

To assess the diagnostic performance of VI-RADS scoring in determining muscle invasion in bladder cancer patients prior to surgical intervention.

Methods:

This prospective study enrolled 62 patients between June 2021 and April 2023 who presented with bladder masses. Each underwent mp-MRI followed by surgical treatment, including either TURBT or radical cystectomy. Two radiologists independently evaluated images using VI-RADS scoring. The results were compared with final histopathological findings to determine diagnostic accuracy.

Results:

VI-RADS scores of 4 and 5 were observed in 10 (16%) and 19 (30.6%) patients respectively; scores of 3, 2, and 1 were assigned to 3 (4.8%), 25 (40.3%), and 5 (8.0%) patients, respectively. Histopathological evaluation confirmed muscle invasion in 29 patients (46.77%) and non-muscle-invasive disease in 33 (53.22%). The mp-MRI demonstrated a sensitivity of 93.10%, specificity of 93.94%, and an overall accuracy of 93.54% in detecting muscle invasion.

Conclusion:

Mp-MRI interpreted using the VI-RADS system offers more than 90% sensitivity and specificity for detecting muscle invasion in bladder cancer. VI-RADS may serves as a valuable tool for preoperative staging, potentially optimizing treatment planning and reducing unnecessary restaging TURBT.

Keywords

mp-MRI: Multiparametric magnetic resonance imaging VI-RADS: Vesical imaging reporting and data system TURBT: Transurethral resection of bladder tumor MIBC : Muscle invasive bladder cancer NMIBC : Non muscle invasive bladder cancer

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