Novel utility of Vesical Imaging-Reporting and Data System in multimodal treatment for muscle-invasive bladder cancer
- PMID: 37045982
- DOI: 10.1007/s00330-023-09627-8
Novel utility of Vesical Imaging-Reporting and Data System in multimodal treatment for muscle-invasive bladder cancer
Abstract
Objectives: To examine the clinical significance of the Vesical Imaging-Reporting and Data System (VI-RADS) in predicting outcome of multimodal treatment (MMT) in muscle-invasive bladder cancer (MIBC) patients.
Methods: We reviewed 78 pathologically proven MIBC patients who underwent MMT including transurethral resection and chemoradiotherapy, followed by partial or radical cystectomy. Treatment response was assessed through histologic evaluation of cystectomy specimens. Two radiologists categorized the index lesions of pretherapeutic MRI according to the 5-point VI-RADS score. The associations of VI-RADS score with the therapeutic effect of MMT were analyzed. The diagnostic performance of VI-RADS scores with a cut-off VI-RADS scores ≤ 2 or ≤ 3 for predicting pathologic complete response to MMT (MMT-CR) was evaluated.
Results: MMT-CR was achieved in 2 (100%) of VI-RADS score 1 (n = 2), 16 (84%) of score 2 (n = 19), 12 (86%) of score 3 (n = 14), 7 (64%) of score 4 (n = 11), and 14 (44%) of score 5 (n = 32). VI-RADS score was inversely associated with the incidence of MMT-CR (p = 0.00049). The cut-off VI-RADS score ≤ 2 and ≤ 3 could predict the favorable therapeutic outcome of MMT with high specificity (0.89 with 95% confidence interval [CI]: 0.71-0.98 and 0.82 with 95% CI: 0.62-0.94, respectively) and high positive predictive value (0.86 with 95% CI: 0.64-0.97 and 0.86 with 95% CI: 0.70-0.95, respectively).
Conclusion: VI-RADS score may serve as an imaging marker in MIBC patients for predicting the therapeutic outcome of MMT.
Clinical relevance statement: Muscle-invasive bladder cancer patients with a lower Vesical Imaging-Reporting and Data System score can be a good candidate for bladder-sparing treatment incorporating multimodal treatment.
Key points: • Vesical Imaging-Reporting and Data System (VI-RADS) score was potentially valuable for classifying pathologic tumor response in patients with muscle-invasive bladder cancer. • The likelihood of achieving complete response of multimodal treatment (MMT) decreased with increasing VI-RADS score. • VI-RADS score could serve as an imaging marker that optimizes patient selection for MMT.
Keywords: Chemoradiotherapy; Magnetic resonance imaging; Transurethral resection of bladder; Urinary bladder neoplasms.
© 2023. The Author(s), under exclusive licence to European Society of Radiology.
Similar articles
-
Prospective Assessment of Vesical Imaging Reporting and Data System (VI-RADS) and Its Clinical Impact on the Management of High-risk Non-muscle-invasive Bladder Cancer Patients Candidate for Repeated Transurethral Resection.Eur Urol. 2020 Jan;77(1):101-109. doi: 10.1016/j.eururo.2019.09.029. Epub 2019 Nov 5. Eur Urol. 2020. PMID: 31699526
-
Preoperative detection of Vesical Imaging-Reporting and Data System (VI-RADS) score 5 reliably identifies extravesical extension of urothelial carcinoma of the urinary bladder and predicts significant delayed time to cystectomy: time to reconsider the need for primary deep transurethral resection of bladder tumour in cases of locally advanced disease?BJU Int. 2020 Nov;126(5):610-619. doi: 10.1111/bju.15188. Epub 2020 Aug 17. BJU Int. 2020. PMID: 32783347
-
Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions.Eur Radiol. 2021 Feb;31(2):875-883. doi: 10.1007/s00330-020-07153-5. Epub 2020 Aug 23. Eur Radiol. 2021. PMID: 32829418
-
The effectiveness of multiparametric magnetic resonance imaging in bladder cancer (Vesical Imaging-Reporting and Data System): A systematic review.Arab J Urol. 2020 Mar 1;18(2):67-71. doi: 10.1080/2090598X.2020.1733818. Arab J Urol. 2020. PMID: 33029409 Free PMC article. Review.
-
Diagnostic Performance of Vesical Imaging Reporting and Data System for the Prediction of Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis.Eur Urol Oncol. 2020 Jun;3(3):306-315. doi: 10.1016/j.euo.2020.02.007. Epub 2020 Mar 19. Eur Urol Oncol. 2020. PMID: 32199915 Free PMC article.
Cited by
-
Clinical application of bladder MRI and the Vesical Imaging-Reporting and Data System.Nat Rev Urol. 2024 Apr;21(4):243-251. doi: 10.1038/s41585-023-00830-2. Epub 2023 Nov 30. Nat Rev Urol. 2024. PMID: 38036666 Review.
-
The role of multiparametric MRI-based VI-RADS in predicting the need for a second TURB.World J Urol. 2025 May 5;43(1):271. doi: 10.1007/s00345-025-05666-6. World J Urol. 2025. PMID: 40325235
References
-
- International Agency for Research on Cancer (2020) Cancer Fact Sheets Bladder. World Health Organization, Geneva. Available via https://gco.iarc.fr/today/data/factsheets/cancers/30-Bladder-fact-sheet.pdf. Accessed 27 Jul 2022
-
- Expert Panel on Urological I, Allen BC, Oto A et al (2021) ACR Appropriateness Criteria(R) post-treatment surveillance of bladder cancer: 2021 update. J Am Coll Radiol 18:S126-S138
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical