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Bicchetti, Marco; Simone, Giuseppe; Giannarini, Gianluca; Girometti, Rossano; Briganti, Alberto; Brunocilla, Eugenio; Cardone, Gianpiero; De Cobelli, Francesco; Gaudiano, Caterina; Del Giudice, Francesco; Flammia, Simone; Leonardo, Costantino; Pecoraro, Martina; Schiavina, Riccardo; Catalano, Carlo; Panebianco, Valeria
Radiologia medica, 08/2022, Letnik: 127, Številka: 8Journal Article
Purpose To determine the clinical, pathological, and radiological features, including the Vesical Imaging-Reporting and Data System (VI-RADS) score, independently correlating with muscle-invasive bladder cancer (BCa), in a multicentric national setting. Method and Materials Patients with BCa suspicion were offered magnetic resonance imaging (MRI) before trans-urethral resection of bladder tumor (TURBT). According to VI-RADS, a cutoff of ≥ 3 or ≥ 4 was assumed to define muscle-invasive bladder cancer (MIBC). Trans-urethral resection of the tumor (TURBT) and/or cystectomy reports were compared with preoperative VI-RADS scores to assess accuracy of MRI for discriminating between non-muscle-invasive versus MIBC. Performance was assessed by ROC curve analysis. Two univariable and multivariable logistic regression models were implemented including clinical, pathological, radiological data, and VI-RADS categories to determine the variables with an independent effect on MIBC. Results A final cohort of 139 patients was enrolled (median age 70 IQR: 64, 76.5). MRI showed sensitivity, specificity, PPV, NPV, and accuracy for MIBC diagnosis ranging from 83–93%, 80–92%, 67–81%, 93–96%, and 84–89% for the more experienced readers. The area under the curve (AUC) was 0.95 (0.91–0.99). In the multivariable logistic regression model, the VI-RADS score, using both a cutoff of 3 and 4 ( P < .0001), hematuria ( P = .007), tumor size ( P = .013), and concomitant hydronephrosis ( P = .027) were the variables correlating with a bladder cancer staged as ≥ T2. The inter-reader agreement was substantial ( k = 0.814). Conclusions VI-RADS assessment scoring proved to be an independent predictor of muscle-invasiveness, which might implicate a shift toward a more aggressive selection approach of patients’ at high risk of MIBC, according to a novel proposed predictive pathway.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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