Diagnostic Accuracy of Vesical Imaging-Reporting and Data System (VI-RADS) in Suspected Muscle Invasive Bladder Cancer: A Systematic Review and Diagnostic Meta-Analysis

In this meta-analysis, we looked at the overall performance of VIRADS in detecting MIBC. As MRI is getting more popular in cancer staging, including bladder cancer, and the generalization of standard reporting protocols, it is important for general and oncologic urologists to understand the limitations and strengths of these reporting systems. In the urology world, the adoption of MRI for prostate imaging has been a success story in improving clinical decision making. However, in the case of bladder cancer, the MRI is still in initial stages of adoption.

In our review, we found that VIRADS has acceptable sensitivity and specificity in discerning MIBC from NMIBC, overall. In addition to the main concept of our findings on the potential ability of VIRADS ≥3 as a highly sensitive tool for discrimination of MIBC from NMIBC in suspected cases, we found that characteristics of MRI and the radiologist experience would significantly impact the accuracy of VIRADS. Besides, the MRI interval as an important factor for MRI quality should be investigated in further studies.

In interpreting the results of the MRI, we should keep in mind that TURBT remains the gold standard for diagnosis and initial staging procedure for the bladder tumors and MRI can only help to improve the staging process and not to replace it. Further work both in the accuracy of VIRADs and more importantly, implementation of MRI in the staging of bladder cancer is necessary to further improve the diagnostic value of MRI in patients with bladder cancer.

Written by: Hojat Dehghanbanadaki, Mahdie Hosseini, Pourya Taghipour, Seyed Behzad Jazayeri, Mark Bandyk, Department of Urology, University of Florida, Jacksonville, FL.

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