Our purpose was to evaluate the prognostic value of Vesical Imaging Reporting and Data System (VI-RADS) in bladder cancer (BCa) staging and predicting recurrence or progression.
We retrospectively analyzed the prospectively collected data from 96 patients with bladder tumors who underwent VI-RADS-based multiparametric magnetic resonance imaging (mpMRI) before endourological treatment from April 2021 to December 2022. Diagnostic performance was evaluated by comparing mpMRI reports with final pathology, using logistic regression for muscle-invasive bladder cancer (MIBC) predictors. Follow-up until May 2023 included Kaplan-Meier and Cox regression analysis to assess VI-RADS predictive roles for recurrence-free survival (RFS) and progression-free survival (PFS).
A total of 96 patients (19.8% women, 80.2% men; median age 68.0 years) were included, with 71% having primary tumors and 29% recurrent BCa. Multiparametric MRI exhibited high sensitivity (92%) and specificity (79%) in predicting MIBC, showing no significant differences between primary and recurrent cancers (AUC: 0.96 vs. 0.92, P = .565). VI-RADS emerged as a key predictor for MIBC in both univariate (OR: 40.3, P < .001) and multivariate (OR: 54.6, P < .001) analyses. Primary tumors with VI-RADS ≥ 3 demonstrated significantly shorter RFS (P = .02) and PFS (P = .04).
In conclusion, mpMRI with VI-RADS has a high diagnostic value in predicting MIBC in both primary and recurrent BCa. A VI-RADS threshold ≥ 3 is a strong predictor for MIBC, and in primary tumors predicts early recurrence and progression.
World journal of urology. 2024 Jul 24*** epublish ***
Mieszko Kozikowski, Magdalena Zagrodzka, Marek Zawadzki, Przemysław Zugaj, Rafał Osiecki, Franciszek Rzymkowski, Mateusz Śledź, Roman Sosnowski, Jakub Dobruch, Francesco Del Giudice, Wojciech Krajewski
Polish Center of Advanced Urology, Department of Urology, St. Anne's Hospital EMC, Piaseczno, Poland. ., Department of Diagnostic Imaging - Quadia, Piaseczno, Poland., Polish Center of Advanced Urology, Department of Urology, St. Anne's Hospital EMC, Piaseczno, Poland., Urology Clinic of Medical Postgraduate Education Centre, Department of Urology, Independent Public Hospital them. prof. W. Orlowski, Warsaw, Poland., Section of Urologic Oncology of Polish Urological Association, Warsaw, Poland., Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy.