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Experience in using the VI-RADS system in assessing the depth of invasion of bladder tumors

https://doi.org/10.24835/1607-0763-1242

Abstract

Introduction. Survival rates and treatment algorithms for patients with bladder cancer (BC) depend on the depth of tumor invasion, in particular on the presence of the bladder muscle layer invasion and extraorganic spread. To assess the depth of bladder invasion, the VI-RADS system was developed in 2018, which is based on multiparametric MRI (mpMRI). According to published studies on the VI-RADS effectiveness, there is a high diagnostic accuracy for identifying formations with probable invasion into the muscle layer. The data on BC extraorganic spread are limited and the issue of assessing the sensitivity and specificity of this system requires further study.

Aim of the study. To evaluate the diagnostic performance of mpMRI using the VI-RADS system in detecting muscle invasion and BC extraorganic growth.

Materials and methods. A prospective study was conducted in the clinics of the National Medical Research Radiological Centre and included 75 patients aged 19 to 85 years, of which 39 (52%) had been newly diagnosed with BC, 36 (48%) had a relapse or continuous tumor growth. All patients underwent pelvic organs mpMRI on a tomograph with a magnetic field induction of 1.5T, followed by transurethral resection (TUR), TUR-biopsy of the bladder or cystectomy no later than 6 weeks after scanning.. The description of the bladder tumor included its measurements, localization and VI-RADS scale assessment. The data obtained by mpMRI were compared with the results of the morphological study using statistical analysis.

Results. According to the results of the study, the overall VI-RADS scale sensitivity for categories above 3 (the presence of muscle invasion is equivocal) was 95.15% [90.11%; 99.95%], above 4 (muscle invasion is likely) – 92.59% [82.11%; 97.94%], specificity was determined at the level of 47.62% [25.71%; 70.22%] and 80.95% [58.09%; 94.55%] respectively. When assessing extraorganic spread in 30 patients, the sensitivity was 83.33% [62.62%; 95.26%], specificity – 83.33% [35.88%; 99.58%]. The accuracy and positive predictive value also had high levels from 80 to 95%, in contrast to the negative predictive value (55.56%).

Conclusion. The scale for BC invasion depth assessing VI-RADS is characterized by high rates of sensitivity, specificity and accuracy, in particular when used in determining extraorganic spread.

About the Authors

A. D. Kaprin
Moscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology”, Ministry of Healthcare of Russia; Medical institute of the Peoples' Friendship University of Russia
Russian Federation

Andrey D. Kaprin – Full Member of the Russian Academy of Sciences, Corresponding Member of Russian Academy of Education, Doct. of Sci. (Med.), Professor, General Director, 3, 2nd Botkinskiy pr., 125284 Moscow; 

Head of Department of urology and surgical nephrology with a course of oncourology at the medical faculty, 6, Miklukho-Maklay str., Moscow 117198



N. A. Rubtsova
Moscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology”, Ministry of Healthcare of Russia
Russian Federation

Natalia A. Rubtsova – Doct. of Sci. (Med.), Head of Radiology Department,

3, 2nd Botkinskiy pr., 125284 Moscow



D. O. Kabanov
Moscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology”, Ministry of Healthcare of Russia
Russian Federation

Dmitry O. Kabanov – radiologist, Department of Оncourology,

3, 2nd Botkinskiy pr., 125284 Moscow



A. B. Golbits
Moscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology”, Ministry of Healthcare of Russia
Russian Federation

Aleksandra B. Golbits – radiologist, Department of computed tomography and magnetic resonance imaging,

3, 2nd Botkinskiy pr., 125284 Moscow



N. V. Vorobyev
Moscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology”, Ministry of Healthcare of Russia; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Nikolai V. Vorobyev – Cand. of Sci. (Med.), Head of Оncourology Department, 3, 2nd Botkinskiy pr., 125284 Moscow;

Assistant Professor of the Department of Oncology, Radiotherapy and Plastic Surgery, 8, bld. 2, Trubetskaya str., Moscow 119991



P. S. Pilchuk
Moscow Research Oncological Institute named after P.A. Herzen – branch of “National Medical Research Center of Radiology”, Ministry of Healthcare of Russia
Russian Federation

Pavel S. Pilchuk – oncologist, Department of computed tomography and magnetic resonance imaging,

3, 2nd Botkinskiy pr., 125284 Moscow



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For citations:


Kaprin A.D., Rubtsova N.A., Kabanov D.O., Golbits A.B., Vorobyev N.V., Pilchuk P.S. Experience in using the VI-RADS system in assessing the depth of invasion of bladder tumors. Medical Visualization. 2023;27(3):118-129. (In Russ.) https://doi.org/10.24835/1607-0763-1242

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