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VI-RADS based on multi-parametric MRI for the prediction of muscle-invasion in bladder cancer and MRI findings of muscle-invasion in bladder cancer located in ureteral orifice
DENG Lei  ZOU Yujian  YANG Shuiqing  ZHANG Kunlin  HUANG Xiang  LI Jianpeng 

Cite this article as: Deng L, Zou YJ, Yang SQ, et al. VI-RADS based on multi-parametric MRI for the prediction of muscle-invasion in bladder cancer and MRI findings of muscle-invasion in bladder cancer located in ureteral orifice[J]. Chin J Magn Reson Imaging, 2022, 13(7): 121-125. DOI:10.12015/issn.1674-8034.2022.07.022.


[Abstract] Objective To explore the performance of Vesical Imaging-Reporting and Data System (VI-RADS) score based on multi-parametric magnetic resonance imaging (mp-MRI) in predicting muscle invasion in bladder cancer, and to analyze MRI findings of muscle invasion in bladder cancer occurring at ureteral orifice.Materials and Methods A total of 87 patients with 122 lesions diagnosed as bladder cancer by pathology were enrolled, and all the patients who had undergone mp-MRI were analyzed retrospectively. The two groups of radiologists, who were blinded to pathology and clinical data, reviewed and scored each lesion separately according to VI-RADS. The interobserver agreement of VI-RADS score was assessed by Kappa statistics. The predictive efficiency of detection of muscle invasion in bladder cancer was evaluated by receiver operator characteristic (ROC) curve. The relationship between bladder cancer located around ureterovesical orifice and ureter was also analyzed.Results Interobserver agreement of VI-RADS score between the two groups of radiologists was good [Kappa value=0.727, P＜0.001, the area under the ROC curve were 0.880 (95% confidence interval: 0.808-0.932) and 0.905 (95% confidence interval: 0.838-0.950)].With regard to ROC analysis, the best cutoff-point was 3 for the detection of muscle invasion. The Youden index was 67.8%, with a sensitivity of 76.7%, specificity of 91.1%, positive predictive value of 82.5% and negative predictive value of 87.8%. Twenty-nine lesions were located in the ureterovesical orifice. The 7 lesions of 29 lesions appeared as pedicle embedding the ureteral orifice, and 85.7% (6/7) were non-muscle invasive bladder cancer. The other 22 lesions showed blurred boundary with ureterall orifice, and 95.5% (21/22) were muscle invasive bladder cancer.Conclusions Multi-parametric MRI-based VI-RADS exhibited a high agreement between different radiologists, and can effectively predict the muscle invasion of bladder cancer. In the case of the bladder cancer located in the bilateral ureteral orifice, further review on the association between pedicle of tumour or tumour tissue and ureteral orifice is required.
[Keywords] Vesical Imaging-Reporting and Data System；bladder neoplasms；muscular invasiveness；ureteral orifice；magnetic resonance imaging

DENG Lei   ZOU Yujian   YANG Shuiqing   ZHANG Kunlin   HUANG Xiang   LI Jianpeng*  

Department of Radiology, Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's hospital), Dongguan 523000, China

Li JP, E-mail: ljp0885@qq.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Dongguan Science and Technology of Social Development Program (No. 20211800905212).
Received  2022-03-07
Accepted  2022-06-24
DOI: 10.12015/issn.1674-8034.2022.07.022
Cite this article as: Deng L, Zou YJ, Yang SQ, et al. VI-RADS based on multi-parametric MRI for the prediction of muscle-invasion in bladder cancer and MRI findings of muscle-invasion in bladder cancer located in ureteral orifice[J]. Chin J Magn Reson Imaging, 2022, 13(7): 121-125. DOI:10.12015/issn.1674-8034.2022.07.022.

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