Preoperative prediction of muscle invasion in bladder cancer in the Indian population using the Vesical Imaging-Reporting and Data System (VI-RADS) score and individual multiparametric magnetic resonance imaging (MRI) characteristics.

AIM: This study aimed to prospectively validate the Vesical Imaging-Reporting and Data System (VI-RADS) score in the preoperative prediction of muscle invasion in bladder cancer in the Indian population.

MATERIALS AND

METHODS

The study prospectively reviewed patients with bladder masses who underwent 1.5T multiparametric magnetic resonance imaging between December 2018 and April 2023. Clinical and pathological data were collected, and bladder tumors were evaluated using a 5-point VI-RADS scoring system. Independent measurements of quantitative parameters (maximum tumor diameter [DMax] and tumor contact length [TCL]) were performed. These parameters and VI-RADS scores were compared to postoperative pathology to assess muscle invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using a cutoff score of 4. Receiver Operating Characteristic (ROC) analysis evaluated the diagnostic performance of quantitative values.

RESULTS

A total of 55 patients were included in the analysis, of whom 36 were non-muscle invasive and 19 were muscle invasive on the final histopathological report. A VI-RADS score of ≥4 as the cutoff for muscle invasion yielded a sensitivity and specificity of 94.7% (95% CI 72.7%-99.9%) and 97.2% (95% CI 85%-99.9%), with PPV and NPV value of 94.7% and 97.2%, respectively. The receiver operating curve showed an area under the curve (AUC) of 0.958 (95% CI 0.89-1.0). The AUC of TCL and TCL/DMax values for muscle invasion were 0.811 and 0.835, respectively.

CONCLUSIONS

The VI-RADS scoring system, qualitative parameters, as well as the TCL and TCL/Dmax exhibits a strong correlation with pathological staging, indicating to be an effective method for the preoperative determination of muscle invasion in bladder cancer.