Multiparametric MRI Evaluation of VI-RADS for Bladder Tumors Located at the Ureteral Orifice

Background: The Vesical Imaging Reporting and Data System (VI-RADS) based on multiparametric MRI scans standardizes -preoperative bladder cancer staging. However, limitations have been reported for VI-RADS, particularly for ureteral orifice tumors. Purpose: To investigate the diagnostic performance and interobserver agreement of VI-RADS in evaluating muscle invasion for bladder tumors located at the ureteral orifice. Materials and Methods: In this retrospective study, patients with histopathologically confirmed bladder cancer occurring at the -ureteral orifice from January 2012 to November 2021 were analyzed. Two blinded radiologists independently scored -multiparametric MRI scans according to VI-RADS. Interobserver agreement of the VI-RADS scores was evaluated with weighted k analysis. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of the VI-RADS scores in the prediction of muscle invasion. Results: A total of 78 patients (mean age, 67 years 6 7 [SD]; age range, 46-90 years; 67 men) were included in the final -analysis: 25 with non-muscle-invasive bladder cancer and 53 with muscle-invasive bladder cancer (MIBCa). At consensus -reading, one (1%) case was scored as VI-RADS 1, 27 cases (35%) were scored as VI-RADS 2, six (8%) were scored as VI-RADS 3, 10 (13%) were scored as VI-RADS 4, and 34 (44%) were scored as VI-RADS 5. On comparison of the VI-RADS score with -histopathologic findings, it was confirmed that the presence of muscle invasion was 0% (zero of one) for VI-RADS 1, 15% (four of 27) for VI-RADS 2, 83% (five of six) for VI-RADS 3, 100% (10 of 10) for VI-RADS 4, and 100% (34 of 34) for VI-RADS 5. The area under the receiver operating characteristic curve of VI-RADS in the detection of MIBCa was 0.96 (95% CI: 0.92, 1.00). Conclusion: The Vesical Imaging Reporting and Data System could be used to accurately predict muscle invasion for bladder tumors occurring at the ureteral orifice. (C) RSNA, 2022

Automated summary

The study investigates the diagnostic performance and interobserver agreement of the Vesical Imaging Reporting and Data System (VI-RADS) in evaluating muscle invasion for bladder tumors located at the ureteral orifice. The results suggest that VI-RADS has high accuracy in predicting muscle invasion for bladder tumors occurring at the ureteral orifice.