Multiparametric MRI-based VI-RADS: can it predict 1-to 5-year recurrence of bladder cancer?

Objectives To evaluate whether Vesical Imaging-Reporting And Data System (VI-RADS) scores based on multiparametric MRI (mp-MRI) can predict bladder cancer (BCa) recurrence. Methods In this retrospective study, 284 patients with pathologically confirmed bladder neoplasms from November 2011 to October 2020 were included. Two radiologists blindly and independently scored mp-MRI scans according to VI-RADS. Scoring inconsistency was resolved in consensus. The latest follow-up was completed in December 2022. Pearson's correlation analyses, independent-sample t-tests, and receiver operating characteristic analyses were performed to assess the efficacy of VI-RADS score for the 1- to 5-year recurrence prognostication. Results Based on the latest follow-up, 37 (of 284, 13.0%), 69 (of 284, 24.3%), 70 (of 234, 29.9%), 72 (of 190, 37.9%), and 63 (of 135, 46.7%) patients had cancer recurrence at 1- to 5-year follow-up, respectively. VI-RADS scores showed significantly intergroup differences between recurrent and nonrecurrent cases during 1- to 4-year surveillance (p < 0.05). The recurrence-free survival was significantly higher in patients with VI-RADS scores of 1 or 2, compared to those with scores of 3, 4, or 5 (p < 0.05). Areas under the receiver operating characteristic curves for 1- to 5-year recurrence prediction were 0.744, 0.686, 0.656, 0.595, and 0.536, respectively. VI-RADS score of 3 or more was the threshold for 1-year recurrence assessment, and VI-RADS more than 3 was the cutoff for 2-year recurrence prediction. Conclusion VI-RADS score has potential in preoperative prognostication of BCa recurrence, but its predictive power decreases over time. Clinical relevance statement VI-RADS has potential in bladder cancer recurrence assessment, but its prognostic value decreases over time. Patients with VI-RADS >= 3 may be more likely to recur in 1 or 2 years postoperatively, thus should be performed with intensive surveillances. Key Points center dot VI-RADS scores had significant differences in 1- to 4-year recurrent and nonrecurrent patient groups.center dot Patients with VI-RADS scores of <= 2 showed more favorable recurrence-free survival outcomes.center dot The prognostic value of VI-RADS score decreased over time for bladder cancer recurrence prediction.

Automated summary

The study found that VI-RADS scores based on mp-MRI can predict bladder cancer recurrence. Patients with higher scores are more likely to experience recurrence within 1 to 2 years, and the predictive power of the scores decreases over time.