The Value Of Vesical Imaging-reporting And Data System In Assessing Muscle Infiltration By Bladder Cancer

Objective:To evaluate the accuracy of vesical imaging-reporting and data system(VI-RADS)to determine whether the muscularis of the bladder has been infiltrated by cancer tissues,and to explore its value in clinical application.Methods:A total of 251 patients with bladder cancer were selected from November 2015 to November 2019 in the second affiliated hospital of Kunming medical university.All patients were first diagnosed with bladder cancer and underwent radical cystectomy or partial cystectomy within 2 weeks after multi-parameter magnetic resonance imaging.Then,the two deputy senior radiologists rated the tumor MRI images separately according to the VI-RADS scoring rule,and the same score was determined as the final result,and if there was a difference,the agreement was reached after mutual consultation.Furthermore,the final pathological results of the patients were unknown during the imaging diagnosis and scoring.Next,the samples were divided into NMIBC group and MIBC group according to the pathological results,and the Ⅵ-RADS scores were analyzed for correlation with pathological stages and different groups.In addition,Wilcoxon signed rank test and chi-square test were used to compare the differences and specific composition ratios of different groups on the Ⅵ-RADS scores,respectively.Finally,the receiver operator characteristic curve was used to evaluate the diagnostic performance of the VI-RADS score to determine whether the muscularis of the bladder has been infiltrated by cancer tissuesResults:A total of 251 patients were included in our study,including 215 males and 36 females.The patients with VI-RADS score 1～5 were 12,93,33,43 and 70,respectively.There was a significant positive correlation between the VI-RADS score and tumor muscular infiltration(r=0.841,P<0.01),and between the VI-RADS score and pathological staging(r=0.842,P<0.01).The distribution of NMIBC and MIBC on the VI-RADS scores was significantly different(Wilcoxon W=7298.000,Z=-13.304,P<0.01),and the specific score composition was significantly different(X2=191.86,P<0.01).The VI-RADS scores of NMIBC was mainly 1～3,while the VI-RADS scores of MIBC was mainly 3～5.The VI-RADS score of 2.5 was the best critical value on the ROC curve.When the VI-RADS score of more than 2.5(i.e.3 to 5)was used to judge the tumor as MIBC,the sensitivity was 96.3%,the specificity was 86.2%,the positive predicted value was 89.0%,and the negative predicted value was 95.2%.When the critical value was adjusted to 3.5,the sensitivity and specificity of diagnosing tumor as MIBC were 82.2%and 98.3%,respectively,while the positive and negative predicted values were 98.2%and 82.6%,respectively.Conclusions:The VI-RADS scoring system has high accuracy in judging whether the bladder muscle layer is infiltrated by bladder cancer,and can accurately distinguish between MIBC and NMIBC.The VI-RADS scoring system can optimize the MRI diagnosis and reporting mode of bladder cancer,and can guide surgeons to formulate reasonable treatment plan for patients,which has good use value for clinical decision-making.