Mesane kanserinin kas invazyonunu öngörmede vezikal görüntüleme-raporlama ve veri sistemi (VI-RADS) skorlamasının etkinliğinin değerlendirilmesi

Yıl 2022, , 63 - 69, 30.09.2022

Harun Özdemir , Merve Şam Özdemir , Metin Savun , Emin Taha Keskin , Abdülmüttalip Şimşek , Halil Lütfi Canat

https://doi.org/10.54233/endouroloji.1161910

Öz

Amaç: Biz bu çalışmada mesane kanserinin kas invazyonunu preoperatif tahmin etmede “Vesical Imaging Reporting and Data System” (VI-RADS) skorlama sisteminin doğruluğunu araştırmayı amaçladık.
Gereç ve Yöntemler: Ağustos 2020 ile Mart 2022 arasında preoperatif mp-MRG çekilen mesane kanserli hastalar çalışmaya dahil edildi. Mesane tümörleri deneyimli bir üroradyolog tarafından VI-RADS skorlama sistemi ile değerlendirildi. VI-RADS skoru, kas invazyonunu belirlemek için postoperatif patoloji ile karşılaştırıldı. VI-RADS ≥3 ve VI-RADS ≥4 kesme noktası için duyarlılık, özgüllük, poizitif öngörü değeri (PÖD), negatif öngörü değeri (NÖD) ve doğruluk hesaplandı.
Bulgular: Toplam 102 hastanın dördünde bening patoloji (Üç hastada sistitis sistika, bir hastada nefrojenik adenom) saptandı. Çalışmaya kalan 98 hasta dahil edildi. 38 hastada kasa invaziv ve 60 hastada ise kasa invaziv olmayan mesane kanseri saptandı. Kas invazyonunu belirlemede VI-RADS skorunun eşik değeri 3 olarak alındığında duyarlılık, özgüllük, PÖD, NÖD ve doğruluğu sırasıyla %92, %85, %94, %80 ve %88 olarak hesaplandı. Bununla beraber VI-RADS skorunun eşik değeri 4 olarak alındığında duyarlılık, özgüllük, PÖD, NÖD değeri ve doğruluğu sırasıyla %82, %95, %89, %91 ve %90 saptandı.
Sonuç: Sonuç olarak mesane mp-MRG, VI-RADS kriterleri eşliğinde VI-RADS eşik değer 3 veya 4’ün kas invaziv mesane kanserinin saptanmasında başarılı bir yöntem olup tanısal performansı artırabilir.

Anahtar Kelimeler

Mesane Kanseri, Ürogenital Kanserler, MRG, VIRADS

Evaluation of the effectiveness of vesical imaging-reporting and data system (VI-RADS) scoring in predicting muscle invasion of bladder cancer

Öz

Objective: In this study, we aimed to investigate the accuracy of the “Vesical Imaging Reporting and Data System” (VI-RADS) scoring system in predicting preoperative muscle invasion of bladder cancer.
Material and Methods: Patients with bladder cancer who underwent pre-operative mp-MRI between August 2020 and March 2022 were included in the study. Bladder tumors were evaluated by an experienced uroradiologist using the VI-RADS scoring system. The VI-RADS score was compared with postoperative pathology to determine muscle invasion. Sensitivity, specificity, positive predictive value (PPD), negative predictive value (NPD), and accuracy were calculated for the VI-RADS ≥3 and VI-RADS ≥4 cut-off points.
Results: Benign pathology (cystitis cystica in three patients, nephrogenic adenoma in one patient) was found in four of 102 patients. The remaining 98 patients were included in the study. Muscle-invasive bladder cancer was detected in 38 patients and non-muscle-invasive bladder cancer in 60 patients. When the threshold value of the VI-RADS score was taken as 3 in determining muscle invasion, sensitivity, specificity, PPD, NPD value and accuracy were calculated as 92%, 85%, 94%, 80% and 88%, respectively. However, when the threshold value of the VI-RADS score was taken as 4, sensitivity, specificity, PPD, NPD value and accuracy were found to be 82%, 95%, 89%, 91% and 90%, respectively.
Conclusion: In conclusion, bladder mp-MRI is a successful method in the detection of muscle-invasive bladder cancer with a VI-RADS threshold value of 3 or 4, accompanied by VI-RADS criteria, and may increase the diagnostic performance.

Anahtar Kelimeler

Bladder Cancer, MRI, Urogenital Cancers, VI-RADS

Kaynakça

• Cumberbatch M, Jubber I, Black PC, et. al. Epidemiology of bladder cancer: a systematic review and contemporary update of risk factors in 2018. Eur Urol. 2018;74:784-795. https://doi.org/10.1016/j.eururo.2018.09.001
• Czerniak B, Dinney C, McConkey D. Origins of bladder cancer. Annu Rev Pathol. 2016;11:149-174. https://doi.org/10.1146/annurev-pathol-012513-104703
• Gruber K. Coffee consumption and bladder cancer are linked, analysis shows. BMJ.2015; 350. https://doi.org/10.1136/bmj.h1477
• Markowski MC, Boorjian SA, Burton JP, et al. The microbiome and genitourinary cancer: a collaborative review. Eur Urol.2019;75(4):637–646. https://doi.org/10.1016/j.eururo.2018.12.043
• Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 2596 patients from seven EORTC trials. Eur Urol. 2006; 49:466-475. https://doi.org/10.1016/j.eururo.2005.12.031
• Kluth LA, Black PC, Bochner BH, et al. Prognostic and prediction tools in bladder cancer: a comprehensive review of the literature. Eur Urol. 2015; 68:238–253. https://doi.org/10.1016/j.eururo.2015.01.032
• Gontero P, Sylvester R, Pisano F, et al. Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with Bacillus Calmette-Guerin: results of a retrospective multicenter study of 2451 patients. Eur Urol. 2015;67:74-82. https://doi.org/10.1016/j.eururo.2014.06.040
• Panebianco V, Narumi Y, Altun E, et al. Multiparametric magnetic resonance imaging for bladder cancer: development of VI-RADS (Vesical Imaging-Reporting And Data System). Eur Urol. 2018;74(3): 294-306. https://doi.org/10.1016/j.eururo.2018.04.029
• De Haas RJ, Steyvers MJ, and Fütterer JJ. Multiparametric MRI of the Bladder: Ready for Clinical Routine?, Am J Roentgenol. 2014;202(6):1187–1195. https://doi.org/10.2214/AJR.13.12294
• Barentsz JO, Ruijs SH, Strijk SP. The role of MR imaging in carcinoma of the urinary bladder. Am J Roentgenol 1993;160:937–47. https://doi.org/10.2214/ajr.160.5.8470608.
• Panebianco V, Barchetti F, de Haas RJ, et al. Improving staging in bladder cancer: the increasing role of multiparametric magnetic resonance imaging. EurUrol Focus. 2016;2:113–21. https://doi.org/10.1016/j.euf.2016.04.010
• Nicola R, Pecoraro M, Lucciola S, et al. VI-RADS score system - A primer for urologists. Int Braz J Urol. 2022;48:609-622. https://doi.org/10.1590/S1677-5538.IBJU.2021.0560
• Woo S, Panebianco V, Narumi Y, et al. Diagnostic performance of vesical imaging reporting and data system for the prediction of muscle-invasive bladder cancer: a systematic review and meta-analysis. Eur Urol Oncol. 2020;3(3):306-315. https://doi.org/10.1016/j.euo.2020.02.007
• Jazayeri SB, Dehghanbanadaki H, Hosseini M, et al. Diagnostic accuracy of vesical imaging-reporting and data system (VI-RADS) in suspected muscle invasive bladder cancer: A systematic review and diagnostic meta-analysis. Urol Oncol. 2022;40(2):45-55. https://doi.org/10.1016/j.urolonc.2021.11.008
• Del Giudice F, Flammia RS, Pecoraro M, et.al. The accuracy of Vesical Imaging-Reporting and Data System (VI-RADS): an updated comprehensive multi-institutional, multi-readers systematic review and meta-analysis from diagnostic evidence intofuture clinical recommendations. World J Urol. 2022 Jul;40(7):1617-1628. https://doi.org/10.1007/s00345-022-03969-6
• Del Giudice F, Leonardo C, Simone G, et. al. Preoperative detection of Vesical Imaging-Reporting and Data System (VI-RADS) score 5 reliably identifies extravesical extension of urothelial carcinoma of the urinary bladder and predicts significant delayed time to cystectomy: time to reconsider the need for primary deep transurethral resection of bladder tumour in cases of locally advanced disease? BJU Int. 2020;126(5):610–619. https://doi.org/10.1111/bju.15188