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

Yıl 2022, Cilt: 14 Sayı: 3, 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

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