GIÁ TRỊ CỦA CỘNG HƯỞNG TỪ ĐA THAM SỐ TRONG ĐÁNH GIÁ XÂM LẤN LỚP CƠ Ở BỆNH NHÂN UNG THƯ BÀNG QUANG

Abstract

Objectives: To investigate the diagnostic value of multiparametric magnetic resonance imaging (mpMRI) in assessing muscle invasion of bladder cancer based on the VI-RADS scoring system. Subjects and Methods: A retrospective and prospective descriptive study was conducted on 39 patients with suspected bladder cancer who underwent mpMRI and subsequent surgery with histopathological examination at 108 Military Central Hospital from September 2024 to July 2025. All preoperative mpMRI images were evaluated according to the VI-RADS score and compared with postoperative histopathological findings. Results: Each tumor was evaluated separately, and in cases with multiple tumors, the highest VI-RADS score was used. Histopathology showed 10 muscle-invasive tumors (25.6%) and 29 non-muscle-invasive tumors (74.4%). Tumors classified as VI-RADS 1 were all non-muscle-invasive, whereas all tumors classified as VI-RADS 4, 5 were muscle-invasive. For the threshold of VI-RADS ≥ 4, overal VI-RADS yielded sensitivity, specificity, PPV, NPV, and ACC of 80%, 100%, 100%, 93.5%, and 94.9%, respectively-superior to any single sequence. The area under the ROC curve (AUC) for overall VI-RADS was 0.943, indicating excellent diagnostic performance. Conclusion: Multiparametric MRI is valuable in diagnosing muscle-invasive bladder cancer based on the VI-RADS scoring system, with the optimal threshold being VI-RADS ≥ 4.