NGHIÊN CỨU GIÁ TRỊ CỦA THANG ĐIỂM VI-RADS TRONG ĐÁNH GIÁ UNG THƯ BÀNG QUANG XÂM LẤN CƠ TRÊN CỘNG HƯỞNG TỪ 1.5 TESLA

Abstract

Objectives: To describe the imaging characteristics of bladder cancer on magnetic resonance imaging (MRI) and  the diagnostic performance of bladder MRI to detect the muscle layer invasion of bladder cancer using VI-RADS score.  Subjects and methods: The patients with suspected bladder cancer who underwent MRI before transurethral resection of bladder tumor (TURBT) for pathology from October 2021 to July 2022 at National Cancer Hospital. All preoperative MRI were read and graded according to VI-RADS score and compared with pathology results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each pulse sequence and overall VI-RADS. Receiver operating characteristic (ROC) curves were performed to determine the optimal threshold for diagnosis. Results: A total of 36 patients were enrolled in the study with 52 tumors classified according to VI-RADS. Most patients have 1 tumor (27/36). Among 52 tumors, 10 (19.2%) were muscle-invasive and 42 (80.8%) were non-muscle-invasive. Tumors classified as VI-RADS 1 were all non-muscle-invasive while all VI-RADS 5 tumors were muscle-invasive. Using a VI-RADS score of 2 or greater as the cutoff value for muscle-invasive bladder cancer (MIBC), sensitivity, specificity, PPV, NPV and accuracy of 90%, 88.1%, 64.3%, 97.4%,90.2%, respectively, which is higher than for each individual pulse sequence. If the threshold VI-RADS > 3 is selected, the specificity and PPV increase but the sensitivity decreases. The area under the curve (AUC) for the overall VI-RADS score of 0.94 demonstrates good diagnostic ability. Conclusion: The VI-RADS score is valuable in diagnosing muscle-invasive bladder cancer with a threshold of VI-RADS > 2.