Differentiation of bladder cancer stages using the vesical imaging -reporting and data system and apparent diffusion...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Accurate preoperative T staging is crucial for bladder cancer (BC) treatment and prognosis.
• Current preoperative T staging methods for BC present challenges.
• Multiparametric magnetic resonance imaging (mpMRI) shows potential for improving BC staging accuracy.

Purpose of the Study:

• To evaluate the diagnostic performance of the Vesical Imaging-Reporting and Data System (VI-RADS) and volumetric apparent diffusion coefficient (ADC) histogram parameters.
• To differentiate between T2 stage and below (≤T2) versus T3 stage and above (≥T3) BCs using mpMRI.
• To assess the combined value of VI-RADS and ADC histogram parameters in BC staging.

Main Methods:

• Included 62 patients with pathologically confirmed BC.
• Radiologists scored tumors using the VI-RADS system.
• Volumetric ADC histogram parameters were extracted from ADC maps.
• Statistical analyses included Cochran-Armitage and Mann-Whitney U tests.
• Receiver operating characteristic (ROC) curve analysis was used to assess predictive power.

Main Results:

• ADC histogram parameters (minimum, mean, median, maximum, percentiles) were significantly higher in ≤T2 stage BCs compared to ≥T3 stage BCs.
• Skewness and kurtosis showed opposite trends.
• VI-RADS achieved an area under the curve (AUC) of 0.834.
• The combination of VI-RADS with skewness and kurtosis yielded a significantly higher AUC (0.915) than VI-RADS alone.

Conclusions:

• VI-RADS and volumetric ADC histogram analysis effectively discriminate between ≤T2 and ≥T3 stage BCs.
• Volumetric ADC histogram analysis provides supplementary information to enhance VI-RADS performance.
• These mpMRI techniques offer valuable tools for preoperative BC staging.