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Implementing VIRADS score for image-guided assessment of muscle invasiveness in bladder cancer pre-TURBT: An updated meta-analysis

  • 0Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
Arab Journal of Urology +

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April 4, 2025

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April 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The Vesical Imaging-Reporting and Data System (VI-RADS) shows high accuracy in distinguishing bladder cancer stages using MRI. A VI-RADS score of 3 or higher effectively identifies muscle-invasive bladder cancer (MIBC).

Area Of Science

  • Uro-oncology
  • Diagnostic Imaging
  • Medical Malignancy Staging

Background

  • Bladder urothelial carcinoma is a common urinary system malignancy.
  • Accurate staging, differentiating non-muscle-invasive (NMIBC) from muscle-invasive bladder cancer (MIBC), is critical for treatment selection.
  • Multiparametric MRI (mpMRI) is increasingly used for bladder cancer assessment.

Purpose Of The Study

  • To systematically review and meta-analyze the diagnostic accuracy of the Vesical Imaging-Reporting and Data System (VI-RADS) scoring system.
  • To evaluate the sensitivity and specificity of VI-RADS using mpMRI in differentiating NMIBC from MIBC.
  • To assess the utility of VI-RADS in improving bladder cancer staging.

Main Methods

  • Systematic review and meta-analysis conducted following PRISMA guidelines.
  • Searched PubMed, Web of Science, Embase, and Cochrane databases up to December 2023.
  • Included studies evaluating VI-RADS diagnostic accuracy for NMIBC vs. MIBC differentiation using mpMRI; calculated pooled sensitivity and specificity.

Main Results

  • Included 31 studies with 3,798 bladder cancer patients.
  • Pooled sensitivity and specificity for predicting MIBC with a VI-RADS cutoff score ≥3 was 89%, with moderate heterogeneity.
  • Higher diagnostic accuracy observed in studies using 3.0 Tesla MRI scanners and involving multiple radiologists.

Conclusions

  • The VI-RADS system demonstrates high diagnostic accuracy for differentiating NMIBC from MIBC.
  • A VI-RADS cutoff score of ≥3 provides optimal sensitivity and specificity for MIBC prediction.
  • Integration of VI-RADS into clinical practice can potentially reduce invasive procedures and improve treatment decisions.

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