A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion
Abstract Background Muscle invasion in bladder cancer is a paramount factor in prognosis and setting the management plan. MRI is gaining preference in this field, being noninvasive with no radiation hazards and having good resolution, especially with the development of the standardized system of (VI...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-01-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-023-01181-z |
| _version_ | 1797276706263793664 |
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| author | Nesma Elshewy Adel Ali Ramadan Wael Mohamed Sameh Mohamed Emad-ElDeen Eid Samar El Achy Omnia Ezz Eldin |
| author_facet | Nesma Elshewy Adel Ali Ramadan Wael Mohamed Sameh Mohamed Emad-ElDeen Eid Samar El Achy Omnia Ezz Eldin |
| author_sort | Nesma Elshewy |
| collection | DOAJ |
| description | Abstract Background Muscle invasion in bladder cancer is a paramount factor in prognosis and setting the management plan. MRI is gaining preference in this field, being noninvasive with no radiation hazards and having good resolution, especially with the development of the standardized system of (VI RADS). Moreover, multiple other imaging features can aid in predicting muscle invasion. We studied some of the most commonly reported features to develop the most reliable combination to anticipate the presence of muscle invasion. Results Our prospective study on 80 patients showed 39 (48.75%) muscle invasive (MIBC) and 41 (51.25%) non-muscle invasive (NMIBC) bladder cancer cases. The inter-observer agreement on the VI RADS score and the ADC measurements were very good and they had high-accuracy predicting muscle invasion with areas under the curve (AUCs) on ROC curve analysis reaching 0.905 and 0.857, respectively. The imaging variables that showed statistically significant differences between NMIBC and MIBC cases were: the multiplicity of the lesions, vesicoureteric junction (VUJ) involvement with distal ureteric backpressure, tumor–wall contact length (TCL), tumor volume, tumor shape (sessile or papillary), presence of a stalk, the final VI RADS score and the ADC value. On the multiple regression analysis model, the multiplicity of the lesions, the minimum ADC value by ROI method and the final VI RADS score showed independent correlation with muscle invasion, negatively with the first two and positively with the latter. The combination of the six statistically significant variables on the univariate regression analysis (final VI RADS score, minimum ADC by ROI, multiplicity, index tumor shape, TCL and distal ureteric backpressure changes) showed the best AUC (0.944). Conclusions VI RADS has good diagnostic accuracy regarding muscle invasion; however, this can even be enhanced by including other quantitative and qualitative commonly reported MRI features as a proposed modification to the VI RADS. |
| first_indexed | 2024-03-07T15:32:04Z |
| format | Article |
| id | doaj.art-d1680d70fa9044b2afe55dd75bd8a295 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-03-07T15:32:04Z |
| publishDate | 2024-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-d1680d70fa9044b2afe55dd75bd8a2952024-03-05T16:23:50ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622024-01-0155111210.1186/s43055-023-01181-zA proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasionNesma Elshewy0Adel Ali Ramadan1Wael Mohamed Sameh2Mohamed Emad-ElDeen Eid3Samar El Achy4Omnia Ezz Eldin5Diagnostic and Interventional Radiology Department, Alexandria Faculty of MedicineDiagnostic and Interventional Radiology Department, Alexandria Faculty of MedicineUrology Department, Alexandria Faculty of MedicineDiagnostic and Interventional Radiology Department, Alexandria Faculty of MedicinePathology Department, Alexandria Faculty of MedicineDiagnostic and Interventional Radiology Department, Alexandria Faculty of MedicineAbstract Background Muscle invasion in bladder cancer is a paramount factor in prognosis and setting the management plan. MRI is gaining preference in this field, being noninvasive with no radiation hazards and having good resolution, especially with the development of the standardized system of (VI RADS). Moreover, multiple other imaging features can aid in predicting muscle invasion. We studied some of the most commonly reported features to develop the most reliable combination to anticipate the presence of muscle invasion. Results Our prospective study on 80 patients showed 39 (48.75%) muscle invasive (MIBC) and 41 (51.25%) non-muscle invasive (NMIBC) bladder cancer cases. The inter-observer agreement on the VI RADS score and the ADC measurements were very good and they had high-accuracy predicting muscle invasion with areas under the curve (AUCs) on ROC curve analysis reaching 0.905 and 0.857, respectively. The imaging variables that showed statistically significant differences between NMIBC and MIBC cases were: the multiplicity of the lesions, vesicoureteric junction (VUJ) involvement with distal ureteric backpressure, tumor–wall contact length (TCL), tumor volume, tumor shape (sessile or papillary), presence of a stalk, the final VI RADS score and the ADC value. On the multiple regression analysis model, the multiplicity of the lesions, the minimum ADC value by ROI method and the final VI RADS score showed independent correlation with muscle invasion, negatively with the first two and positively with the latter. The combination of the six statistically significant variables on the univariate regression analysis (final VI RADS score, minimum ADC by ROI, multiplicity, index tumor shape, TCL and distal ureteric backpressure changes) showed the best AUC (0.944). Conclusions VI RADS has good diagnostic accuracy regarding muscle invasion; however, this can even be enhanced by including other quantitative and qualitative commonly reported MRI features as a proposed modification to the VI RADS.https://doi.org/10.1186/s43055-023-01181-zBladder cancerMuscle invasionVI RADSMRI features |
| spellingShingle | Nesma Elshewy Adel Ali Ramadan Wael Mohamed Sameh Mohamed Emad-ElDeen Eid Samar El Achy Omnia Ezz Eldin A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion The Egyptian Journal of Radiology and Nuclear Medicine Bladder cancer Muscle invasion VI RADS MRI features |
| title | A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion |
| title_full | A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion |
| title_fullStr | A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion |
| title_full_unstemmed | A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion |
| title_short | A proposed inclusion of magnetic resonance imaging features to the VI RADS to enhance its accuracy in predicting muscle invasion |
| title_sort | proposed inclusion of magnetic resonance imaging features to the vi rads to enhance its accuracy in predicting muscle invasion |
| topic | Bladder cancer Muscle invasion VI RADS MRI features |
| url | https://doi.org/10.1186/s43055-023-01181-z |
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