Abstract
Purpose
The Vesical Imaging-Reporting and Data System (VI-RADS) criteria are expanding, providing fine differentiation of bladder wall layers involvement. We aimed to explore the feasibility of a novel categorical scoring, the Neoadjuvant chemotherapy VI-RADS (nacVI-RADS) for radiologic assessment of response (RaR), to define the spectrum of treatment response among patients with muscle invasive bladder cancer (MIBC).
Methods
Ten consecutive patients diagnosed with non-metastatic MIBC were prospectively enrolled and addressed to NAC and underwent mpMRI before staging resection and after the chemotherapy cycles. The follow-up MRI assessment was performed using the nacVI-RADS algorithm for evaluation of response to therapy. NacVI-RADS categorically define complete RaR, based on prior VI-RADS score, presence of residual disease, tumor size, and infiltration of the muscularis propria.
Results
NacVI-RADS categories were able to match all the final radical cystectomy pathology both for complete pT0 responders and for the patients defined as partial or minimal responders, who only showed some RaR inter-scoring class downstaging.
Conclusion
This report is the preliminary evidence of the feasibility of nacVI-RADS criteria. These findings might lead to possible paradigmatic shifts for cancer-specific survival risk assessment and to possibly drive the therapeutic decision through active surveillance programs, bladder-sparing modalities, or to the standard of care.
Graphical abstract
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are available from the corresponding author, (V.P.), upon reasonable request.
References
Panebianco V, Narumi Y, Altun E, Bochner BH, Efstathiou JA, Hafeez S, et al. Multiparametric Magnetic Resonance Imaging for Bladder Cancer: Development of VI-RADS (Vesical Imaging-Reporting And Data System). European Urology 2018;74:294–306. https://doi.org/10.1016/j.eururo.2018.04.029.
Woo S, Panebianco V, Narumi Y, Del Giudice F, Muglia VF, Takeuchi M, et al. Diagnostic Performance of Vesical Imaging Reporting and Data System for the Prediction of Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis. European Urology Oncology 2020:S2588931120300328. https://doi.org/10.1016/j.euo.2020.02.007.
Del Giudice F, Pecoraro M, Vargas HA, Cipollari S, De Berardinis E, Bicchetti M, et al. Systematic Review and Meta-Analysis of Vesical Imaging-Reporting and Data System (VI-RADS) Inter-Observer Reliability: An Added Value for Muscle Invasive Bladder Cancer Detection. Cancers (Basel) 2020;12. https://doi.org/10.3390/cancers12102994.
Panebianco V, Pecoraro M, Del Giudice F, Takeuchi M, Muglia VF, Messina E, et al. VI‐RADS for Bladder Cancer: Current Applications and Future Developments. J Magn Reson Imaging 2020:jmri.27361. https://doi.org/10.1002/jmri.27361.
Fleischmann A, Thalmann GN, Perren A, Seiler R. Tumor regression grade of urothelial bladder cancer after neoadjuvant chemotherapy: a novel and successful strategy to predict survival. Am J Surg Pathol 2014;38:325–32. https://doi.org/10.1097/PAS.0000000000000142.
Barchetti G, Simone G, Ceravolo I, Salvo V, Campa R, Del Giudice F, et al. Multiparametric MRI of the bladder: inter-observer agreement and accuracy with the Vesical Imaging-Reporting and Data System (VI-RADS) at a single reference center. Eur Radiol 2019;29:5498–506. https://doi.org/10.1007/s00330-019-06117-8.
Del Giudice F, Barchetti G, De Berardinis E, Pecoraro M, Salvo V, Simone G, et al. Prospective Assessment of Vesical Imaging Reporting and Data System (VI-RADS) and Its Clinical Impact on the Management of High-risk Non–muscle-invasive Bladder Cancer Patients Candidate for Repeated Transurethral Resection. European Urology 2020;77:101–9. https://doi.org/10.1016/j.eururo.2019.09.029.
Metwally MI, Zeed NA, Hamed EM, Elshetry ASF, Elfwakhry RM, Alaa Eldin AM, et al. The validity, reliability, and reviewer acceptance of VI-RADS in assessing muscle invasion by bladder cancer: a multicenter prospective study. Eur Radiol 2021. https://doi.org/10.1007/s00330-021-07765-5.
Rosenblatt R, Sherif A, Rintala E, Wahlqvist R, Ullén A, Nilsson S, et al. Pathologic downstaging is a surrogate marker for efficacy and increased survival following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive urothelial bladder cancer. Eur Urol 2012;61:1229–38. https://doi.org/10.1016/j.eururo.2011.12.010.
Becker REN, Meyer AR, Brant A, Reese AC, Biles MJ, Harris KT, et al. Clinical Restaging and Tumor Sequencing are Inaccurate Indicators of Response to Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer. Eur Urol 2021;79:364–71. https://doi.org/10.1016/j.eururo.2020.07.016.
Yoshida S, Koga F, Kawakami S, Ishii C, Tanaka H, Numao N, et al. Initial Experience of Diffusion-weighted Magnetic Resonance Imaging to Assess Therapeutic Response to Induction Chemoradiotherapy Against Muscle-invasive Bladder Cancer. Urology 2010;75:387–91. https://doi.org/10.1016/j.urology.2009.06.111.
Caglic I, Panebianco V, Vargas HA, Bura V, Woo S, Pecoraro M, et al. MRI of Bladder Cancer: Local and Nodal Staging. J Magn Reson Imaging 2020:jmri.27090. https://doi.org/10.1002/jmri.27090.
Necchi A, Bandini M, Calareso G, Raggi D, Pederzoli F, Farè E, et al. Multiparametric Magnetic Resonance Imaging as a Noninvasive Assessment of Tumor Response to Neoadjuvant Pembrolizumab in Muscle-invasive Bladder Cancer: Preliminary Findings from the PURE-01 Study. Eur Urol 2020;77:636–43. https://doi.org/10.1016/j.eururo.2019.12.016.
Bandini M, Calareso G, Raggi D, Marandino L, Colecchia M, Gallina A, et al. The Value of Multiparametric Magnetic Resonance Imaging Sequences to Assist in the Decision Making of Muscle-invasive Bladder Cancer. European Urology Oncology 2020:S2588931120300821. https://doi.org/10.1016/j.euo.2020.06.004.
Acknowledgements
None.
Funding
This research did not receive any specific grant from funding agencies in the Public, Commercial, or not-for-profit sectors.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
V. Panebianco certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are none.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Pecoraro, M., Del Giudice, F., Magliocca, F. et al. Vesical Imaging-Reporting and Data System (VI-RADS) for assessment of response to systemic therapy for bladder cancer: preliminary report. Abdom Radiol 47, 763–770 (2022). https://doi.org/10.1007/s00261-021-03365-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-021-03365-5