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Use of Vesical Imaging-Reporting and Data System (VI-RADS) for detecting the muscle invasion of bladder cancer: a diagnostic meta-analysis

  • Magnetic Resonance
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European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To comprehensively assess the diagnostic performance of Vesical Imaging-Reporting and Data System (VI-RADS) score for detecting the muscle invasion of bladder cancer.

Methods

PubMed, Web of Science, and Embase were searched up to November 20, 2019. QUADAS-2 tool assessed the quality of included studies. The diagnostic estimates including sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the area under the curve (AUC) of hierarchical summary receiver operating characteristic (HSROC) were calculated. Further subgroup analysis, meta-regression and sensitivity analysis were conducted.

Results

Six studies with 1064 patients were finally included. The pooled sensitivity, specificity, and AUC value were 0.90 (95% CI 0.86–0.94), 0.86 (95% CI 0.71–0.94), and 0.93 (95% CI 0.91–0.95) for VI-RADS 3 as the cutoff value. The corresponding estimates were 0.77 (95% CI 0.65–0.86), 0.97 (95% CI 0.88–0.99), and 0.92 (95% CI 0.89–0.94) for VI-RADS 4 as the cutoff value. Meta-regression analysis revealed that study design (p value 0.01) and surgical pattern of reference standard (p value 0.02) were source of the heterogeneity of pooled sensitivity. No publication bias was observed.

Conclusions

The VI-RADS score can provide a good predictive ability for detecting the muscle invasiveness of primary bladder cancer with VI-RADS 3 or VI-RADS 4 as the cutoff value.

Key Points

• VI-RADS score has high sensitivity and specificity for predicting muscle invasion.

• The diagnostic efficiencies of VI-RADS 3 and VI-RADS 4 as the cutoff value are similar.

• VI-RADS score could be used for detecting muscle invasion of bladder cancer in clinical practice.

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Abbreviations

AUC:

Area under the curve

CT:

Computed tomography

DCE:

Dynamic contrast enhancement

DWI:

Diffusion-weighted imaging

FN:

False negative

FP:

False positive

HSROC:

Hierarchical summary receiver operating curve

LR+, LR−:

Positive likelihood ratio, negative likelihood ratio

MIBC:

Muscle invasive bladder cancer

MRI:

Magnetic resonance imaging

NMIBC:

Non-muscle invasive bladder cancer

PRISMA:

Preferred Reporting Items for Systematic and Meta-analyses

QUADAS:

Quality Assessment of Diagnostic Accuracy Studies

T2WI:

T2-weighted imaging

TN:

True negative

TP:

True positive

TURBT:

Transurethral resection of bladder tumor

VI-RADS:

Vesical Imaging-Reporting and Data System

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China

    Cheng Luo, Bin Huang, Yukun Wu, Junxing Chen & Lingwu Chen

Authors
  1. Cheng Luo
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  2. Bin Huang
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  3. Yukun Wu
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  4. Junxing Chen
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  5. Lingwu Chen
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Corresponding authors

Correspondence to Junxing Chen or Lingwu Chen.

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Guarantor

The scientific guarantor of this publication is Lingwu Chen.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because this study was a meta-analysis.

Ethical approval

Institutional Review Board approval was not required because this study was a meta-analysis.

Methodology

• Retrospective

• Diagnostic or prognostic study

• Performed at one institution

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Electronic supplementary material

ESM 1

Supplementary Fig. 1: Schematic diagram of VI-RADS score system. Source: [12]. CE: dynamic contrast-enhanced imaging; DWI: diffusion-weighted imaging; SC: structural category; SI: signal intensity. Supplementary Fig. 2: Methodological quality of the graph. Supplementary Fig. 3: Methodological quality of the summary. Supplementary Fig. 4: Forest plot of pooled sensitivity and specificity of VI-RADS 4 as the cutoff value (DOCX 817 kb)

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Luo, C., Huang, B., Wu, Y. et al. Use of Vesical Imaging-Reporting and Data System (VI-RADS) for detecting the muscle invasion of bladder cancer: a diagnostic meta-analysis. Eur Radiol 30, 4606–4614 (2020). https://doi.org/10.1007/s00330-020-06802-z

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  • DOI: https://doi.org/10.1007/s00330-020-06802-z

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