Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer
Abstract Background Vesical Imaging-Reporting and Data System (VI-RADS) based on multiparametric magnetic resonance imaging (mp-MRI) performed well in diagnosing muscle-invasive bladder cancer (MIBC). However, certain cases may present challenges in determining the final VI-RADS score using only T2-...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12880-025-01595-3 |
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| author | Peikun Liu Lingkai Cai Linjing Jiang Haonan Chen Qiang Cao Kexin Bai Rongjie Bai Qikai Wu Xiao Yang Qiang Lu |
| author_facet | Peikun Liu Lingkai Cai Linjing Jiang Haonan Chen Qiang Cao Kexin Bai Rongjie Bai Qikai Wu Xiao Yang Qiang Lu |
| author_sort | Peikun Liu |
| collection | DOAJ |
| description | Abstract Background Vesical Imaging-Reporting and Data System (VI-RADS) based on multiparametric magnetic resonance imaging (mp-MRI) performed well in diagnosing muscle-invasive bladder cancer (MIBC). However, certain cases may present challenges in determining the final VI-RADS score using only T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) sequences, especially in the absence of dynamic contrast-enhanced (DCE) imaging. This study aims to evaluates whether biparametric MRI (bp-MRI) achieve comparable diagnostic performance to mp-MRI for predicting MIBC and seeks to identify the most suitable bp-MRI criterion by establishing four specific conditions based on T2WI and DWI. Methods A retrospective analysis was conducted on 447 patients who underwent preoperative mp-MRI. Images were evaluated according to the VI-RADS protocol by three independent readers. In the bp-DWI and bp-DWI Plus criteria, DWI was the primary sequence used for lesion assessment, while T2WI was the primary sequence for bp-T2WI and bp-T2WI Plus criteria. The Plus criteria (bp-DWI Plus and bp-T2WI Plus) assigned a final VI-RADS score of 4 when both T2WI and DWI scores were 3. The gold standard for diagnosis was histopathological evaluation after surgery. Diagnostic performance was evaluated by comparing the area under the curve (AUC), sensitivity, specificity, and inter-reader agreement using Cohen’s kappa analysis. Results Among 447 patients, 304 confirmed as NMIBC and 143 as MIBC. The kappa values were 0.876, 0.873, 0.873, 0.642, and 0.642 for mp-MRI, bp-DWI, bp-DWI Plus, bp-T2WI, and bp-T2WI Plus, respectively, when VI-RADS cutoff > 2. Similarly, when cutoff > 3, the kappa values were 0.848, 0.811, 0.873, 0.811, and 0.873. No significant differences were observed between mp-MRI and bp-DWI (AUC: 0.916 vs. 0.912, p = 0.498), but mp-MRI and bp-DWI had higher AUCs compared to bp-DWI Plus, bp-T2WI, and bp-T2WI Plus. Conclusions Both mp-MRI and bp-DWI demonstrate excellent performance in predicting MIBC, with bp-DWI being an alternative to mp-MRI. Trial registration retrospectively. |
| format | Article |
| id | doaj-art-64cfdbf1e5f24cdcaab930752537db0a |
| institution | DOAJ |
| issn | 1471-2342 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Medical Imaging |
| spelling | doaj-art-64cfdbf1e5f24cdcaab930752537db0a2025-08-20T03:03:36ZengBMCBMC Medical Imaging1471-23422025-02-012511910.1186/s12880-025-01595-3Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancerPeikun Liu0Lingkai Cai1Linjing Jiang2Haonan Chen3Qiang Cao4Kexin Bai5Rongjie Bai6Qikai Wu7Xiao Yang8Qiang Lu9Department of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Urology, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Background Vesical Imaging-Reporting and Data System (VI-RADS) based on multiparametric magnetic resonance imaging (mp-MRI) performed well in diagnosing muscle-invasive bladder cancer (MIBC). However, certain cases may present challenges in determining the final VI-RADS score using only T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) sequences, especially in the absence of dynamic contrast-enhanced (DCE) imaging. This study aims to evaluates whether biparametric MRI (bp-MRI) achieve comparable diagnostic performance to mp-MRI for predicting MIBC and seeks to identify the most suitable bp-MRI criterion by establishing four specific conditions based on T2WI and DWI. Methods A retrospective analysis was conducted on 447 patients who underwent preoperative mp-MRI. Images were evaluated according to the VI-RADS protocol by three independent readers. In the bp-DWI and bp-DWI Plus criteria, DWI was the primary sequence used for lesion assessment, while T2WI was the primary sequence for bp-T2WI and bp-T2WI Plus criteria. The Plus criteria (bp-DWI Plus and bp-T2WI Plus) assigned a final VI-RADS score of 4 when both T2WI and DWI scores were 3. The gold standard for diagnosis was histopathological evaluation after surgery. Diagnostic performance was evaluated by comparing the area under the curve (AUC), sensitivity, specificity, and inter-reader agreement using Cohen’s kappa analysis. Results Among 447 patients, 304 confirmed as NMIBC and 143 as MIBC. The kappa values were 0.876, 0.873, 0.873, 0.642, and 0.642 for mp-MRI, bp-DWI, bp-DWI Plus, bp-T2WI, and bp-T2WI Plus, respectively, when VI-RADS cutoff > 2. Similarly, when cutoff > 3, the kappa values were 0.848, 0.811, 0.873, 0.811, and 0.873. No significant differences were observed between mp-MRI and bp-DWI (AUC: 0.916 vs. 0.912, p = 0.498), but mp-MRI and bp-DWI had higher AUCs compared to bp-DWI Plus, bp-T2WI, and bp-T2WI Plus. Conclusions Both mp-MRI and bp-DWI demonstrate excellent performance in predicting MIBC, with bp-DWI being an alternative to mp-MRI. Trial registration retrospectively.https://doi.org/10.1186/s12880-025-01595-3Bladder cancer, Biparametric MRI, VI-RADSMIBCDiagnostic performance |
| spellingShingle | Peikun Liu Lingkai Cai Linjing Jiang Haonan Chen Qiang Cao Kexin Bai Rongjie Bai Qikai Wu Xiao Yang Qiang Lu Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer BMC Medical Imaging Bladder cancer, Biparametric MRI, VI-RADS MIBC Diagnostic performance |
| title | Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer |
| title_full | Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer |
| title_fullStr | Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer |
| title_full_unstemmed | Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer |
| title_short | Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer |
| title_sort | comparative diagnostic performance of vi rads based on biparametric and multiparametric mri in predicting muscle invasion in bladder cancer |
| topic | Bladder cancer, Biparametric MRI, VI-RADS MIBC Diagnostic performance |
| url | https://doi.org/10.1186/s12880-025-01595-3 |
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