Multiparametric magnetic resonance imaging for bladder cancer: a comprehensive systematic review of the Vesical Imaging-Reporting and Data System (VI-RADS) performance and potential clinical applications.

The Vesical Imaging-Reporting and Data System (VI-RADS) score is a novel standardized approach to image and report bladder cancer (BC) with multiparametric MRI (mpMRI).

To describe and evaluate the performance of the VI-RADS score using mpMRI and assess its potential clinical applications and limitations.

A systematic review was conducted using the MEDLINE and EMBASE electronic bibliographic databases between June 2020 and December 2020. All reports deemed relevant to describe the VI-RADS score and assess its performance and applications were retrieved. Results presentation stands as narrative, purely descriptive synthesis based on aggregate studies data.

A total of 20 relevant studies were retrieved: three meta-analyses, five prospective studies, and twelve retrospective studies. The retrospective studies covered 1676 patients, while the prospective studies included a total number of 468 patients. Pooled sensitivity, specificity to differentiate muscle-invasive from non-muscle-invasive bladder cancer, ranged from 74.1% to 97.3%, and 77% to 100%, respectively. The chosen VI-RADS score thresholds for this discrimination varied across studies. The interreader agreement ranged from 0.73 to 0.95. Currently, the potential clinical applications of VI-RADS consist of initial BC risk stratification, assessment of neoadjuvant therapies response, and bladder sparing approaches, although further validation is required.

The VI-RADS score helps to discriminate muscle invasive from non-muscle invasive BC with good performance and reproducibility. A simple algorithm based on four basic questions may enhance its popularization. Further studies are required to validate the clinical applications.

Therapeutic advances in urology. 2021 Aug 25*** epublish ***

Denis Séguier, Philippe Puech, Ronald Kool, Léa Dernis, Héléna Gabert, Wassim Kassouf, Arnauld Villers, Gautier Marcq

Urology Department, Claude Huriez Hospital, CHU Lille, Lille, Hauts-de-France, France., Univ. Lille, Inserm, CHU Lille, Department of Radiology, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France., Division of Urology, McGill University Health Centre, McGill University, Montreal, QC, Canada., Department of Radiology, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France., Lille University, School of Medicine, Urology Department, Claude Huriez Hospital, CHRU Lille, LILLE Cedex, France Researcher - PhD Candidate, Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France.

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