# A Prospective Assessment of the Vesical Imaging Reporting and Data System in the Diagnosis of Muscle-Invasive Bladder Cancer

## TL;DR

This study evaluates the Vesical Imaging Reporting and Data System (VI-RADS) for diagnosing muscle-invasive bladder cancer and finds it reliable for staging and differentiating cancer types.

## Contribution

The study provides a prospective assessment of VI-RADS for diagnosing muscle-invasive bladder cancer in a specific clinical setting.

## Key findings

- VI-RADS scores ≥3 showed high sensitivity (93.75%) for muscle-invasive bladder cancer.
- Scores of 4 and 5 were highly predictive of muscle invasion, while scores of 1 and 2 indicated non-muscle invasion.
- VI-RADS reliably differentiates non-muscle-invasive and muscle-invasive bladder cancer with statistical significance.

## Abstract

Background

Worldwide, bladder cancer is one of the more common types of cancer. This study was conducted to evaluate the Vesical Imaging Reporting and Data System (VI-RADS) score for the diagnosis of muscle-invasive bladder cancer (MIBC). Additionally, the VI-RADS scores were compared with various relevant parameters and cancer stages.

Materials and methods

A prospective observational study design was used. The study was carried out in the Urology Department of the Indira Gandhi Institute of Medical Sciences (IGIMS) in Patna, India. It was conducted over a period of one and a half years, i.e., from December 2022 to July 2024. Overall, 71 patients were enrolled in the study.

Results

With a cut-off score of ≥3 for T2 (muscle-invasive), sensitivity and specificity were 93.75% (79.19% to 99.23%) and 76.92% (60.67% to 88.87%), respectively. With a cut-off score of VI-RADS ≥4 for muscle invasion, sensitivity and specificity were 62.5% (43.69% to 78.90%) and 89.74% (75.78% to 97.13%), respectively. VI-RADS scores of 1 and 2 were fairly accurate for non-muscle invasion, while scores of 4 and 5 were highly predictive of muscle invasion. A VI-RADS score of 3 remained the grey zone.

Conclusion

It is easy to interpret the VI-RADS score and assess detrusor muscle invasion. The present study on VI-RADS shows reliability for local staging and for differentiating non-MIBC (NMIBC) and MIBC. Among the VI-RADS scores, it was found that the result was statistically significant between high-grade and low-grade cancer, with a p-value <0.001.