Clinical utility of vesical imaging-reporting and data system (VI-RADS) in non-muscle invasive bladder cancer (NMIBC) patients candidate for en-bloc transurethral resection: A prospective study.

Autor: El-Karamany TM; Department of Urology, Benha university, Benha, Egypt., Al-Adl AM; Department of Urology, Benha university, Benha, Egypt., Hosny MM; Radiology Department, Benha university, Benha, Egypt., A Eldeep H; Department of Urology, Benha university, Benha, Egypt., El-Hamshary SA; Department of Urology, Benha university, Benha, Egypt. Electronic address: salah.abdelhamed@fmed.bu.edu.eg.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2022 Oct; Vol. 40 (10), pp. 454.e1-454.e7. Date of Electronic Publication: 2022 Apr 22.
DOI: 10.1016/j.urolonc.2022.03.008
Abstrakt: Objectives: To assess accuracy of vesical imaging-reporting and data system (VI-RADS) 5-point score in detection of muscle invasive bladder cancer and avoiding second look transurethral resection of the tumors (TURBT). Additionally, to assess safety and efficacy of bipolar en-block transurethral urethral resection of bladder tumor.
Methods: Patients with bladder mass up to 5 cm were included in the study. VI-RADS 5-point score was done preoperative for all cases and postoperatively before second look TURBT. Patients were followed up for 12 months.
Results: In all, 80 cases were eligible for the study. Preoperative VI-RADS score at cutoff of 3 had sensitivity of 89.3 %, specificity 83.3 %, postive predective value (PPV) 92.6 %, negative predictive value (NPV) 76.9 %, accuracy of 87.5 %, while at cutoff 2 sensitivity was 82.1%, specificity 91.7%, PPV 95.8%, NPV 68.8%, accuracy of 85.0%. Operative time 28.8 ± 9.4 minutes, hemoglobin drop 0.3 ± 0.05 g/dl, catheterization time 2.8 ± 0.8 days, hospital stay 1.4 ± 0.4 days. No complications occurred. Recurrence in field of resection 3.75%. Detrusor muscle was available in 76 cases (95%). Postoperative VI-RADS score at cutoff of 3 had sensitivity of 78.6%, specificity 77.8%, PPV 84.6%, NPV 70.0%, accuracy of 78.3%. At cutoff 2 VI-RADS score sensitivity was 71.4%, specificity 77.8%, PPV 83.3%, NPV 63.6%, accuracy of 73.9%.
Conclusion: VI-RADS 5-point score showed high sensitivity and specificity in preoperative discrimination of non-muscle invasive bladder cancer (NMIBC) from muscle invasive bladder cancer cases and in avoiding unnecessary second look TURBT. Bipolar en-block TURBT technique is both safe and efficacious in resecting NMIBC cases with low recurrence rate.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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