Exploring the potential of the combined diagnostic model of ADC value and bp-MRI VI-RADS in the evaluation of muscle invasion in bladder Cancer

• Published in: Abdominal imaging Vol. 50; no. 7; pp. 3100 - 3107
• Main Authors: Zhang, Zhichao, Xiao, Weixiong, Wang, Yiqian, Zhang, Wei, Luo, Min
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2025; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Agreements; Bladder; Bladder cancer; Calibration; Cancer; Confidence intervals; Data systems; Diffusion coefficient; Diffusion Magnetic Resonance Imaging - methods; Female; Females; Gastroenterology; Hepatology; Humans; Imaging; Infiltration; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Muscle Neoplasms - diagnostic imaging; Neoplasm Invasiveness - diagnostic imaging; Neoplasm Invasiveness - pathology; Pathology; Patients; Radiology; Radiology Information Systems; Reproducibility; Retrospective Studies; Sensitivity; Sensitivity and Specificity; Statistical analysis; Urinary Bladder Neoplasms - diagnostic imaging; Urinary Bladder Neoplasms - pathology; Urological surgery; Variables; Vesical imaging reporting and data system; Magnetic resonance imaging; Bladder cancer; Apparent diffusion coefficient
• ISSN: 2366-0058; 2366-004X; 2366-0058
• DOI: 10.1007/s00261-024-04788-6

Objective This study investigates the diagnostic value of Vesical Imaging Reporting and Data System (VI-RADS) in biparametric MRI (bp-MRI) for the detection of muscular infiltration in bladder cancer, and to investigate whether apparent diffusion coefficient (ADC) value can function as a potential indicator of bp-MRI VI-RADS for patient benefit. Materials and methods This single-center retrospective study enrolled 81 patients with pathologically confirmed bladder cancer from October 2019 to November 2021. Two readers independently scored the T2-weighted images and diffusion-weighted images of each index lesion based on the VI-RADS criteria, subsequently deriving the bp-MRI VI-RADS scores. Both ADC values and bp-MRI VI-RADS scores were utilized to develop a simple model by logistic regression. Receiver-operating characteristic curve assessed all systems, while decision curve analysis (DCA) and calibration curves evaluated the model’s performance. Results The area under the curve (AUC) of bp-MRI VI-RADS was 0.886 (95% confidence interval [CI]: 0.801–0.971), with the diagnostic accuracy, sensitivity, and specificity being 0.753, 0.962, and 0.655 respectively. Regarding the ADC value, its AUC was 0.899 (95% CI: 0.821–0.977), and the diagnostic accuracy, sensitivity, and specificity were 0.877, 0.846, and 0.891. The AUC of the simple combined model achieved 0.942 (95% CI: 0.881–0.999), and the diagnostic accuracy, sensitivity, and specificity were 0.889, 0.885, and 0.891. The DeLong test verified that there was a statistically significant difference in AUC between the model and bp-MRI VI-RADS alone ( P  < 0.05). The simple model demonstrated excellent clinical applicability via DCA and calibration plots. Conclusions The contrast-free bp-MRI VI-RADS demonstrates commendable diagnostic efficacy for diagnosing muscular infiltration in bladder cancer. Additionally, ADC values can complement bp-MRI VI-RADS, enhancing diagnostic performance.