Comparative diagnostic performance of VI-RADS based on biparametric and multiparametric MRI in predicting muscle invasion in bladder cancer

作者：Peikun Liu, Lingkai Cai, Linjing Jiang, Haonan Chen, Qiang Cao, Kexin Bai, Rongjie Bai, Qikai Wu, Xiao Yang, Qiang Lü · 发表于：BMC Medical Imaging · 年份：2025 · DOI：10.1186/s12880-025-01595-3 · 被引用次数：8 · 研究领域：Bladder and Urothelial Cancer Treatments、Urinary and Genital Oncology Studies、Prostate Cancer Diagnosis and Treatment

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...