Efficacy test of mp-MRI-based VI-RADS score for diagnosis of muscle-invasive bladder cancer,a Meta-analysis
10.3760/cma.j.cn112330-20241206-00538
- VernacularTitle:基于mp-MRI的VI-RADS评分诊断肌层浸润性膀胱癌效能的Meta分析
- Author:
Qingyang YU
1
;
Kangkang CHEN
;
Tonglei ZHAO
;
Weipu MAO
;
Zejun WANG
;
Xinyang PENG
;
Zihui ZHAO
;
Xingui PENG
;
Ming CHEN
;
Jianping WU
Author Information
1. 东南大学附属中大医院泌尿外科，南京 210009
- Publication Type:Journal Article
- Keywords:
Bladder cancer;
Multi-parameter magnetic resonance imaging;
Vesical imaging-reporting and data system;
Muscle invasion;
Meta-analysis
- From:
Chinese Journal of Urology
2025;46(6):430-438
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic performance of the Vesical Imaging-Reporting and Data System（VI-RADS）based on multiparametric magnetic resonance imaging（mp-MRI）for muscle-invasive bladder cancer（MIBC）.Methods:A systematic search was conducted in PubMed，Web of Science，and Embase databases for studies published between September 2018 and December 2023 that investigated the use of VI-RADS for diagnosing MIBC. Inclusion criteria were studies utilizing mp-MRI-based VI-RADS scoring to determine MIBC. Exclusion criteria were studies with fewer than 10 patients，overlapping study populations，or those failing to assess the diagnostic performance of VI-RADS for MIBC. After quality assessment，RevMan 5.4 and Stata 15.1 were used to calculate pooled sensitivity and specificity，generate forest plots and summary receiver operating characteristic（SROC）curves，and determine the area under the curve（AUC）. Publication bias was assessed using Deeks funnel plot. Heterogeneity was evaluated using the I2 statistic，with meta-regression and subgroup analyses to explore its sources. Results:Twenty-nine studies involving 3 577 patients were included. At a VI-RADS cutoff of 3，the pooled sensitivity and specificity for MIBC diagnosis were 93%（95%CI 0.90-0.95）and 82%（95%CI 0.76-0.88），respectively. At a cutoff of 4，these values were 83%（95%CI 0.78-0.87）and 93%（95%CI 0.90-0.95）. The hierarchical SROC（HSROC）AUCs were 0.95 and 0.94 for cutoffs of 3 and 4，respectively. Subgroup and meta-regression analyses revealed that at a cutoff of 3，patient sample size，study design，MRI field strength，number of radiologists，surgical approach，and DWI/DCE imaging planes contributed to sensitivity heterogeneity（ P < 0.05）. All factors except study design and DWI plane were sources of specificity heterogeneity（ P < 0.05）. At a cutoff of 4，all factors significantly influenced heterogeneity in both sensitivity and specificity（ P < 0.05）. Meta-regression confirmed that both cutoffs（3 and 4）were significant sources of heterogeneity（ P < 0.05）. Conclusions:VI-RADS demonstrates excellent diagnostic performance for MIBC at both cutoffs（3 and 4），with VI-RADS ≥ 3 showing superior sensitivity and VI-RADS ≥ 4 offering higher specificity. The cutoff of 3 provides better overall diagnostic efficacy.
