ABSTRACT
Abstract Objective: To evaluate the retrospective accuracy of the Vesical Imaging-Reporting and Data System (VI-RADS) in detecting muscle invasion in bladder cancer. Materials and Methods: We investigated patients who underwent pelvic magnetic resonance imaging and were submitted to transurethral resection of a bladder tumor between 2015 and 2018. Thirty cases were reviewed by radiologists blinded to the final clinical stage. The VI-RADS score was applied and compared with the histopathological findings in the surgical specimen. Results: Of the 30 patients with suspicious bladder lesions, 5 (16.6%) had benign histopathological findings, 17 (56.6%) had non-muscle-invasive bladder cancer, and 8 (26.6%) had muscle-invasive bladder cancer. The optimal criterion to detect muscle-invasive bladder cancer was a final VI-RADS score > 3, for which the sensitivity and specificity were 100% (95% CI: 56.0-100%) and 90.9% (95% CI: 69.3-98.4%), respectively. Conclusion: The VI-RADS appears to estimate correctly the degree of muscle invasion in suspicious bladder lesions. However, prospective studies evaluating larger samples are needed in order to validate the method.
Resumo Objetivo: O objetivo deste estudo foi avaliar retrospectivamente a acurácia do Vesical Imaging-Reporting and Data System (VI-RADS) para detectar invasão muscular em câncer de bexiga. Materiais e Métodos: Foram inseridos pacientes submetidos a ressonância magnética pélvica e a ressecção transuretral de bexiga entre 2015 e 2018. Trinta casos foram revisados, sem o conhecimento do estágio clínico final. O escore do VI-RADS foi aplicado e comparado aos achados histopatológicos da ressecção transuretral de bexiga. Resultados: Entre os 30 pacientes com lesões vesicais suspeitas, 5 (16,6%) tinham achados histopatológicos benignos, 17 (56,6%) tinham câncer de bexiga não músculo invasivo e 8 (26,6%) tinham câncer de bexiga músculo invasor. O critério ideal para detectar câncer de bexiga músculo invasor foi o escore final do VI-RADS > 3, em que sensibilidade e especificidade foram, respectivamente, 100% (IC 95%: 56,0-100%) e 90,9% (IC 95%: 69,3-98,4%). Conclusão: O VI-RADS parece estimar corretamente o grau de invasão muscular em lesões suspeitas da bexiga; no entanto, estudos maiores e prospectivos são necessários para validar o método.