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European Radiology

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01-04-2022 | Magnetic Resonance Imaging | Magnetic Resonance

Biparametric magnetic resonance imaging assessment for detection of muscle-invasive bladder cancer: a systematic review and meta-analysis

Authors: Lei Ye, Yuntian Chen, Hui Xu, Huimin Xie, Jin Yao, Jiaming Liu, Bin Song

Published in: European Radiology | Issue 9/2022

Abstract

Objectives

To investigate if removing DCE from the Vesical Imaging Reporting and Data System (VI-RADS) influences the diagnostic accuracy of muscle-invasive bladder cancer (MIBC). We also explored using different reference standards on the MRI diagnostic performance.

Methods

We searched the Cochrane Library, Embase, and PubMed databases to June 26, 2021. Pooled biparametric MRI (bpMRI, T2WI+DWI) and multiparametric MRI (mpMRI, T2WI+DWI+DCE) sensitivities and specificities and the diagnostic performances of these methods for MIBC were compared using different reference standards.

Results

Seventeen studies with 2344 patients were finally included, of which 7 studies, including 1041 patients, reported the diagnostic performance of bpMRI. VI-RADS showed sensitivities and specificities of 0.91 (95% CI 0.87–0.94) and 0.86 (95% CI 0.77–0.91) at cutoff scores of 3, and 0.85 (95% CI 0.77–0.90) and 0.93 (95% CI 0.89–0.96) at cutoff scores of 4. BpMRI showed sensitivities and specificities of 0.90 (95% CI 0.69–0.97) and 0.90 (95% CI 0.81–0.95), and 0.84 (95% CI 0.78–0.88) and 0.97 (95% CI 0.87–0.99), respectively, for cutoff scores of 3 and 4. The sensitivities of bpMRI vs mpMRI for MIBC were not significantly different, but bpMRI was more specific than mpMRI at cutoff scores of 3 (p = 0.02) and 4 (p = 0.02). The VI-RADS studies using primary transurethral resection of bladder tumors (TURBT) as the reference standard had significantly higher sensitivities (p < 0.001) than those using secondary TURBT or radical cystectomy as the reference.

Data conclusion

BpMRI and conventional VI-RADS had similar diagnostic efficacies for MIBC. Since MRI overestimated MIBC diagnoses using primary TURBT as the reference standard, we recommend using secondary TURBT as the reference standard.

Key Points

• Biparametric MRI without DCE had similar diagnostic efficacies for MIBC compared with conventional VI-RADS.

• The sensitivity of VI-RADS was overestimated when referring to the primary TURBT results.

• Biparametric MRI comprised of T2WI and DWI could be used for detecting MIBC in clinical practice.

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Title: Biparametric magnetic resonance imaging assessment for detection of muscle-invasive bladder cancer: a systematic review and meta-analysis
Authors: Lei Ye
Yuntian Chen
Hui Xu
Huimin Xie
Jin Yao
Jiaming Liu
Bin Song
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: European Radiology / Issue 9/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08696-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Biparametric magnetic resonance imaging assessment for detection of muscle-invasive bladder cancer: a systematic review and meta-analysis

Abstract

Objectives

Methods

Results

Data conclusion

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Data conclusion

Key Points

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