Effects of vesical imaging reporting and data system (VIRADS) on the clinical diagnosis and treatment in multiparametric magnetic resonance i̇maging in bladder tumors

Objective: The aim of our study is to determine the local staging of the tumor in bladder cancer patients with preoperatively mpMRI (multiparametric magnetic resonance imaging) method and to show its clinical effectiveness by comparing it with histopathological results. Materials and Methods: Between November 2020 and April 2022, 63 patients who were planned cystoscopy with preliminary diagnosis of bladder cancer and previously diagnosed with bladder cancer included in the study. Preoperatively, these patients were evaluated together with T2-weighted (T2W) imaging, diffusion-weighted imaging (DAG), and dynamic contrast imaging (DKG) sequences with mpMRI method. All MRI images were examined according to the criteria of "Vesical Imaging Reporting and Data System" (VIRADS). All lesions were classified according to VIRADS scores consisting of 5 categories. Afterwards, biopsies obtained from the patients were examined histopathological and compared with radiological findings. Results: Of the 63 patients included in the study, 60 were (%95,2) male and 3 were (%4,8) female. The age of the patients ranged from 22 to 89 years, with a mean age of 64,2 years. 41 of the patients were included in the group of patients with primary bladder tumor and 22 patients with recurrent bladder tumor, residual tumor and/or who planned radical cystectomy. When tumors that VIRADS score >3 were grouped as muscle invasive, 53 patients (%84) were radiologically evaluated as invasive bladder tumor. However, according to the histopathological results, invasive bladder tumor was detected in 33 (52.4%) patients. In this study, sensitivity was calculated as 100%, specificity 33%, negative predictive value 100%, positive predictive value 62%. In addition, as a result in this study, it is concluded that there is not significant positive relationship between the prediction of the VIRADS score in detecting muscle invasion and tumor volume (p value 0,529). Conclusion: According to the results of our study, preoperatively, bladder cancer staging is important in terms of clinical diagnosis and treatment approach. The VIRADS scoring system obtained by using MpMRI is a successful method, especially in detecting non-muscle invasive bladder tumor, and also its successful in detecting muscle invasion is a method in which diagnostic efficiency can be increased with further studies. Key words: bladder cancer, VIRADS, muscle invasion