Abstract #0785

Diagnosis of muscle-invasive urothelial carcinoma with variant histology using biparametric MRI and VI-RADS in a radical cystectomy cohort

Yuki Arita^1,2, Thomas C Kwee³, Joao Miranda², Keisuke Shigeta⁴, Ryota Ishii⁵, Hiromi Edo⁶, Lisa Ruby², Josip Nincevic², Yuma Waseda⁷, Daiki Tamada⁸, Ada Muellner², Sunny Nalavenkata⁹, and Hedvig Hricak²

¹Radiology, Keio University School of Medicine, Tokyo, Japan, ²Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ³Radiology, University Medical Center Groningen, Groningen, Netherlands, ⁴Urology, Keio University School of Medicine, Tokyo, Japan, ⁵Biostatistics, University of Tsukuba, Ibaraki, Japan, ⁶Radiology, National Defence Medical College, Saitama, Japan, ⁷Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan, ⁸Radiology, University of Wisconsin–Madison, Madison, WI, United States, ⁹Urology, Memorial Sloan Kettering Cancer Center, New York, NY, United States

Synopsis

Keywords: Urogenital, Bladder, VI-RADS

Motivation: To determine if contrast-free biparametric MRI (bpMRI), which offers potential cost, comfort and safety advantages, could replace multiparametric MRI (mpMRI) in diagnosing muscle-invasive bladder cancer (MIBC) in patients with urothelial carcinoma of variant histology (VUC).

Goal(s): To compare the diagnostic accuracy of bpMRI and conventional mpMRI for detecting MIBC in patients with VUC who underwent radical cystectomy (the optimal reference standard).

Approach: A retrospective, multicenter diagnostic study using radical cystectomy as the reference standard.

Results: The diagnostic performance of bpMRI was confirmed to be weaker than that of mpMRI in the assessment of muscle invasion in bladder VUC.

Impact: When applying VI-RADS, bpMRI had weaker diagnostic performance than mpMRI in assessing muscle invasion in patients with bladder VUC who had radical cystectomy (the optimal reference standard). Consequently, we recommend employing mpMRI-based methods for evaluating muscle invasion in bladder VUC.

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